…smaller than average. Higher doses may be required in the critically ill patient. Intravenous antibiotics Drug eGFR 90 60 89 30 59 15 29 <15…

…with 2 nd and 98 th percentile in parenthesis. These numbers were published by Rijnbeek et al and are currently the most reliable for patients…

…with 2 nd and 98 th percentile in parenthesis. These numbers were published by Rijnbeek et al and are currently the most reliable for patients…

…IV Exacerbation of COPD with an indication for antibiotics amoxicillin 750 mg × 3 PO 5–7 days or doxycycline 200 mg × 1 on day 1…

…patients with hepatic cirrhosis — creatinine based eGFR substantially overestimates renal function. Staging of chronic kidney disease Stage eGFR Description : : : G1 ≥ 90 Normal or high G2…

…Reperfusion therapy Management Recommendation Level of evidence Reperfusion is indicated in all patients with symptoms of ischaemia of <12 h duration and persistent ST segment…

…heart failure with preserved ejection fraction—and chronic kidney disease. After approximately 70 years of age, isolated systolic hypertension accounts for more than 90% of…

…despite multidrug treatment rather than through specific symptoms. The clinical importance lies in its association with: Increased cardiovascular disease risk; Greater risk of myocardial infarction…

…the initial one year treatment with Ticagrelor 90 mg or treatment with another adenosine diphosphate (ADP) receptor inhibitor for patients who had coronary syndrome and…

…is 24 hours, not 48. The 2024 ESC guidelines and several Swedish clinical knowledge resources have tightened the former 48 hour rule for patients with…

…Thus, optimal blood pressure is significantly lower than the current threshold for hypertension, and the current treatment target levels for patients with and without diabetes…

…The unstable patient Hypotension (systolic < 90 mmHg for 15 minutes, or a need for a vasopressor), obstructive shock or cardiac arrest with suspected pulmonary…

…and drug induced reactions. Approximately 90% of anaphylactic cardiac arrests present with pulseless electrical activity (PEA) as the initial rhythm, while the remainder manifest ventricular…

…with concurrent physical illness or after prolonged very high intake More than 90 percent of withdrawal seizures occur within 48 hours. Seizures later than this…

…°C, with a non shockable initial rhythm More patients with a good neurological outcome (CPC 1–2) at 90 days, 10.2 % versus 5.7 %…

…s formula. Note that a QTc interval 480 is always considered pathological. For patients with bundle branch blocks, the corresponding figure is 500 ms. The…

…At least 90% of AAAs larger than 4 cm are associated with atherosclerotic pathology. AAA prevalence increases with age and is approximately five times higher…

…assessment must determine whether immediate blood pressure lowering treatment is required. Patients with suggestive symptoms, signs or a medical history indicating possible secondary hypertension should…

…the Treatment of Cardiogenic Shock (N Engl J Med 2021; 385:516 525) In a randomized, double blind study involving 192 patients with cardiogenic shock…

…coronary blood flow by relaxing vascular smooth muscle. They are contraindicated in patients with bronchospastic lung disease, or a history of significant reactive airway disease…

…cardiovascular medicine. As a primary driver of sudden cardiac death (SCD) and a major cause of morbidity in patients with structural heart disease, VT necessitates…

…pressure is more than 20/10 mmHg above the treatment goal, lifestyle and pharmacological treatment should be initiated concurrently. In patients with a confirmed indication…

…acute renal failure, pre eclampsia) — intravenous treatment with a controlled reduction, as a rule no more than 25% during the first hour. The exception is…

…IMH and carry greater risk of progression or rupture than asymptomatic lesions. Predisposing conditions Aortic dissection and its variants are associated with conditions that cause…

…the number of kringle IV type 2 repeats. Lp(a) concentration is predominantly genetically determined, with heritability estimated at approximately 85% to more than 90%…

…threatening ischaemia (CLTI). Clinical presentation and symptoms Asymptomatic and atypical disease Fewer than half of patients with PAD have typical symptoms. Many have impaired walking…

…comprising approximately 20–25% of secondary hypertension cases. Coarctation of the aorta and renovascular disease are important non endocrine causes, particularly in patients with resistant…

…QRS duration greater than 110 ms in adults, greater than 90 ms in children 8 to 16 years of age, and greater than 80 ms…

…of congestion Dyspnea is the dominant presenting symptom in acute decompensated heart failure and occurs in more than 90% of patients presenting with the syndrome…

…estimates approached 20%, whereas contemporary trials and observational databases report approximately 5–10%. Only about 10% of patients who develop shock present with it at…

…proBNP concentrations than chronic, stable disease, and greater volume overload is usually associated with higher levels. However, this relationship is not universal. In ambulatory patients…

…approximately 90% of renal glucose reabsorption. The remaining glucose is reabsorbed by SGLT1 in the S3 segment. SGLT2 also mediates proximal tubular sodium reabsorption, with…

…for more than 2–3 hours. Patients with a working diagnosis of STEMI should, whenever possible, be transported directly to a hospital with 24/7…

…< 90 mmHg Suggestion of gastrointestinal hemorrhage Persistent bradycardia (< 40 beats/min) Undiagnosed systolic murmur Carotid sinus massage should be considered in patients with…

…at the top. Refer to Figure 1 . Patients with left ventricular hypertrophy may instead display normalization of secondary T wave inversions (lead V5, V6, aVL…

…For instance, administering nitroglycerin to alleviate ischemic chest pain may lead to hemodynamic collapse in patients with right ventricular ischemia or infarction. Recognizing ECG signs…

…Right dominant system is by far the most common anatomy, occurring in 90% of all individuals. Figure 2. Coronary arteries in a right dominant system…

…expiration, with the tape horizontal and without compressing the skin. Ratios and other measurements Measurement Calculation Threshold : : : Waist–hip ratio Waist / hip Men 0.90…

…than 90 mmHg—accompanied by signs of poor vital organ perfusion or frank shock states. In the specific context of perioperative care in patients with…

…s formula. Note that a QTc interval 480 is always considered pathological. For patients with bundle branch blocks, the corresponding figure is 500 ms. It…

…than an exact estimate of blood loss [1]. Strong indications for activation Ongoing bleeding with haemodynamic instability, for example a systolic blood pressure below 90…

…is also clinically relevant: Hyperacute: less than 24 hours from symptom onset. Acute: 1–14 days. Subacute: 15–90 days. Chronic: more than 90 days…

…it is referred to as a left dominant system ). In patients with right dominance the RCA supplies the atrioventricular (AV) node . In 60% of individuals…

…In many cardiomyopathies, women manifest disease later than men, with the timing shifted by approximately 10 years in some studies. Inheritance patterns Autosomal dominant inheritance…

…grafting (CABG) or percutaneous coronary intervention (PCI). Contraindications for myocardial perfusion imaging Exercise stress testing is contraindicated in patients with acute myocardial infarction, unstable angina…

…pathological Q waves in two patients with acute STEMI. Figure 2. Examples of STE ACS (STEMI). Note that these patients presented with pathological Q waves…

…movement; those that fail usually do so because the patient tenses up with pain, or because the operator pulls harder rather than more slowly. The…

…5 L/min — the patient then rebreathes carbon dioxide from the mask Mask with a reservoir 10–15 L/min 60–90 % For acute severe…

…0.79 Reduced compression (20–30 mmHg) under vascular surgical supervision Diabetes with neuropathy Reduced compression, closer monitoring — the patient cannot feel pressure injury Peripheral…

…patient with STEMI may present during any of the phases illustrated in this figure, which is why it should be studied in detail. Figure 2…

…120 minutes of the STEMI diagnosis. With a longer expected delay and a symptom duration of less than 12 hours, immediate fibrinolysis is recommended in…

…41–0.90 Peripheral arterial disease, mild to moderate Secondary prevention, walking exercise ≤ 0.40 Severe ischaemia Urgent vascular surgical assessment Exercise ABI. With a…

…symptoms are particularly important because of the increased risk of cerebrovascular complications. Seizures in a patient with preeclampsia indicate eclampsia. Postpartum disease is clinically important…

…the tourniquet 10–15 cm proximal to the intended puncture site, let the arm hang, ask the patient to pump with the hand, and pa

Info Brugada's algorithm is the most used algorithm for distinguishing ventricular tachycardia (VT) and supraventricular tachycardia (SVT) with wide QRS complex. The algorithm entails…

…the posterior surface of the patella. The shoulder The patient sits with the arm hanging relaxed and slightly internally rotated. The posterior approach is preferable…

… safer than the dorsogluteal site because the sciatic nerve and the superior gluteal artery are avoided. The patient lies on their side with the knee…

…3.7 Survival with good neurological function (CPC 1 2,%) < 2.7 0.9 0.1 0.4 0.8 2.1 Table 1…