…balance. The principal sporadic subtypes are: Aldosterone producing adrenal adenoma Bilateral adrenal hyperplasia Primary or unilateral adrenal hyperplasia Rare aldosterone producing adrenal carcinoma Less commonly…

…previous angina. Patients should be advised to seek emergency medical assistance rather than self presenting to an emergency department or contacting primary care first. If…

…other platelet pathways. The distinction between primary and secondary prevention is fundamental: Primary prevention refers to individuals without established atherosclerotic cardiovascular disease (ASCVD), coronary artery…

…cardiovascular risk factors. Primary prevention Primary prevention targets people without clinical CVD who nevertheless have established risk factors or an elevated estimated risk. It combines…

Mitral valve regurgitation Primary parameters Mild regurgiation Moderate regurgitation Severe regurgitation Vena contracta (cm) < 0,3 0,3 0,69 0,69 EROA (cm²…

Tricuspid valve regurgitation Primary parameters Mild regurgiation Moderate regurgitation Severe regurgitation PISA radius < 0,6 0,6 0,9 0,9 Vena contracta (cm…

…started . Suspected white coat hypertension: raised office blood pressure without organ damage. Suspected masked hypertension: normal office blood pressure but organ damage or high risk…

…commonest cause of vertigo in primary care and one of the few diagnoses that can be cured on the spot, in three minutes, without drugs …

…UA) Non ST elevation myocardial infarction (NSTEMI) ST elevation myocardial infarction (STEMI) This applies to patients undergoing either primary or delayed percutaneous coronary intervention (PCI)…

…myocardial dysfunction caused by coronary artery disease (CAD). The clinical syndrome may resemble primary dilated cardiomyopathy, particularly when angina or a previous myocardial infarction (MI…

…reduction of low density lipoprotein cholesterol (LDL C), the primary lipid target in contemporary secondary prevention. Statins inhibit hepatic 3 hydroxy 3 methylglutaryl coenzyme A…

…hypokalaemia. Endocrine disorders account for many secondary forms. Primary hyperaldosteronism is identified as the most frequent cause, comprising approximately 20–25% of secondary hypertension cases…

…one of the most common symptoms in the emergency department, as well as in primary health care. The cause (etiology) of chest pain varies according…

…into a major focus of contemporary cardiac electrophysiology [1] . Recognized as a primary inherited arrhythmia syndrome, BrS is characterized by a distinct electrocardiographic (ECG) signature…

…Like all other cells in the human body, cardiac myocytes use ATP (adenosine triphosphate) as the primary energy source. ATP is produced by metabolizing carbohydrates …

…predictors in prediction models. Targeting risk factors has been very successful in the primary and secondary prevention of atherosclerotic cardiovascular disease, both at the population…

…cardiovascular medicine. As a primary driver of sudden cardiac death (SCD) and a major cause of morbidity in patients with structural heart disease, VT necessitates…

…surgeon The following locations must not be handled routinely in primary care or in the emergency department without contacting the appropriate specialty: Location Risk Management …

…expected pCO₂ or HCO₃. A value outside the expected range means there is a further primary disorder 4 Is there a metabolic acidosis? Calculate the…

…life produces more marked suppression. Stress dosing in known adrenal insufficiency A patient with primary adrenal insufficiency (Addison's disease), secondary adrenal insufficiency or long…

…Sampling for a suspected sexually transmitted infection — although chlamydia and gonorrhoea can be tested on urine or a self taken vaginal sample without a speculum…

…single most important tool when intubation fails, since it restores oxygenation without requiring a view down into the larynx. The difficult airway rarely kills because…

Referensvärden "Liver function tests" mainly measure damage , not function. The tests that reflect the synthetic function of the liver are the prothrombin time (INR) , the…

…Addisonian crisis, hydrocortisone must be given immediately — the test must never delay treatment. Indications Suspected primary adrenal insufficiency (Addison's disease): fatigue, weight loss, hyperpigmentation…

…or a dressing alone. Contraindications Primary closure must be avoided or considered carefully in: Bite wounds — particularly cat and human bites, and all bites on…

…widely used CHA₂DS₂ VASc score, with the primary distinction being the exclusion of sex parameter (female sex) as a risk factor. Rationale for the development…

…32–60 25–31 18–24 <17 Tricuspid valve Tricuspid valve regurgitation Primary parameters Mild regurgiation Moderate regurgitation Severe regurgitation PISA radius < 0,6…

…by echocardiography. Reduced LVEF reliably identifies a high risk group that derives a large, trial proven survival benefit from primary prevention ICDs. Its dominance, though…

…consider both cardiac and non cardiac etiologies [1]. Cardiac Causes The primary differential diagnoses include conditions that directly affect the myocardium or major vessels. 1…

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

…those achieved during testing. Exercise ECG has become less prominent as a primary diagnostic test for obstructive coronary artery disease (CAD), because coronary computed tomography…

… 150 mg/dL (≥1.7 mmol/L) in ESC primary prevention guidance 175–499 mg/dL (2.0–5.6 mmol/L) Severe HTG ≥500…

…primary rupture of the vasa vasorum, followed by disruption of the intima. Intramural haematoma differs from classic dissection because haemorrhage occurs within the media without…

…whereas primary PCI appears to reduce its risk. VSR incidence has decreased from approximately 1–2% without reperfusion to about 0.2% in the reperfusion…

…cessation is therefore the preferred therapeutic endpoint. The cardiovascular benefits of cessation extend across primary and secondary prevention. Observational evidence indicates that cessation lowers the…

…Selection of the reperfusion strategy Primary PCI as the preferred strategy Primary percutaneous coronary intervention (PPCI) is preferred to fibrinolysis when the anticipated interval from…

…hypotension and bradycardia. However, some patients exhibit a primary cardioinhibitory response with pronounced bradycardia. Most cardioinhibitory events are due to sinus bradycardia, though transient atrioventricular…

…onset, is of paramount importance. The primary concern in correcting hyponatremia is the prevention of osmotic demyelination syndrome (ODS), previously known as central pontine myelinolysis…

…the cooling process. Malignant hyperthermia Malignant hyperthermia may manifest under two primary circumstances: Due to a genetic mutation in the RYR1 receptor, resulting in persistent…

…rhabdomyoma is most common. Myxoma Myxoma is the most common primary cardiac tumor. These tumors most often debute at the age of 30 60 years…

…impulse conduction. 2. Calcium Hypercalcemia Causes of hypercalcaemia Primary hyperparathyroidism and malignancies cause 90% of all cases of hypercalcemia. Less common causes are immobilization, sarcoidosis…

…The coronary arteries: a brief overview The two primary coronary arteries originate from the aortic bulb ( Figure 1 ): The right coronary artery ( RCA ) originates on…

…hypertension have essential hypertension , also referred to as primary hypertension . Essential hypertension is defined as hypertension without an identifiable underlying cause. Researchers previously believed that…

…efficiency of the pumping function. The primary ECG manifestations of conduction defects are prolonged QRS complexes and altered QRS appearance. These concepts will be discussed…

…declined steadily ever since. The marked decline in death rates and case fatality is most likely explained by successful primary preventive strategies, such as reduced…

…interval. The primary hazard lies in long QTc intervals because they induce a very unstable polymorphic ventricular tachycardia referred to as torsade de pointes . Abnormally…

…The transition from a quiescent plaque to a highly thrombogenic surface occurs via three primary mechanisms: Plaque Rupture: Accounting for 60 70% of ACS presentations…

…if the load becomes prolonged. However, most often the cause of the load is the primary problem. Among the causes are pulmonary embolism, pulmonary hypertension…

…the primary ischemic ECG changes. ST segment depressions in NSTE ACS are frequently accompanied by T wave inversions (or flat T waves), but the primary…

…Myocardial oxygen demand Myocardium can only function under aerobic conditions (oxygen is required for ATP synthesis [ATP is the primary energy source in all cells])…

…STEMI: time targets and choice of reperfusion Primary PCI is the method of choice if PCI can be performed within 120 minutes of the STEMI…

…interruptions and early defibrillation are what determine the outcome; drugs are given without pausing the compressions. Anaphylaxis Intramuscular adrenaline into the lateral thigh is the…

…9 ± 1.5 11.2 ± 1.4 Aortic regurgitation (AR) Primary parameters Mild regurgitation Moderate regurgitation Severe regurgitation Vena contracta (cm) < 0.3 0…

…first dose, then 1 g × 1 IV Clostridioides difficile, primary infection, low risk of recurrence vancomycin 125 mg × 4 PO 10 days Clostridioides difficile, high…

…9 ± 1.5 11.2 ± 1.4 Aortic regurgitation (AR) Primary parameters Mild regurgitation Moderate regurgitation Severe regurgitation Vena contracta (cm) < 0,3 0…

…of VT are a strong predictor of SCD. Unexplained Syncope : Syncope without a clear cause may indicate underlying arrhythmias. Age : Younger patients are generally at…

…timeframes. I A If timely primary PCI cannot be performed, fibrinolytic therapy is recommended within 12 h of symptom onset in patients without contraindications. I…

…such as thiazide and loop diuretics. Diagnostics Electrocardiogram (ECG) The ECG is the primary diagnostic tool for evaluating acquired QT prolongation. The upper 99% limits…

…who were unable or unwilling to take statins. Approximately 70% were in secondary prevention and 30% in primary prevention; 23% were taking a small dose…