…abdominal region, with its bifurcation usually located near the umbilicus and the fourth lumbar vertebral level. Physical examination can identify a large aneurysm as a…

…bacterial CNS infections states that CT must not be performed before lumbar puncture in suspected bacterial meningitis — not even with a reduced level of consciousness…

…elderly, or patients with diabetes [4]. Associated Findings: The sudden onset of symptoms coupled with diaphoresis should always raise concern for a cardiovascular cause [4]…

…The patient should remain seated comfortably in a quiet environment for 5 minutes. The back and arm should be supported, with the cuff at heart…

…account for approximately half of patients with symptomatic HF. The distinction is clinically useful but not absolute. Ejection fraction is a continuous variable and echocardiographic…

…perception in patients without demonstrable ischaemia. The absence of obstructive disease therefore does not establish a benign diagnosis. ANOCA/INOCA is associated with recurrent symptoms…

…cornerstones of management of patients with chest pain. A 12 lead ECG recording must be registered and interpreted within 10 minutes of arrival at the…

…material. Clinical Presentation and Symptoms Aortic dissection is an uncommon cause of acute chest pain but carries a particularly high mortality when diagnosis is delayed…

Cardiology Diagnosis and treatment of bradycardia (bradyarrhythmia) Acute bradycardia with hemodynamic instability Acute bradycardia with hemodynamic effects is a potentially life threatening condition and should…

…been fraught with controversies, particularly regarding the risk stratification of asymptomatic patients, the prognostic utility of electrophysiological studies (EPS), and the transition from a purely…

…quality of life. Approximately half of all patients with heart failure die suddenly, as a result of ventricular arrhythmias (ventricular tachycardia, ventricular fibrillation). Early diagnosis…

…that the patient actually has endocarditis (this the probability should be estimated before echocardiography is performed). Among patients with a very high probability of endocarditis…

…of diagnostic tests, and treatment strategies have been updated. For example, exercise stress testing is no longer recommended in the initial evaluation of patients with…

…angina pectoris. The location of the pain beneath the xiphoid and epigastrium, combined with patient denial, often leads to a mistaken impression of indigestion. STEMI…

…and atypical disease Fewer than half of patients with PAD have typical symptoms. Many have impaired walking or a slow gait without describing classic claudication…

…reperfusion therapy. This approach fails to identify a substantial proportion of patients with acute coronary occlusion (ACO) who present without diagnostic ST elevation, often resulting…

…troponin levels are normal in patients with NSTE ACS, the condition is classified as unstable angina (UA) . Please refer to Diagnostic Criteria for Myocardial Infarction…

…branch block. Cardiac monitoring is indicated for patients with a high pretest probability of arrhythmia causing syncope. In hospital monitoring is reserved for those wit

…of AV blocks (AV block 1, 2 & 3) Evaluation of patients with suspected AV blocks requires a thorough medical history (with emphasis on causes of…

…communities. Late presentation is clinically important: Within 12 hours of symptom onset: reperfusion therapy is recommended for all patients with a working diagnosis of STEMI…

…value of at least 50%. A patient with persistently mildly reduced systolic function. This dynamic nature makes prior imaging particularly important when interpreting a current…

…spectrum of non ST elevation acute coronary syndrome (NSTE ACS). The clinical spectrum includes patients with a confirmed NSTEMI, patients with a working diagnosis of…

…I A In the absence of ST segment elevation, primary PCI is indicated in patients with symptoms suggestive of acute myocardial infarction and at least…

…clinical populations include only a minority with symptoms having all of the traditional aggravating and relieving characteristics of angina; many patients report less characteristic symptoms…

…can shorten the time to diagnosis and facilitate triage of patients with suspected ST segment elevation myocardial infarction to a percutaneous coronary intervention capable hospital…

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

…For the same reason, patients with STEMI are at higher risk of life threatening ventricular arrhythmias in the acute phase. Ventricular tachycardia (VT) and ventricular…

…associated with coronary artery bypass grafting (CABG). Clinical Presentation and Symptoms The diagnosis of an acute MI remains a comprehensive clinical diagnosis based on patient…

…crush technique, stent fracture or collapse Lesion specific angiographic features Residual dissection at a stent margin, impaired flow into or out of the stent, stent…

…conscious patients who experienced a brief cardiac arrest. Post resuscitation care is an integral component of the chain of survival. It includes diagnosis of post…

…Establishing a diagnosis of Q wave infarction requires that pathological Q waves be present in at least two anatomically contiguous leads. In patients with STEMI…

…most important dangerous differential diagnosis. Clear focal neurological findings are absent in roughly half of patients with a central cause. A normal routine neurological examination…

…NSTEMI) and Unstable Angina (UA) The focus of this chapter is the diagnosis and management of patients with Non ST Elevation Myocardial Infarction (NSTEMI) and…

…availability of hepatic LDL receptors. Rare biallelic variants in LDLRAP1, which impair LDL receptor endocytosis and produce an FH like phenotype. Individuals with a single…

…not every patient with an initial STEMI pattern has myocardial infarction as the final diagnosis. The underlying process usually involves acute thrombotic obstruction of an…

…A notch is evident in the ascending part of the ST segment. A male patient (Figure 1) presented at age 36 years with an ECG…

…minutes of standing in older patients, patients with diabetes and anyone with dizziness Definitions White coat hypertension: a raised office reading but normal readings at…

…myocardial perfusion imaging Diagnosis of coronary artery disease (CAD) : Myocardial perfusion imaging can confirm or rule out CAD in patients with symptoms suggestive of CAD…

…of morbidity in patients with structural heart disease, VT necessitates a nuanced, multidisciplinary approach to diagnosis and management. Over the past decade, the landscape of…

…provide a more accurate assessment of atherogenic burden than LDL cholesterol alone in patients with diabetes. Insulin resistance is accompanied by compensatory hyperinsulinaemia and, with…

…help determine expected normal values based on body surface area (BSA), aiding in the diagnosis of aortic root dilation. Key Formulas BSA Calculation (Mosteller formula): [ …

…quality of life. Approximately half of all patients with heart failure die suddenly, as a result of ventricular arrhythmias (ventricular tachycardia, ventricular fibrillation). Early diagnosis…

…may present with P waves at the onset of the QRS complex. Nonrespiratory sinus arrhythmia may also be observed as a consequence of drug toxicity…

…strongly with total and cardiovascular mortality ( Curtis et al ). Among patients with coronary heart disease, left ventricular function is actually a stronger predictor of death…

…in patients with severe aortic stenosis, particularly the low flow, low gradient phenotype, or those undergoing aortic valve replacement [1, 5, 10]. A history of…

…Patients with previous acute coronary syndromes (ACS) Exercise stress testing is routinely performed after acute myocardial infarction in order to assess the presence of myocardial…

…Brugada syndrome. This disorder is easy to diagnose with a simple blood test and the ST segment elevations resolve after normalization of potassium levels. Brugada…

…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…

…or a range of miscellaneous conditions. Because several mechanisms may coexist, diagnosis and classification must integrate haemodynamics with the patient’s clinical context and the…

…COPD. Adenosine has caused mild to moderate exacerbation of asthma symptoms. Adenosine should be used with caution in patients with obstructive lung disease or asthma…

…older patients delirium is often multifactorial. 7. Start non pharmacological treatment immediately , in parallel with the investigation. 8. Document the diagnosis and communicate it at…

…more antihypertensive drugs from different classes at maximally tolerated doses, including a diuretic appropriate for kidney function. In patients with an estimated glomerular filtration rate…

…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…

…comprises a spectrum of clinical presentations caused by suspected acute myocardial ischaemia. It includes patients with recent changes in symptoms or clinical signs, with or…

…regardless of profession, must be able to diagnose ventricular tachycardia. Causes of ventricular tachycardia Patients with ventricular tachycardia almost invariably have significant underlying heart disease…

…the diagnosis is uncertain, cardiogenic shock is present, or symptoms have been present for more than 2–3 hours. Patients with a working diagnosis of…

…patients with a low to intermediate likelihood of CAD when cardiac troponin and/or the ECG is normal or inconclusive. The principal diagnostic strength of…

…idiopathic or genetic dilation of the left ventricle . Patients with DCM typically develop heart failure early in life and a family history of heart failure…

…Prevention of recurrence after a healed venous ulcer. After deep vein thrombosis with post thrombotic syndrome. Differential diagnosis Feature Venous ulcer Arterial ulcer Diabetic foot…

…despite correction of the initiating disorder. Earlier diagnosis is associated with a greater likelihood of cure. When to investigate General indications Patients with suggestive signs…