…A personal history of premature CAD, cerebral vascular disease or peripheral vascular disease. A family history of premature myocardial infarction, vascular disease or marked hypercholesterolaemia…

…index Asian ancestry Previous muscle disease or a personal or family history of muscle disorders Acute infection Renal or hepatic impairment Hypothyroidism Vitamin D deficiency…

…Clinical assessment History that affects the level of risk Ask briefly and to the point: When did the deterioration begin, suddenly or over several days…

…ketamine or a combination. It requires a fasting history, two people, full monitoring and airway preparedness With procedural sedation, one person must manage the sedation…

…of medical suitability is made by the transplant team. Never rule out a possible donor on your own on grounds of age or medical history…

…antibiotics are associated with a worse outcome in sepsis and in several studies of neutropenic patients. In septic shock, or where sepsis is highly likely…

…Comparison with the expected score for a person of the same age and sex CAC may also reveal extracoronary findings, including pericardial or aortic calcification…

…with correctly performed compression. The reason compression nevertheless so often fails is that it is done wrongly: the patient pinches the nasal bone instead of…

…of hemodynamic parameters. Hence, heart rate and blood pressure must also be noted. In summary, the following variables should be included in the survey: personal…

…anatomical complexity of CAD, particularly in patients with multivessel disease or left main coronary artery disease . It integrates multiple variables, including the number of lesions…

…and tendon sheaths, loss of function Orthopaedic or hand surgeon, urgently Perianal and perirectal Often larger than it appears; risk of fistula Surgeon, often operative…

…the diagnosis is based on HbA1c. Albumin affects the total calcium — use the ionised calcium or correct for albumin. Biotin supplements interfere with many immunoassays…

…year risk of ≥10% is considered sufficiently high to support BP lowering treatment, whether through lifestyle intervention, pharmacological therapy, or both. A person may also…

…anticoagulants can reduce the risk of stroke by 70%, as compared with placebo. Besides anticoagulation, atrial fibrillation is treated with rate and/or rhythm control …

…hours, or days. In the vast majority of cases, the re entry circuit in atrial flutter is located in the right atrium and it typically…

…negative chronotropic effect. Among persons who do not suffer from heart failure, chronotropic incompetence may be caused by beta blockers, amiodarone or digitalis. Sinus node…

…required, in addition to the mealtime dose Never stop basal insulin in a person with type 1 diabetes , not even before fasting or an investigation…

…with a full stomach. Preparation and equipment A laryngeal mask of the correct size plus one size above and one below. Second generation masks with…

…haemostatic capacity, but it cannot compensate for an uncontrolled source of bleeding. Minimise the time to surgery, endoscopy, an obstetric procedure or angiographic intervention. Summon…

…Note that narrow complex tachyarrhythmia rarely causes circulatory compromise or collapse. Causes of tachycardia (tachyarrhythmia) with wide QRS complexes (QRS duration ≥0,12 s) : ventricular…

…the presence of multilevel disease and collateral circulation. Flow limitation may be clinically silent, manifest as exertional symptoms, or progress to chronic limb threatening ischaemia…

…Physical activity should be assessed and prescribed using the components of: Frequency Intensity Time or duration Type Progression The prescription should be individualized rather than…

…Intervention BLS or ACLS NNT to save 1 person Reference Early detection of cardiac arrest BLS 11 Berdowski et al Bystander CPR BLS 15 Hasselqvist…

…the chin up. Does the person breathe? Look for respiratory signs for 10 seconds. Palpation of pulses : carotid, femoral or radial artery. According to current…

…recorded ECG) is a very strong predictor of survival. This is because cardiac arrest presenting with ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT) can…

…Note that narrow complex tachyarrhythmia rarely causes circulatory compromise or collapse. Causes of tachycardia (tachyarrhythmia) with wide QRS complexes (QRS duration ≥0,12 s) : ventricular…

…Fortunately, most children (even the youngest) can be distracted by a parent or other personnel. Distracting the child during ECG recording may be recommended to…

…ventricular filling). Persons with premature beats might perceive this as palpitations, because of the stronger ventricular contractions caused by the increased filling. Frequent premature beats…

…the impulse is discharged in the ventricles it will spread partly or entirely outside of the conduction system and thus produce a wide QRS complex…

…The person may have some circulation despite circulatory collapse (e.g., with sustained ventricular tachycardia). Experimental and clinical understanding of hypoxic neuronal cell death stems…

…by myocardial ischemia (affecting the sinoatrial node), sinus node dysfunction or side effects of digoxin treatment. If the rhythm becomes completely regular when holding the…

…aphasia, hemianopia or hand paresis in a person of working age Blood pressure Measure initially in both arms if this does not delay reperfusion treatment…

…can swallow safely. 4. Give intravenous glucose if the patient has a reduced level of consciousness, is having seizures or cannot swallow. 5. If there…

…is 12 h, a primary PCI strategy is indicated in the presence of ongoing ischemic symptoms, haemodynamic instability, or life threatening arrhythmias. I C A…

…cessation Improve management of hypertension, dyslipidaemia, and diabetes mellitus Reduce anxiety and depressive symptoms Facilitate return to work and appropriate recreational or sporting activity Limit…

…However, left bundle branch block morphology is more common (regardless of heart rate) among persons with heart disease. Alternating block (right and left bundle branch…

…referred to as high sensitive cardiac troponin, may actually detect the presence of troponins in most normal persons. In 2017 it was possible to detect…

…a fairly good estimate of the actual workload. The perceived exertion may be graded from 0 (none) to 10 (maximal exertion) or according to the…

…delivers the electrical impulse to the posterior and inferior walls of the left ventricle. Anatomical or functional block in the anterior fascicle leads to left…

…and ECG changes. Although the risk of cardiac arrest is very small, personnel must be well trained in resuscitation. Subject preparations The procedure must be…

…The New England Journal of Medicine, 1812. Remarks on Angina Pectoris by John Warren The remarkable facts, that the paroxysm, or indeed the disease itself…

…form of ischemia located in the subendocardium during exercise; this manifests with ST segment depressions with upsloping ST segment during exercise but the person is…

…node dysfunction is an umbrella term for conditions that either affect the automaticity of the sinoatrial node or block the impulse from reaching the atria…

…STEMI The diagnosis is straightforward using the electrocardiogram (ECG). Prehospital personnel have proven to be capable of recognizing STEMI using 12 lead ECG. The sensitivity…

…According to the chain of survival, the first task is to recognize cardiac arrest and alert the EMS (in OHCA) or cardiac arrest team (in…

…an unexpected death due to cardiac causes that occur within 1 hour of symptom onset. The person may or may not have known cardiac disease…