…macrophages, neurons and other tissues. This distribution helps explain why PA produces cardiovascular injury beyond its effects on blood pressure and potassium balance. The principal…

…after onset: routine primary PCI should be considered in otherwise stable patients. More than 48 hours after onset: routine PCI of an occluded infarct related…

…the clinical importance of non fatal gastrointestinal and intracranial haemorrhage is substantial, particularly because the absolute cardiovascular benefit is small in many primary prevention populations…

…reduction in risk across a large population may prevent more events than a major reduction in risk among a small number of high risk individuals…

…publication of the American Society of Echocardiography 30 (4), pp. 303–371. DOI: 10.1016/j.echo.2017.01.007. Mitral valve stenosis Primary parameters…

…weak, slow deceleration variable dense, steep deceleration, early termination of diastolic flow Jet width colour Doppler small,, < 10 mm length, narrow origin variable large…

Procedurer Two recordings that are performed in primary care but interpreted as specialist investigations. Both fail more often for practical than for medical reasons: the…

…to a hanging head. Frenzel goggles or video Frenzel if available — small beats of nystagmus can otherwise be hard to see, particularly when the patient…

…primary or delayed percutaneous coronary intervention (PCI). Contraindications Prasugrel should not be used in the following situations: Hypersensitivity to the active substance or any of…

…angina may diminish or disappear. Others have no recognized history of angina or MI, making the distinction from primary dilated cardiomyopathy particularly difficult. When present…

…syndromes (ACS). Its principal therapeutic objective is reduction of low density lipoprotein cholesterol (LDL C), the primary lipid target in contemporary secondary prevention. Statins inhibit…

…unavailable in primary care. Before investigating secondary causes, pseudo resistance must be excluded. This includes: Poor adherence to antihypertensive treatment White coat hypertension Other contributors…

…table below shows a systematic history taking in patients presenting with chest pain (chest discomfort) or other symptoms suggestive of the five conditions listed above…

…syndrome (BrS) has evolved from an obscure electrocardiographic curiosity into a major focus of contemporary cardiac electrophysiology [1] . Recognized as a primary inherited arrhythmia syndrome…

…ECG signs and development of infarction Like all other cells in the human body, cardiac myocytes use ATP (adenosine triphosphate) as the primary energy source…

…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…

…complex and potentially lethal spectrum of cardiac arrhythmias that remains a formidable challenge in contemporary cardiovascular medicine. As a primary driver of sudden cardiac death …

…vascular injury, pseudoaneurysm Surgeon, ultrasound first Other situations that argue for the operating theatre rather than the emergency room: a very large or deep abscess…

…simple disorder, or two opposing primary disorders It is therefore not enough to ask which of the pCO₂ and the HCO₃ deviates most. What matters…

…perforation. Sources Endocrine Society clinical practice guideline on the diagnosis and treatment of primary adrenal insufficiency. The summary of product characteristics for each glucocorticoid preparation…

…Self sampling for HPV is now a permanent part of the programme and is widely used — a woman who does not attend for a gynaecological…

…the larger , since a mask that is too small leaks and gives a poorer seal. Procedure Insertion of the laryngeal mask 1. Check the mask…

…tumour, primary biliary cholangitis, drugs Mixed Both raised Drug induced liver injury is the commonest cause Isolated bilirubin Unconjugated, the others normal Gilbert's syndrome…

Procedurer The test measures the ability of the adrenal cortex to respond to maximal ACTH stimulation, and it is rarely the injection itself that determines…

…been assessed for tendon and nerve injury will heal badly however neatly the suture is placed. The commonest cause of wound infection is retained contamination…

…It is a modification of the widely used CHA₂DS₂ VASc score, with the primary distinction being the exclusion of sex parameter (female sex) as a…

…Doppler weak, slow deceleration variable dense, steep deceleration, early termination of diastolic flow Jet width colour Doppler small,, < 10 mm length, narrow origin va

…prediction tool currently exists. At the other end, roughly two thirds of ICDs implanted for reduced LVEF never deliver an appropriate shock, so the false…

…is often indicative of a noncardiac source [4]. 3. Pneumonia with Pleurisy Pain Characteristics: Pleuritic pain is a common presentation [2]. 4. Other Systemic/Local…

…control in atrial fibrillation, particularly when other therapeutic options cannot be pursued. Patients receiving digoxin may present with symptoms of digitalis toxicity, which manifests across…

…of rupture, or determine whether ischaemia would occur at workloads greater than those achieved during testing. Exercise ECG has become less prominent as a primary…

…adequacy of LDL C lowering treatment. In severe primary HTG, whether specialist lipid assessment is required. A comprehensive cardiovascular assessment should include review of modifiable…

…Pain may be absent, particularly in iatrogenic aortic injury. Iatrogenic lesions commonly follow cardiac surgery, coronary angiography or other invasive procedures, and affected patients may…

…particularly primary percutaneous coronary intervention (PCI). In a large epidemiological analysis, mechanical complications occurred in approximately 0.27% of STEMI cases and 0.06% of…

…endpoint. The cardiovascular benefits of cessation extend across primary and secondary prevention. Observational evidence indicates that cessation lowers the risk of peripheral artery disease, myocardial…

…least 50% resolution of ST segment elevation, and haemodynamic stability. Selection of the reperfusion strategy Primary PCI as the preferred strategy Primary percutaneous coronary intervention…

…by bradycardia. Most cases involve a mixed response of both hypotension and bradycardia. However, some patients exhibit a primary cardioinhibitory response with pronounced bradycardia. Most…

…S Ca 2+ 2.6 mmol/L In approximately 90% of cases, hypercalcemia is attributed to primary hyperparathyroidism or neoplastic etiologies. Other causes include immobilization…

…J, Toivio T, et al. Does appropriate treatment of the primary underlying cause of PEA during resuscitation improve patients’ survival? Resuscitation 2012;83:81922. Mroczek…

…often exhibits cavities, which consist of hemorrhages in the tumor. Polypoid myxoma usually causes haemodynamic complications due to obstruction. Papillary myxomas are small; they have…

…from primary urine), renal failure, small bowel syndrome, parathyroid gland surgery, use of bisphosphonates, excess calcitonin, use of phenytoin, use of phosphate substitution, use of…

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

…often necessary to normalize blood pressure. Management of hypertension requires careful consideration of other cardiovascular risk factors and coexisting conditions. Therapy must be tailored to…

…disturbance in ventricular activation will reduce the efficiency of the pumping function. The primary ECG manifestations of conduction defects are prolonged QRS complexes and altered…

…fatality is most likely explained by successful primary preventive strategies, such as reduced smoking rates, aggressive lowering of blood lipids with statins and sophisticated treatments…

…decreases and vice versa. The physiological purpose of this phenomenon is to allow for faster cardiac cycles during tachycardia (e.g during physical exertion). Therefore…

…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…

…significance of the ST segment depression differs markedly in NSTE ACS and STE ACS. In NSTE ACS the ST segment depressions are the primary ischemic…

…for ATP synthesis [ATP is the primary energy source in all cells]). The heart consumes approximately 30 kilograms of ATP per day (Neubauer et al…

…primary PCI if the total expected time is 120 minutes or less If PCI cannot be performed within 120 minutes Fibrinolysis within 10 minutes of…

…is available; in VF/VT only after the 3rd defibrillation 0.01 mg/kg (0.1 mL/kg of 0.1 mg/mL), maximum 1…

…indexed Aortic annulus 20 31 mm 12 14 mm/m2 Sinuses of Valsalva 29 45 mm 15 20 mm/m2 Sinotubular junction 22 36 mm…

…primary infection, low risk of recurrence vancomycin 125 mg × 4 PO 10 days Clostridioides difficile, high risk of recurrence fidaxomicin 200 mg × 2 PO 10…

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

…PA, Schinkel AFL, Liebregts M, et al. Validation of the 2014 European Society of Cardiology guidelines risk prediction model for the primary prevention of sudden

…routine primary PCI strategy should be considered in patients presenting late (12–48 h) after symptom onset. IIa B In asymptomatic patients, routine PCI of…

…Electrocardiogram (ECG) The ECG is the primary diagnostic tool for evaluating acquired QT prolongation. The upper 99% limits of normal for corrected QT (QTc) values…

…in primary prevention; 23% were taking a small dose of a statin, defined as atorvastatin less than 10 mg daily or an equivalent dose of…