…zero, and several syndromes can overlap [1,4]. Time after a clear reduction or the last intake Common clinical picture : : 4 to 12 hours Tremor…

…ataxia Posterior circulation stroke Unilateral hearing loss or tinnitus Ménière's disease, vestibular schwannoma, labyrinthitis Continuous vertigo that does not come in attacks Vestibular neuritis…

…injury. Eclampsia is the occurrence of new onset seizures or coma in a pregnant woman with preeclampsia. HELLP syndrome—haemolysis, elevated liver enzymes or transaminases…

…pathophysiology Primary aldosteronism (PA), also termed primary hyperaldosteronism or Conn syndrome, comprises disorders in which aldosterone secretion is inappropriately increased, relatively autonomous from angiotensin II…

…al) These reference values are the best available for the neonatal period. The intervals are 98% confidence intervals (the mean is presented in the parenthesis)…

…al) These reference values are the best available for the neonatal period. The intervals are 98% confidence intervals (the mean is presented in the parenthesis)…

…SCORE2 in adults aged 40–69 years SCORE2 is recommended for adults aged 40–69 years with elevated BP who do not already have increased…

…The corresponding figure in children is 28% (Kang et al). The incidence is 10–34% among patients with premature ventricular contractions and/or nonsustained ventricular…

…types are not a bar). Untreated generalised infection, or certain transmissible agents according to the current transmission risk assessment. In DCD: patients in whom death…

…dominant syndrome (4). Figure 1 . 12 lead ECG (presented according to Cabrera), recorded at 63 years of age, demonstrates concave upward ST segment depression in…

…coronary syndrome (ACS) comprises a spectrum of clinical presentations caused by suspected acute myocardial ischaemia. It includes patients with recent changes in symptoms or clinical…

…a clinical syndrome rather than a permanently stable state. Patients may remain stable for prolonged periods, but chronic coronary disease can progress or destabilize abruptly…

…of the pharmacological route used. In patients with acute coronary syndromes (ACS), the early post event period is particularly vulnerable, and delayed intensification of lipid…

…the effusion develops in the early post infarction period. Clinical presentation and symptoms The characteristic clinical syndrome consists of: Malaise Fever Pericardial or chest discomfort…

…risk within several years, although risk may remain higher than that of never smokers for a prolonged period. In heavy smokers, cardiovascular risk falls within…

…that compresses the true lumen. The resulting reduction in coronary blood flow may produce myocardial ischaemia, acute coronary syndrome (ACS), myocardial infarction (MI), or, rarely…

…acceleration in heart rate : If the heart rate accelerates suddenly, the bundle branches may not be able to accommodate (i.e shorten) their refractory periods…

…5. Failure to capture during the refractory period. Figure 6. Tachyarrhythmia with ventricular pacing. Failure to capture Definition : pacing does not result in myocardial activation…

…in clinical practice. Chronic flutter is, however, very rare. Thus, as compared with atrial fibrillation, atrial flutter is not capable of persisting for longer periods…

…good neurological function, which is why CPR should be considered even with extended no flow periods, in cases of unwitnessed cardiac arrests, as well as…

…shockable, as seen in certain causes of cardiac arrest (e.g. pulmonary embolism) or in case of long no flow or low flow periods. Under…

…II, type 1 (Wencheback block) PR interval is gradually prolonged until one atrial impulse (P wave) is blocked in the AV node. Generally not. AV…

…Shockable rhythms (ventricular fibrillation, pulseless ventricular tachycardia) are mostly due to acute myocardial ischemia or myocardial infarction, and in these cases, the likelihood of ROSC…

…However, current guidelines do not consider this fact (beyond the recommendation to defibrillate immediately if cardiac arrest is witnessed and the rhythm is shockable). This…

…or as part of balanced transfusion in massive haemorrhage. Transfusion thresholds in the stable, non bleeding patient Patient category Transfusion threshold (Hb) : : Most stable adult…

…proton pump inhibitor with concomitant NSAID use or a history of ulcer, not routinely Infection Consider Pneumocystis prophylaxis with high doses over a long period…

…3 IV Do not treat asymptomatic bacteriuria. The exceptions are pregnancy and the period before a urological procedure. A positive urine dipstick in an older…

…patellar tendon — do not inject into or beside them. Anticoagulant treatment is not a contraindication to these superficial injections. Preparation and equipment Chlorhexidine in alcohol…

… the reference values are based on them. In kyphosis, or when the patient cannot stand, the arm span divided by 1.06 is used as…

…a hydrogel or silicone elastomer coating may remain for up to twelve weeks, latex with a PTFE coating for a shorter period. Procedure In men…

…1% at 5 years. Stent thrombosis remains clinically important because interruption of antiplatelet therapy, particularly in the perioperative period, may increase risk. The risk is…

…3 month DAPT, but not 6 month DAPT, was associated with higher rates of myocardial infarction or stent thrombosis in ACS patients. Extension beyond 12…

…is not achieved with the maximum tolerated statin dose. This recommendation carries Class I status with Level B evidence in the chronic coronary syndrome lipid…

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

…during the fetal period. This is explained by the configuration of the fetal circulation; pulmonary resistance is high (which means that resistance in the pulmonary…

…statin treatment is more effective than moderate intensity treatment in reducing major cardiovascular events. Acute coronary syndromes The period immediately after ACS is particularly vulnerable…

…least once in every adult’s lifetime. Testing is particularly relevant in: individuals with premature atherosclerotic cardiovascular disease; patients with familial hypercholesterolaemia or very high…

…Conversely, asynchronous pacing may rarely result in pacing during ventricular repolarization and provoke ventricular tachycardia or ventricular fibrillation. The likelihood of clinically significant EMI is…

…6. Which of the following ECG findings is generally considered a normal variant in asymptomatic athletes and typically does not require further evaluation, assuming no…

…share similar efficacy in prolonging repolarization. However, the l isomer is responsible for virtually all of the beta blocking activity. Sotalol does not block alpha…

…the first year, although the available material does not establish a significant increase in late morbidity or mortality attributable to these events. Clinical presentation and…

…are not ischemic! However, T wave inversions that are accompanied by ST segment deviation (either depression or elevation) is representative of ischemia (but in that…

…clinical entity typically associated with drug induced long QT syndrome (DI LQTS) [1]. The condition arises in the setting of both modifiable and nonmodifiable risk…

…to the gastrointestinal tract which reduces blood availability in the heart. Symptoms of ischemic heart disease are generally not related to body position or respiration…

…often check pupil size and reactivity as part of initial and ongoing evaluations of patients in cardiac arrest or after return of spontaneous circulation (ROSC)…

…at increased risk of cardiovascular mortality in general. This is not surprising given the adverse effects of long periods of tachycardia and desynchronized atrial and…

…pregnant adults. The fetus is not harmed by defibrillation, amiodarone, or adrenaline (epinephrine). In the event of a cardiac arrest in a pregnant patient, immediate…

…by the fact that there is no (or very little) turnover of myocardial cells and therefore myocardial troponins should not be detected in the blood…

…Patients with significant heart disease (known or unknown) may not achieve the expected maximum heart rate and it may be hazardous to push them towards…

…during the fetal period. This is explained by the configuration of the fetal circulation; pulmonary resistance is high (which means that resistance in the pulmonary…

…iFR / RFR / Pd Pa / dPR) Resting Pd/Pa during the diastolic “wave free period” (iFR) or the lowest ratio across the full cardiac cycle (RFR)…

…atrial impulses to conduct to the ventricles, resulting in some P waves not being followed by QRS complexes. This condition is further categorized into two…

…vasovagal reaction, well trained athletes) need not be treated. When in doubt whether the bradycardia is physiological, it is useful to perform a Holter ECG…

…only be used if the flow (Q) is constant, which is not the case in the heart. Blood flow is pulsatile during the cardiac cycle…

…increasing coronary blood flow. In circumstances with non shockable rhythm or with prolonged periods of VF (fine VF resistant to defibrillations), the purpose of CPR…