…the blood pressure response Refining risk stratification and prognosis For patients with low or moderate pre test likelihood of obstructive CAD, CCTA or functional imaging…

…particularly for intermediate non left main coronary stenoses. Myocardial ischaemia may occur despite the absence of significant epicardial obstruction. In patients with anginal symptoms and…

…initial test for diagnosing CAD in stable patients with: Low clinical likelihood or no previous diagnosis of CAD Characteristics suggesting that good quality imaging is…

…according to the local protocol MRI of the brain DWI FLAIR mismatch can be used for selection with an unknown time of onset when MRI…

…than the scan contributes. Only clinical signs of herniation halt the puncture, and antibiotics and a corticosteroid are then given immediately after blood cultures. For…

…thresholds. Clinical Presentation and Symptoms Most AAAs are asymptomatic and are identified either during routine abdominal examination or incidentally on imaging performed for another indication…

…benefit for patients with symptomatic LV dysfunction, and all placebo controlled chronic HFrEF trials using neurohormonal antagonists have demonstrated a reduction in mortality. The absolute…

…risk for future adverse events in virtually all patient populations, including apparently healthy individuals. Exercise stress testing in the age of non invasive cardiovascular imaging…

…establish the presence or haemodynamic significance of a specific stenosis. Clinical Role and Indications CAC scoring is principally a risk stratification tool for individuals without…

…The necrotic myocardium is replaced by dense collagenous scar, interspersed with surviving bundles of myocytes that form the slow conducting isthmuses critical for re entry…

…Patients without haemodynamic instability require more detailed prognostic evaluation using two complementary domains: Indicators of acute PE severity , including clinical findings, RV dysfunction on imaging…

…potentially indicating microvascular dysfunction or other pathologies. The software allows for detailed regional analysis of myocardial perfusion, highlighting specific segments of the left ventricle that…

…during angiography performed for another indication. When clinically significant, it may present with chronic angina, an anginal equivalent or exertional dyspnoea. Patients may continue to…

…Addition of a PCSK9 inhibitor when the target remains unmet despite maximally tolerated statin therapy and ezetimibe. For patients with a recurrent atherothrombotic event while…

…with CYP3A4 inhibitors and inducers. Clinical indications Heart failure with reduced ejection fraction Ivabradine is an adjunctive option for selected patients with symptomatic HFrEF. The…

…only administered in a monitored clinical setting appropriate for cardioversion. Administration of vernakalant Vernakalant (Brinavess) is administered as an infusion. The infusion is diluted to…

…Table 1 Summary Indications Ticagrelor, in combination with acetylsalicylic acid (ASA), is indicated for the prevention of atherothrombotic events in adult patients with acute coronary…

…Clinical significance is unclear. Metamizole: May reduce the antiplatelet effect of acetylsalicylic acid. Use with caution in patients on low dose acetylsalicylic acid for cardioprotection…

… doubling the dose produces an additional reduction of approximately 6%. Clinical indications and treatment goals Established atherosclerotic cardiovascular disease Patients with established ASCVD are at…

…of cure. When to investigate General indications Patients with suggestive signs, symptoms, or medical histories should undergo appropriate screening for secondary hypertension. The initial clinical…

…and in patients with diabetes or renal failure the index may be falsely normal because of medial sclerosis — in that case add toe pressure measurement…

…The time critical element The diagnosis and the donor care The time from withdrawal of treatment to circulatory arrest Indications An intensive care patient with…

…mmHg requires assessment for hypertensive emergency. In that setting, clinical assessment must determine whether immediate blood pressure lowering treatment is required. Patients with suggestive symptoms…

…serious arrhythmia indications, and potential adverse effects, consideration should be given to initiating therapy with the patient hospitalized and monitored for at least several days…

…detection clinically important. Current European recommendations advise screening adults with confirmed hypertension by measuring renin and aldosterone, although the strongest indications arise in patients with…

…Indications Sotalol is approved to treat patients with life threatening ventricular tachyarrhythmias and atrial fibrillation (AF). It is also effective in preventing the recurrence of…

…barriers associated with more frequent injectable therapy, although the clinical importance of improved adherence remains dependent on sustained follow up and administration. Clinical indications and…

…mode no shock at all is then delivered while the patient deteriorates. Indications Emergency, irrespective of duration and anticoagulation status: Tachyarrhythmia with haemodynamic compromise: hypotension…

…and the expected continued bleeding matters more than an exact estimate of blood loss [1]. Strong indications for activation Ongoing bleeding with haemodynamic instability, for…

…period of anticipated EMI. The perioperative strategy should also recognize that CRT patients may rely on continuous biventricular pacing for haemodynamic stability. In patients with…

…much of the evidence for shortened regimens derives from selected populations, frequently with low or intermediate ischemic risk and under representation of patients with STEMI…

…on the sample. Indications Diagnostic paracentesis: Newly detected ascites — always. Every admission of a patient with known ascites. Clinical deterioration in a cirrhotic patient with…

…assessment The evaluation of a patient with AF who may require anticoagulation should establish: Whether AF is clinical or device detected subclinical AF. The AF…

…and the patient must leave with clear information about the symptoms that should make them seek help immediately. Indications An undisplaced or reduced fracture to…

…Patients with suspected ACS are categorized into a STEMI pathway or an NSTE ACS pathway according to the initial ECG and clinical presentation. For suspected…

…haemorrhage meeting the criteria for activation of the massive transfusion protocol. Plasma and platelets: in ongoing bleeding with coagulopathy, or as part of balanced transfusion…

…genes have been discovered. Genetic testing for DCM Genetic testing of patients with confirmed or likely dilated cardiomyopathy can be recommended. There are several commercially…

…composite of cardiovascular death, non fatal myocardial infarction and non fatal stroke. The clinical development of canakinumab for this indication did not continue because of…

…The indication rests on the clinical picture together with echocardiographic signs of tamponade — not on how wide the rim of fluid looks. With ultrasound guidance…

…combined with pleurodesis), and in chest trauma and postoperatively. Emergency needle decompression: a clinical suspicion of tension pneumothorax in a haemodynamically or respiratorily unstable patient…

…The clinical rationale for DAPT is particularly strong after ACS and coronary stent implantation. ACS is associated with a high risk of platelet driven atherothrombosis…

…of patients. Evaluation and clinical assessment Clinical factors influencing treatment selection The following characteristics favour CABG when clinically and anatomically appropriate: Diabetes mellitus, particularly with…

…situations that argue for the operating theatre rather than the emergency room: a very large or deep abscess, a markedly unwell patient with fever and…

…reversal. The indication is stronger in younger individuals. Individual patient circumstances and clinical judgment are paramount in determining the appropriateness and feasibility of ECMO initiation…

…absolute indication for intubation. Assess ventilation, airway protection, the expected course and the possibility of rapid reversal with an antidote. Intubation is recommended for neurological…

…in parallel: mechanical control of bleeding, tranexamic acid where it is not contraindicated, and contact with the on call coagulation service. Send samples for INR…

…Prasita Indications Prasugrel, administered in combination with acetylsalicylic acid (ASA), is indicated for the prevention of atherothrombotic events in adult patients with acute coronary syndromes…

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

…for ventilatory support . At the same time, exacerbation is a clinical syndromic diagnosis, not a sufficient explanation for all acute dyspnoea in a patient with…

…In patients with a confirmed indication for treatment but blood pressure in the range of 120–139/70–89 mmHg, concomitant indications and overall cardiovascular…

…plan for what happens when the INR runs away or the patient bleeds. In Sweden the treatment is usually managed from an anticoagulation clinic with…

…GY. Evaluation of risk stratification schemes for ischaemic stroke and bleeding in 182,678 patients with atrial fibrillation: the Swedish Atrial Fibrillation cohort study. Eur…

…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…

…is much less common in the acute phase. The chain of care in acute STEMI Optimal care for patients with STEMI requires a well coordinated…

…with diuretics, whereas norepinephrine and/or inotropes are reserved for low output and hemodynamic instability. Evaluation and physical examination The objective of decongestion is clinical…

…or by the treatment. Indications A clinically or radiologically confirmed dislocation of the shoulder, elbow, finger, patella, jaw or hip prosthesis. A dislocation with neurovascular…

…one: with an indication, a route of administration and a target range for the saturation . What usually goes wrong is not that the patient gets…

…the lower leg in a patient with peripheral arterial disease or diabetes — the wound may not heal. Over superficial nerves (the lateral aspects of the…

…spicules are left behind — which is the commonest cause of recurrence. Indications Condition Procedure : : Acute paronychia with fluctuance or visible pus Incision and drainage Acute…

…the test must therefore never be performed without atropine, ECG monitoring and access to airway support. Indications Clinically suspected myasthenia gravis in a patient with…