…begin at a low level and progress slowly. Exercise Intensity Intensity may be prescribed using several complementary approaches. Heart rate based methods For patients with…

…the patient, work systematically through the possible causes, apply several non pharmacological measures at the same time, and use drugs only in severe agitation or…

…time to antibiotics that saves the patient — the puncture must never delay it. Indications Suspected meningitis or encephalitis. Suspected subarachnoid haemorrhage with a normal or…

…physical exertion 30 minutes A large meal 2 hours Withholding applies only to diagnostic spirometry with a reversibility test. At follow up during ongoing treatment…

…Subclinical cerebral injury may contribute to vascular dementia, and thromboembolism may affect organs other than the brain. Patients with AF in the setting of ACS…

…that CRT patients may rely on continuous biventricular pacing for haemodynamic stability. In patients with resynchronization devices, maintaining CRT during surgery is recommended to provide…

…and carefully without delaying time to treatment. History taking, physical examination, ECG and laboratory tests are the cornerstones of management of patients with chest pain…

…sufficiently specific to identify the underlying mechanism. Microvascular, vasospastic, and obstructive angina may produce overlapping symptom patterns. Patients may present with: exertional angina or angina…

…disease or after treatment. During exertion, however, the limited diastolic reserve becomes evident, with a rise in left atrial and pulmonary pressures that contributes to…

…physiological or systemic stressors, with treatment directed at the precipitating condition. Myocardial and non ischaemic mimics Takotsubo syndrome, myocarditis, and cardiomyopathies may present with symptoms…

…PCWP) ≥15 mmHg at rest or ≥25 mmHg during exercise [4] . This hemodynamic criterion underscores that "preserved" ejection fraction does not equate to normal cardiac…

…terminology to reflect the dynamic nature of myocardial remodeling. The designation "Heart Failure with improved Ejection Fraction" (HFimpEF) is now applied to patients with a…

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

…with preserved ejection fraction (HFpEF; LVEF ≥50%). Patients with HFmrEF may represent individuals whose LVEF has improved from below 40% or has declined from at…

…whether long term oral anticoagulation is required; tolerance of treatment during the initial months. Patients with HBR are the principal candidates for abbreviated DAPT. However…

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

All patients with NSTE ACS (NSTEMI or unstable angina) are treated similarly with respect to anti ischemic and anti thrombotic drugs. Management must, however, be…

…information about each step, take place with the patient's ongoing consent, and be able to be stopped at any moment. A trauma informed approach…

…with concurrent signs of acute organ damage or failure. Any of the drugs listed below may be used to treat hypertensive emergencies. The desired time…

…infarction and it is associated with poorer survival. Patients with unstable angina pectoris with low risk (according to TIMI score or similar) may undergo stress…

…with concurrent signs of acute organ damage or failure. Any of the drugs listed below may be used to treat hypertensive emergencies. The desired time…

…retention. Chronic urinary retention with renal impairment or a large residual volume. A need for accurate measurement of urine output in a critically ill patient…

Nitroglycerin Patients using nitroglycerin regularly may have developed tolerance and require higher doses, alternatively nitroprusside to achieve desirable blood pressure lowring effect. Drug Nitroglycerin Brand…

…in ACS patients treated with PCI can increase the risk of thrombosis, myocardial infarction, or death. Treatment for up to 12 months is recommended unless…

…trials studied patients with ROSC who did not display ST segment elevations and randomized them to urgent angiography. These trials did not show any benefit…

…excellent, with the vast majority of patients recovering completely after restoration of sinus rhythm (or any other rhythm with normal ventricular rate and activation). Recovery…

…GY. A novel user friendly score (HAS BLED) to assess 1 year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey…

…new symptoms during exercise may signal an adverse clinical response. Recreational activity should therefore be increased at an appropriate intensity, with attention to the emergence…

…important therapeutic objectives. Evidence from randomized trials is often less applicable to very frail or multimorbid patients because these groups have historically been underrepresented. Consequently…

…ACS) with multivessel coronary artery disease (MVD), revascularization may be directed exclusively at the infarct related artery (IRA), or it may extend to additional non…

…patients with ACS to reduce major adverse cardiovascular events. Therapy should preferably begin before planned percutaneous coronary intervention when feasible. Patients already taking low or…

…of Brugada syndrome Most patients are asymptomatic until the age of 20 to 55 years. The disorder may manifest with any of the following symptoms…

…does not ensure complete drainage of the pericardium, and needles or catheters are at risk of bending or damage during chest compressions. References DeBehnke DJ…

…may be used in patients with heart failure, atrial fibrillation, atrial flutter, and in selected cases of paroxysmal supraventricular tachycardia. Due to its profound pro…

…in patients with active bronchospasm, severe hypotension, or high degree AV block. Caffeine and other methylxanthines, which antagonize adenosine receptors, should be avoided for at…

…3) Evaluation of patients with suspected AV blocks requires a thorough medical history (with emphasis on causes of AV blocks; please refer to theCauses of…

…the management of non acute or asymptomatic bradyarrhythmia. In patients presenting with intermittent symptoms of bradycardia, it is fundamental to establish a temporal correlation between…

…in patients with symptoms suggestive of acute myocardial infarction and at least one of the following criteria present: haemodynamic instability or cardiogenic shock recurrent or…

…HFpEF) at hospitalization warrants evaluation [5]. Heightened awareness is essential in patients with severe aortic stenosis, particularly the low flow, low gradient phenotype, or those…

…This means that a patient who experienced chest pain at home may be asymptomatic during the assessment in the ER, only to develop severe chest…

…represents time (the paper speed is typically 25 mm/s or 50 mm/s) and the y axis represents amplitude (millivolts, mV). Please refer to…

…of another or an additional cause [1]. Delirium tremens most often begins after one to three days but can start earlier in patients with previous…

…the principles that are common to all protocols. Children, pregnant women and patients with advanced renal failure, marked heart failure or circulatory shock require a…

…be applied at all, and if so at what pressure. Palpable foot pulses are not an acceptable substitute, and in patients with diabetes or renal…

…list (metformin, NSAIDs, RAAS blockade, gabapentin, direct oral anticoagulants) and refer to nephrology at an eGFR < 30, with rapid deterioration, or with A3 albuminuria.

…if it was raised and follow the trend together with the clinical perfusion Sepsis alerts and standardised care processes can shorten the time to cultures…

…TIA). Stroke Contraindications Cross reactivity: Do not administer to patients with a history of asthma, rhinitis, or urticaria triggered by: Acetylsalicylic acid (aspirin). Other non…

…bleeding risk assessment tools exist for patients with AF, including HAS BLED, HEMORR2HAGES, and ORBIT scores. Each incorporates various clinical parameters to stratify bleeding risk…

…is a widely recognized and validated tool used to assess the one year risk of major bleeding in patients with atrial fibrillation (AF) who are…

…due to risk of bronchospasm). • Used cautiously in bradycardia due to negative chronotropic effect. • In patients with pheochromocytoma, cocaine or methamphetamine overdose, prior treatment with…

…individual patient characteristics. Bazett’s formula has a tendency to overcorrect or undercorrect at extreme heart rates. Thus, it should not be used during bradycardia…

…adult patients with acute coronary syndrome (ACS) or a prior heart attack and a high risk of developing an atherothrombotic event. Contraindications Hypersensitivity to the…

…when associated with nausea or vomiting. Persistent shortness of breath. Weakness, dizziness, light headedness, or loss of consciousness. No symptoms at the time of assessment…

…term interventions intended to reduce recurrent infarction, ischaemic stroke, cardiovascular death, and progression of atherosclerotic disease in patients with established coronary or other atherosclerotic vascular…

…hemodynamics without increasing heart rate or decreasing blood pressure, making it a consideration for patients with low blood pressure secondary to a low cardiac output…