…Coimbra R. Open chest versus closed chest cardiopulmonary resuscitation in trauma patients with signs of life upon hospital arrival: a retrospective multicenter study. Crit Care…

…not have fever, leucocytosis or a positive culture. Older people, the immunosuppressed and patients with renal or hepatic failure can have subtle symptoms. Findings that…

…of congenital heart disease in the general population, such that most clinicians will regularly encounter patients with CHD. Approximately 95% of all incident cases of…

…The patient lies supine, preferably with slight rotation towards the left side so that the fluid collects in the left flank. Have the patient empty…

…the patient first. Marked septal deviation towards the bleeding side (relative). Preparation and equipment Personal protective equipment (gloves, a visor, an apron), suction with a…

…procedure, or over a few days at home for a hard plug. Have the patient lie with the ear uppermost for 5 minutes after instillation…

…preferred for coronary angiography and PCI because it is associated with fewer vascular and bleeding complications than femoral access. In patients with acute coronary syndrome…

…Voiding problems in neurogenic bladder dysfunction, in the first instance with clean intermittent self catheterisation rather than an indwelling catheter. A catheter is not, however…

…from a predominantly pharmacological strategy to one that heavily integrates early catheter ablation and sophisticated device therapy [1] [2] . This exhaustive review provides a comprehensive…

…coronary pressure assessment is recommended in patients with a very high clinical likelihood of obstructive CAD, defined in the source material as greater than 85%…

…majority of patients can only be assessed using echocardiography. A common question is the presence of right ventricular load. This condition implies that the right…

…a minute, and both are routinely missed. The third thing to know by heart is that an arterial line must never be confused with a…

…of norepinephrine. All patients with severe acute heart failure who receive levosimendan should be monitored invasively (e.g. arterial line, PiCCO, central venous catheter). The…

…an unstable trauma patient. An unstable pelvic fracture with circulatory compromise. A ruptured aortic aneurysm or another major vascular bleed. Perioperative bleeding that rapidly fills…

…However, the context indicates that if pharmacological therapy is inadequate, escalation to catheter ablation or mechanical circulatory support remains a viable therapeutic pathway [4]. Furthermore…

…that are often enough: undressing the patient, lowering the room temperature, a fan, paracetamol, cold infusions. A ventilator, an arterial line, a central venous catheter…

…III antiarrhythmic agents may be considered. Catheter ablation should be considered in patients with a high risk of recurrence. Electrical cardioversion is generally ineffective in…

…operating theatre. Careful electrocardiographic and haemodynamic monitoring with ECG, a central venous catheter and an arterial line is necessary to achieve an optimal result. Overview…

…and equipment A central line set with a triple lumen catheter, usually 7 Fr. Catheter length: the right internal jugular vein requires the shortest catheter…

…in a conscious patient. Indications Immediate (transcutaneous) pacing in bradycardia with haemodynamic compromise — hypotension, shock, impaired consciousness, heart failure, myocardial ischaemia or syncope — that has…

…the position that determines whether the tube is safe. A misplaced tube in the airway produces no reliable symptoms in a patient with an impaired…

…the prognosis. The patient must go to cardiothoracic surgery. In profound shock, very limited decompression may be considered in consultation with a cardiothoracic surgeon. Myocardial…

…this with the poison control centre. Gastric lavage is considered only after a life threatening ingestion of a highly toxic substance, where the patient arrives…

…mL syringe with a soft catheter and body temperature water for irrigation. Small children need help to keep still. Sedation is usually better than physical…

…R. Open chest versus closed chest cardiopulmonary resuscitation in trauma patients with signs of life of life hospital arrival upon arrival: a retrospective multicenter study…

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

…circulatory collapse. Slowly accumulating effusions may produce a large pericardial collection with initially limited symptoms because the pericardium has had time to adapt. Hypotension and…

…ER (emergency room). Careful electrocardiographic and hemodynamic monitoring with ECG, central vein catheter and intra arterial catheter (A line) is warranted. Overview of vasopressors and…

…ER (emergency room). Careful electrocardiographic and hemodynamic monitoring with ECG, central vein catheter and intra arterial catheter (A line) is warranted. Overview of vasopressors and…

…the patient is to be punctured. Identify the diaphragm, the liver or spleen, the lung and the fluid level. 2. Choose a point with at…

…when encountering a patient with chest pain the primary task is to exclude or verify the following potentially life threatening causes of chest pain: Ischemic…

…EMI. The perioperative strategy should also recognize that CRT patients may rely on continuous biventricular pacing for haemodynamic stability. In patients with resynchronization devices, maintaining…

…Patients with LVEF 40% have substantial morbidity and mortality, despite often having a greater burden of cardiovascular and non cardiovascular comorbidity than patients with reduced…

…is now applied to patients with a baseline LVEF ≤40% who have experienced a ≥10 point increase in LVEF, with a subsequent measurement of 40…

…distinguish HFpEF from "Heart Failure with improved EF" (HFimpEF). HFimpEF refers to patients with a historical baseline LVEF ≤40% that has subsequently improved to 40…

…be required. Evaluation and physical examination Assessment begins by establishing that the patient has a clinical heart failure syndrome and by determining the LVEF. Physical…

…male and younger than those with HFpEF and have a greater likelihood of coronary artery disease, which is present in approximately 50–60% of patients…

…female than patients with atherosclerotic mediated myocardial infarction. A history of cigarette smoking may be present despite relatively few other conventional atherosclerotic risk factors. A…

…In contrast, patients with confirmed hypertension generally require BP lowering treatment without additional risk stratification for that treatment decision. Population to which SCORE2 and SCORE2…

…in carefully selected patients with high ischemic risk and low bleeding risk. These strategies are intended primarily to reduce bleeding rather than to replace the…

…experience. Studies have demonstrated that a significant proportion of patients with acute coronary occlusion (ACO) do not exhibit classic ST segment elevation on ECG, leading…

…chest discomfort requires a systematic differential diagnosis, as the syndrome associated with ischemic heart disease is broader than chest pain itself, encompassing symptoms like tightness…

…with heritability estimated at approximately 85% to more than 90%. Levels vary among ethnic groups and generally remain relatively stable throughout life. Lp(a) is…

…an increased risk of sudden cardiac arrest. They identified five unrelated families with features that represent a previously unrecognized autosomal dominant syndrome (4). Figure 1 …

…of life. Women with suspected angina are more likely than men to have non anginal symptoms such as dyspnoea and fatigue, as well as a…

…anatomically according to involvement of the ascending aorta: Stanford type A: involves the ascending aorta, with or without extension into the arch or descending aorta…

…those who did, only a minority had a reduced value — the majority of sudden cardiac deaths occur in patients with preserved LVEF, for whom no…

Procedurer For many patients a gynaecological examination is associated with a sense of exposure, and technically correct performance is only half the task. The examination…

…use of validated risk models to estimate the risk of acute myocardial infarction, 30 day and 1 year mortality in patients with NSTE ACS. TIMI…

…of cardiac arrest. Recurrent VT or VF after ROSC in a patient with a coronary risk profile should lead to consideration to perform early angiography.

…The incidence is 10–34% among patients with premature ventricular contractions and/or nonsustained ventricular tachycardia who are referred for electrophysiological evaluation (Hasdemir et al…

…failure and cardiovascular death — a patient with an eGFR of 70 and A3 is at higher risk than one with an eGFR of 50 and…

…hemorrhages] The HEMORR₂HAGES bleeding risk score is a clinical tool developed to assess the risk of major bleeding in patients with atrial fibrillation (AF) on…

…risk of bleeding, especially in patients with known elevated bleeding risk. Discontinuation of Ticagrelor should be avoided. If a dose is missed, only one tablet…

…considerably lower than the risk among patients with Brugada syndrome. It follows that Brugada syndrome is a likely diagnosis in patients presenting with these symptoms…

…be considered. Chronic coronary syndrome For all patients with CCS, a maximally tolerated high intensity statin is recommended as first line pharmacological treatment. Lifestyle measures…

Info This drug manual is provided for use in patients with hypertensive emergency (also referred to as hypertensive crisis or malignant hypertension ). Hypertensive emergency is…

Cardiology Myocardial ischemia and infarction Definition and Purpose Cardiac rehabilitation is a comprehensive, multidisciplinary secondary prevention intervention for patients with cardiovascular disease, including those recovering…

…of death in Western countries, and ultrasound studies are now performed in the majority of patients with stroke or TIA. The purpose of performing an…

…which means that the clinician must set a lower goal regarding workload (e.g. reaching 70% of maximal pulse instead of 85%). Many patients appreciate…