…to diagnosis and long term management. Clinical presentation and symptoms The source material does not describe the typical symptoms or symptom burden of uncomplicated hypertension…

…lifestyle modification reduce the burden of recurrent coronary risk. Nutritional counselling, smoking cessation, blood pressure and lipid management, and diabetes care are therefore integral rather…

…and patients treated with CAR T cells or other advanced immunotherapies may require separate local protocols. Definition Criterion Practical definition : : Fever A single temperature of…

…consciousness Marked gait instability The specificity of the symptoms is limited. In a patient with moderate symptoms the physician must judge the likelihood that the…

…may suggest aortic dissection CT of the brain Exclude intracerebral haemorrhage and assess early ischaemic changes CT angiography The standard investigation in acute stroke to…

…management Any heart rate faster than 100 beats per minute is defined as tachycardia , which is synonymous with tachyarrhythmia. Except for sinus tachycardia during physical…

…team (CAT) and intensive care units and other units caring for resuscitated patients. Figure 1. The chain of survival in out of hospital cardiac arrest…

…physical activity and any other precipitating factor. Thresholds The thresholds below are used above all in diabetes. The severity of the symptoms and the patient…

…In the critically ill patient, AF may be pre existing, newly detected for the first time, or newly developed during management of an acute illness…

…History taking, physical examination, ECG and laboratory tests are the cornerstones of management of patients with chest pain. A 12 lead ECG recording must be…

…medicine, widely utilized for the management of hypertension, chronic ischemic heart disease, heart failure with reduced ejection fraction (HFrEF), and post myocardial infarction (MI) care…

…of symptoms should be documented carefully. Longer standing and more severe pain or functional loss reduce the likelihood of successful limb salvage. Evaluation and physical…

…Physical Examination Initial assessment should establish whether the presentation represents ACS and whether the patient is clinically unstable. Particular attention is required for evidence of…

…onset: routine PCI of an occluded infarct related artery is not recommended in stable, asymptomatic patients without severe ischaemia. Evaluation and Physical Examination The initial…

…In the management of heart failure, digoxin improves hemodynamics without increasing heart rate or decreasing blood pressure, making it a consideration for patients with low…

…evidence of low output despite relatively limited elevation of left sided filling pressure. Evaluation and physical examination Initial assessment should establish whether the patient has…

…pneumothorax and respiratory arrest [1]. The first few minutes 1. Sit the patient up and minimise physical exertion. 2. Attach continuous pulse oximetry and an…

Cardiology Pharmacology & dosing Definition and Pathophysiology Angiotensin converting enzyme inhibitors (ACE inhibitors) constitute a cornerstone in the management of cardiovascular disease, heart failure, and chronic…

…considered one of the greatest advances in cardiology. Until 1961, patients with acute myocardial infarction were placed in beds located far away from physicians' and…

…calm, mildly somnolent but rousable patient, while ventilation, circulation and underlying disease are monitored [3]. The management of complicated withdrawal varies between regions and units…

…Such patients require a mechanism based assessment rather than reassurance based solely on the absence of obstructive CAD. Evaluation and Physical Examination Clinical assessment The…

…integrated with management of precipitating factors such as anaemia, uncontrolled hypertension, thyrotoxicosis, tachyarrhythmia, uncontrolled heart failure, and concomitant valvular disease. Risk factor modification, physical activity…

…possible. Airway management should not interrupt compressions for more than 5 seconds. The effect of cricoid pressure and gastric insufflation remains uncertain ( Panchal et al )…

…and therefore requires an emergency management pathway. Patients without haemodynamic instability require more detailed prognostic evaluation using two complementary domains: Indicators of acute PE severity …

…Definite ACS In patients with ST segment elevation, immediate reperfusion assessment is required. Patients with NSTE ACS should be admitted for management of acute ischaemia…

Conduction defects ECG Management and treatment of AV blocks (AV block 1, 2 & 3) Evaluation of patients with suspected AV blocks requires a thorough medical…

…in T2DM. Cardiovascular benefit depends substantially on comprehensive risk factor management and, in appropriate patients, selection of glucose lowering therapies with demonstrated cardiovascular effects. Diabetes…

Cardiology Critical care Pharmacology & dosing Definition and Pathophysiology In the management of acute heart failure and cardiogenic shock, intravenous vasoactive agents are categorised according to…

…physical examination or general evaluation of patients with bradycardia. Diagnostics Electrocardiographic assessment is fundamental to the diagnosis and management of bradyarrhythmias. In the setting of…

…territory. Recent neurological symptoms are particularly important in determining management. The benefit of carotid revascularisation is greatest in patients with a recent TIA or stroke…

…and quality of life may be equally important therapeutic objectives. Evidence from randomized trials is often less applicable to very frail or multimorbid patients because…

…considerably. Symptoms of systemic venous congestion include: Peripheral edema Rapid weight gain Increasing abdominal girth Early satiety Bendopnea Abdominal ascites Older patients may present atypically…

…to sinus rhythm. Biomarkers and Laboratory Findings Renal function biomarkers are essential in the evaluation and ongoing management of patients on sotalol. Because the drug…

…types of sinus tachycardia are as follows: Normal (physiologic) sinus tachycardia: The automaticity (rate of spontaneous depolarization) in the sinoatrial node is increased during physical…

…based management/treatment. These 9 aspects are all necessary to become confident in ECG interpretation and making clinical decisions using the ECG. Interestingly, none of…

…associated with increased ASCVD risk. Management in this range therefore focuses principally on ASCVD prevention and reduction of LDL C, non HDL C and apolipoprotein…

…sinus bradycardia developing during physical exercise is considered abnormal, because heart rate must increase during exercise. Mechanisms of cardiac arrhythmias The mechanisms underlying cardiac arrhythmias…

…diagnosis, management, treatment response and outcomes of cardiovascular disease. The biological differences between females and males arise partly from the chromosomal distinction between XX and…

…combination with acetylsalicylic acid (ASA), is indicated for the prevention of atherothrombotic events in adult patients with acute coronary syndromes (ACS), including: Unstable angina (UA…

…The diagnosis and the donor care The time from withdrawal of treatment to circulatory arrest Indications An intensive care patient with severe brain injury in…

…symptoms. 4. Blood pressure every second minute and on symptoms. 5. Ask actively about chest pain, breathlessness and leg fatigue; have the patient rate exertion

…risk of cardiac arrest is very small, personnel must be well trained in resuscitation. Subject preparations The procedure must be explained carefully to the patient…

…wards a substantial proportion of older patients are affected, and the incidence is particularly high after hip fracture, major surgery and intensive care [1,2…

…most important dangerous differential diagnosis. Clear focal neurological findings are absent in roughly half of patients with a central cause. A normal routine neurological examination…

…physicians should be interested in. Updates occur frequently. Nuemblog A residents blog with superb, and expanding, content. Beautifully presented and highly relevant for many of…

…Confirm cardiac arrest In case of a collapse (out of hospital or in hospital) the first task is to determine if a cardiac arrest has…

…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

Echocardiography Calculation of hemodynamic parameters by ultrasound Hemodynamics is the study of blood flow dynamics. The physical laws that govern blood flow are fundamental in…

…relaxing vascular smooth muscle. They are contraindicated in patients with bronchospastic lung disease, or a history of significant reactive airway disease. Contraindications also include second…

…waves, which can propagate through vacuum, sound waves can only propagate through a physical medium. This medium may consist of any matter, e.g air…

…antihypertensives, should prompt clinical suspicion [1]. Cardiac Signs and Symptoms Patients often present with symptoms of predominant right heart failure, including lower extremity edema, ascites…

…fraction (LVEF). Heart failure with reduced ejection fraction (HFrEF) is defined by the combination of symptoms, with or without physical signs, and an LVEF below…

…or physical reactions (radiation therapy), frequently involves the conduction system. In these conditions, involvement of the AVN and the conduction system occurs more often than…

…increases the risk of HF and is common among patients with established HF, particularly HFpEF. Assessment of congestion may be difficult because physical findings and…

…which seeks to prevent the development of cardiovascular risk factors themselves, and from secondary prevention, which addresses patients with established disease to reduce recurrent events…

…the intensity of the physical activity. It is based on the subjective physical sensations experienced during exercise, including increased heart rate, increased respiratory rate and…

…not noticeable during rest. As a rule of thumb, the patient must achieve 85% of the (age adjusted) expected maximum heart rate, which can be…

…tachycardia (e.g during physical exertion). Therefore, to judge whether the QT interval is normal or not, one must adjust for the current heart rate…

…myocardium rarely reveals evidence of significant coronary artery stenosis unless the stenosis is severely critical, potentially causing angina during rest. Patients experiencing angina at rest…

…physical activity, but an atherosclerotic plaque may prevent oxygen supply from increasing in parallel with oxygen demands. Depending on several factors– including the severity of…