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

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

…Do not wait for the blood gas result before starting treatment. Clinical assessment History that affects the level of risk Ask briefly and to the…

…head and of vascular injury; always an orthopaedic surgeon, and usually general anaesthesia. An open dislocation. Inadequate analgesia or sedation — the procedure must not then…

…the assessment takes. The task of the health service is to give effect to the deceased person's wishes, not to persuade anyone. This article…

…is not obligatory Hypothermia, new confusion, tachypnoea, hypotension, rigors, abdominal pain or a rapid deterioration in general condition may be the only signs of infection…

…population screening test. It may also be considered in selected lower risk individuals with a family history of premature coronary artery disease. CAC findings incidentally…

…forwards , not backwards. Procedure Step 1 — compression Have the patient blow out the clot. The pinch is applied to the lower third of the nose…

…discusses the principles of the standard echocardiographic examination. Currently, three dimensional (3D) echocardiography is the most revolutionary method, but it is not yet included in…

…SYNTAX Score is a semi quantitative scoring system designed to assess the complexity of coronary artery disease (CAD) and guide the choice between percutaneous coronary…

…of antibiotics — suggests that an abscess has formed. Ultrasound settles the question when the clinical picture is unclear. Cellulitis without a pus cavity must not…

…95 % of a healthy reference population, which means that one healthy value in twenty falls outside them . Order twelve tests in a healthy person and…

…SCORE2 and SCORE2 Older Persons (SCORE2 OP) are European risk prediction models designed to estimate 10 year risk of both fatal and non fatal CVD…

…attempts to restore sinus rhythm by use of antiarrhythmic drugs. Randomized controlled trials have not demonstrated any clear difference in mortality when comparing rate and…

…Examples of atrial flutter. Click to zoom. ECG in atrial flutter The ECG shows regular flutter waves ( F waves ; not to be confused with f…

…heart failure, despite their negative chronotropic effect. Among persons who do not suffer from heart failure, chronotropic incompetence may be caused by beta blockers, amiodarone…

…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…

…cardiac arrest when the person ventilating is not experienced in intubation. Planned anaesthesia for short procedures in a fasted patient at low risk of aspiration…

…while definitive control of the bleeding has not yet been achieved. Penetrating torso injury with shock. A positive FAST scan in an unstable trauma patient…

…If a person with ECG signs of SND is symptomatic, the condition is classified as sick sinus syndrome (SSS) . Causes of tachycardia (tachyarrhythmia) with narrow…

…over 40 years of age, atherosclerosis is the predominant cause. Other mechanisms include thrombosis, embolism, vasculitis, fibromuscular dysplasia, arterial entrapment, cystic adventitial disease and trauma…

…skeletal health, muscular strength, quality of life and psychological well being. Physical inactivity is itself a major cardiovascular risk factor. Sedentary behaviour may confer risk…

…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…

…arrest occurs within a minute after cessation of breathing (apnea), regardless of the cause. A person who is not breathing will therefore develop a cardiac…

…al ). The incidence of treated cardiac arrests outside hospitals (OHCA) is about 70 cases per 100,000 person years in Europe ( EuReCA One, Benjamin et…

…If a person with ECG signs of SND is symptomatic, the condition is classified as sick sinus syndrome (SSS) . Causes of tachycardia (tachyarrhythmia) with narrow…

…upper arm. Placement of chest (precordial) electrodes are not changed but additional leads may be attached in children under the age of 5 years. These…

…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…

…person with premature beats might perceive this as palpitations, because of the stronger ventricular contractions caused by the increased filling. Ventricular premature complexes are not…

…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…

…regular if the person holds the breath. However, sinus arrhythmia may be a pathological finding in some cases. Sinus arrhythmia is not a normal finding…

…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…

…Resolution of the symptoms when the glucose is normalised [3]. A healthy person without diabetes therefore does not normally need investigation on the basis of…

…in the acute phase but should not delay reperfusion treatment. I C Blood samples Management Recommendation Level of evidence Serum biomarkers of myocardial infarction (troponin)…

…burden of recurrent coronary risk. Nutritional counselling, smoking cessation, blood pressure and lipid management, and diabetes care are therefore integral rather than optional components. Psychological…

Arrhythmias and arrhythmology ECG Aberrant ventricular conduction (aberrancy, aberration) Aberrant conduction is not a mechanism of arrhythmia; it is a ventricular conduction disturbance . It is…

…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…

…RATING LEVEL OF EXERTION COMMENT 6 No exertion at all 7 7.5 Extremely light exertion 8 9 Very light exertion For a healthy person…

…The hallmark of fascicular blocks is the deviation of the electrical axis. The QRS duration is slightly prolonged but does not reach 0.12 s…

…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 wall of the artery. Such atherosclerotic plaques start building up early in childhood and by middle age, most persons have some degree of atherosclerosis…

…to endure 20 to 30 minutes of severe ischemia. If myocardial perfusion (blood flow) in the ischemic zone is not restored before that time limit…

…for adequate (high) dosing of rate controlling drugs (e.g beta blockers) without the risk of worsening the bradycardia. Persons with sick sinus syndrome should…

…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…

…1. Thus, the greatest opportunities exist in the first few minutes, which is within the reach of bystanders, first responders and the EMS. Unfortunately, several…

…within 1 hour of symptom onset. The person may or may not have known cardiac disease. Moreover, the time limit (1 hour) is not absolute…