…2 An oral anticoagulant is recommended A DOAC is preferred to warfarin except in a mechanical valve prosthesis and in moderate to severe mitral stenosis…

…anticoagulation is indicated, NOACs should be chosen except in patients with moderate to severe mitral stenosis or mechanical heart valves; for these patients, warfarin is…

…also consider acute severe mitral regurgitation, mechanical complications, and ischaemia related ventricular failure as potential causes of shock. Patients with moderate to severe chronic kidney…

…people with: Documented atherosclerotic cardiovascular disease (ASCVD) Diabetes mellitus in circumstances where diabetes specific risk assessment or risk categorization is applicable Moderate or severe chronic…

…main coronary artery stenosis Moderate to severe aortic stenosis with uncertain relation to symptoms Tachyarrhythmias with uncontrolled ventricular rates Acquired advanced or complete heart block…

…occlusion or relatively prolonged moderate ischemia may produce post ischemic stunning. In the absence of infarction, contractile recovery can occur rapidly after reperfusion, with recovery…

…moderate hepatic impairment (Child Pugh Class A and B). Limited experience exists for patients with mild to moderate hepatic impairment. Contraindicated in patients with severe…

…Patients with gastrointestinal disorders. Patients with severe kidney disease (glomerular filtration rate < 30 mL/min). Patients with mild to moderate heart failure, kidney or…

…patients ≥ 75 years, those with moderate/severe renal impairment, and those concurrently treated with an angiotensin receptor blocker (ARB). Hyperuricemia may occur during treatment with…

…of them have moderate or complicated defects; the remaining third have mild defects ( Baumgartner et al ). Approximately 40,000 children are born with CHD annually…

…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…

…In patients with a high probability, testing may add little diagnostic value and invasive coronary angiography may be more appropriate when symptoms, risk or anatomical…

…CAD is moderate or high, generally greater than 15% and less than 85% Baseline ECG abnormalities make exercise ECG interpretation unreliable The patient cannot perform…

…Children, pregnant women and patients with advanced renal failure, marked heart failure or circulatory shock require a specific protocol and early specialist involvement. DKA and…

…5 or more 5.8% Interpretation of ATRIA risk score. Comparison with other bleeding risk models Several bleeding risk assessment tools exist for patients with…

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

…Arrest Patients). Please refer to HOPE Score. Severity Features Body temperature (°C) Mild hypothermia Conscious with tremors 32 35°C Moderate hypothermia Impaired consciousness, with or…

…anuria, in a dialysis patient, in severe acute kidney injury, in treatment failure or in ongoing massive potassium release. In cardiac arrest with suspected hyperkalaemia…

…F ratio with a PEEP ≥ 5 cmH₂O : : Mild 26.6–40 kPa (200–300 mmHg) Moderate 13.3–26.6 kPa (100–200 mmHg) Severe …

…be preferable in patients aged ≥85 years, those with symptomatic orthostatic hypotension, moderate to severe frailty, or very old or frail patients who may not…

…Patients with left ventricular hypertrophy may instead display normalization of secondary T wave inversions (lead V5, V6, aVL, I). ECG in moderate hyperkalaemia Previously mentioned…

…the stenosis/occlusion, microvascular function, myocardial oxygen extraction, presence of collateral circulation, etc –ischemia may also develop during resting conditions. Indeed, in patients with ischemic…

…regardless of etiology, if the initial rhythm is asystole or PEA. Most current protocols for ECMO exclude patients presenting with asystole or PEA. Duration of…

…Clinical deterioration or a poor response to treatment carries more weight than a single apparently reassuring measurement. Finding Moderate attack Acute severe attack Life threatening…

…In a patient with moderate symptoms the physician must judge the likelihood that the symptoms really are caused by the hyponatraemia. With severe symptoms and…

…indication and with full preparedness Moderate to severe aortic stenosis without symptoms Individual assessment Hypertrophic cardiomyopathy with outflow tract obstruction Caution Tachyarrhythmia or bradyarrhythmia Rate…

…Splinting with a cotton wisp Ingrown nail with moderate inflammation Splinting with a strip of suture material or a drain Ingrown nail, severe or recurrent…

…A lesion that appears moderate may be functionally important, while an anatomically severe lesion may not identify the patient most likely to benefit from intervention…

…For example, a patient with acute graft occlusion may report an abrupt reduction in walking distance before claudication, accompanied by moderate pain or paresthesia, while…

…often indicative of early or mild ischemia. Moderate defects : Associated with wall thinning, suggesting a more advanced level of ischemia or partial scarring. Severe defects :…

…mild, moderate, or severe—is recommended when such findings are available. Further diagnostic imaging solely because calcified plaque is present in an asymptomatic individual is…

…mild to moderate Secondary prevention, walking exercise ≤ 0.40 Severe ischaemia Urgent vascular surgical assessment Exercise ABI. With a normal or borderline resting ABI but…

…aortic stenosis: mild, peak velocity 2.6–2.9 m/s; moderate, 3.0–3.9 m/s; severe, ≥ 4.0 m/s or a…

…imbalance Severe hyperthyroidism Moderate to severe aortic stenosis Insufficiently controlled arrhythmias which may cause hemodynamic compromise Obstructive hypertrophic cardiomyopathy Second degree AV block or third…

…tachyarrhythmia, or severe hypertension with or without left ventricular hypertrophy. Among patients with NSTE ACS undergoing angiography, approximately 10% have no critical epicardial stenosis. In…

…these loci are now recognized as critical modifiers. High PRS burdens correlate with a more severe electrocardiographic phenotype, a higher likelihood of positive provocation testing…

…a pregnant woman with preeclampsia. HELLP syndrome—haemolysis, elevated liver enzymes or transaminases, and thrombocytopenia—is generally regarded as a severe preeclamptic phenotype or variant…

…taking low or moderate intensity statins should have treatment intensified. The 2025 ACS guideline recommendations include: High intensity statin therapy for all patients with ACS…

…moderate predictive abilities for bleeding risks in AF patients, regardless of the type of oral anticoagulant used. Studies have shown that it performs similarly or…

…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…

…Exercise Intensity Intensity may be prescribed using several complementary approaches. Heart rate based methods For patients with cardiovascular disease, dynamic aerobic exercise may be prescrib

…Refining risk stratification and prognosis For patients with low or moderate pre test likelihood of obstructive CAD, CCTA or functional imaging should generally be preferred…

…arteries) Dysplastic, bicuspid or unicuspid pulmonary valve Noonan syndrome : 60% of all individuals with Noonan syndrome have pulmonic stenosis. The stenosis is subvalvular, causing a…

…a); individuals with cardiovascular disease that is not explained by major conventional risk factors; patients at moderate risk or close to a treatment threshold, when…

…synthesis Electrical channelopathies Oxidative stress Cellular apoptosis and necrosis Progressive structural remodelling Alcohol associated hypertension and atherosclerotic coronary disease In patients with heavy alcohol use…

…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…

…Stress dosing in known adrenal insufficiency A patient with primary adrenal insufficiency (Addison's disease), secondary adrenal insufficiency or long term corticosteroid treatment cannot increase…

…moderate hyperglycaemia over a few days. Principles Insulin component Function Who needs it : : : Basal insulin (intermediate or long acting) Covers fasting glucose production Everyone with…

…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…

…particularly in significant coronary artery stenosis. Stress can be induced pharmacologically with coronary vasodilatory agents or simulated hemodynamically through exercise or the use of chronotropic…

…and moderate left ventricular dysfunction. This patient died at age 17 years due to complications related to his arrhythmia. His father and uncle, with similar…

…less Myocardial infarction severe CAPASTAT SULFATE CAPREOMYCIN capreomycin sulfate NA no no INFED IRON DEXTRAN IRON DEXTRAN Mixed ar less patients with pre existing cardiovascular…

…interrogation and reprogramming are warranted in higher risk circumstances, particularly for pacing dependent patients, patients with CRT, and ICD recipients undergoing procedures likely to generate…

…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…

…symptom patterns. Patients may present with: exertional angina or angina like chest discomfort; symptoms suggestive of myocardial ischaemia despite normal or non obstructive coronary arteries;…