…and when to involve a surgeon The following locations must not be handled routinely in primary care or in the emergency department without contacting the…

…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…

…primary PCI should be considered in otherwise stable patients. More than 48 hours after onset: routine PCI of an occluded infarct related artery is not…

…does not reduce cardiovascular or all cause mortality. Reported relative effects include: Approximately 11% reduction in cardiovascular events in a meta analysis of primary prevention…

Cardiology Clinical medicine Definition and Scope Primary prevention aims to prevent the clinical manifestation of cardiovascular disease (CVD) in individuals without established clinical CVD. It…

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

…regurgitation Primary parameters Mild regurgiation Moderate regurgitation Severe regurgitation PISA radius < 0,6 0,6 0,9 0,9 Vena contracta (cm) not defined…

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…

Procedurer Benign paroxysmal positional vertigo is the commonest cause of vertigo in primary care and one of the few diagnoses that can be cured on…

…STEMI) This applies to patients undergoing either primary or delayed percutaneous coronary intervention (PCI). Contraindications Prasugrel should not be used in the following situations: Hypersensitivity…

…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…

…of severe ischemia. If myocardial perfusion (blood flow) in the ischemic zone is not restored before that time limit, the cell will die. Figure 1…

…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…

…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…

…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…

…as a triage test on the same liquid based sample when the HPV test is positive — the sample therefore does not need to be repeated…

…ventilation is difficult or inadequate. The primary airway in cardiac arrest when the person ventilating is not experienced in intubation. Planned anaesthesia for short procedures…

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…

…contamination, not poor suture technique — and the commonest cause of permanent loss of function is a tendon injury that was sutured over without being found…

…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…

…regurgitation Primary parameters Mild regurgiation Moderate regurgitation Severe regurgitation PISA radius < 0,6 0,6 0,9 0,9 Vena contracta (cm) not defined…

…term prediction of sudden cardiac arrest. The constraint does not lie in therapy: implantable cardioverter defibrillators (ICDs) are highly effective, terminating well over 99% of…

…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…

…this pump, digoxin affects multiple cellular processes critical to cardiac myocyte function, ultimately exerting a mild positive inotropic effect. Beyond its direct cellular actions, digoxin…

…would occur at workloads greater than those achieved during testing. Exercise ECG has become less prominent as a primary diagnostic test for obstructive coronary artery…

… 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…

…disruption of the adventitia can result in rupture. An alternative proposed mechanism is primary rupture of the vasa vasorum, followed by disruption of the intima…

…and viable myocardium. The incidence has fallen substantially with contemporary reperfusion, particularly primary percutaneous coronary intervention (PCI). In a large epidemiological analysis, mechanical complications occurred…

…does not produce a proportional reduction in cardiovascular harm. Complete cessation is therefore the preferred therapeutic endpoint. The cardiovascular benefits of cessation extend across primary…

…agents act preferentially when fibrin is present, whereas streptokinase is not fibrin specific and produces more extensive fibrinogen depletion. Successful fibrinolysis is generally accompanied by…

…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…

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

…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…

…sodium levels do not have any effect on the ECG, nor cardiac rhythm, or impulse conduction. 2. Calcium Hypercalcemia Causes of hypercalcaemia Primary hyperparathyroidism and…

…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…

…90–95% of individuals with hypertension have essential hypertension , also referred to as primary hypertension . Essential hypertension is defined as hypertension without an identifiable underlying…

…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…

…to prolonged QT interval The QT interval is the time interval from the beginning of the QRS complex to the end of the T wave…

…the subendothelial accumulation of apolipoprotein B containing lipoproteins, macrophage infiltration, smooth muscle cell proliferation, and extracellular matrix deposition, ultimately leading to the formation of atherosclerotic…

…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…

…ST T segment). For example, a block in the left bundle branch (i.e left bundle branch block) means that the left ventricle will not…

…However, current guidelines do not consider this fact (beyond the recommendation to defibrillate immediately if cardiac arrest is witnessed and the rhythm is shockable). This…

…failed fibrinolysis Immediate rescue PCI The 120 minute limit is a ceiling for the choice between primary PCI and fibrinolysis, not an acceptable routine target…

…and most serious dosing errors arise at the dilution step, not in the choice of dose. Paediatric doses are calculated on actual body weight unless…

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

…g × 3 IV Do not treat asymptomatic bacteriuria. The exceptions are pregnancy and the period before a urological procedure. A positive urine dipstick in an…

…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

…infarction. IIa B Routine blood sampling for serum markers is indicated as soon as possible in the acute phase but should not delay reperfusion treatment…

…sinus beat typically exhibits a longer QT interval, and the T wave is interrupted by a PVC, which serves as the first beat of the…

…by very long chain acyl CoA synthetase 1. This activating enzyme is not expressed in skeletal muscle, a pharmacological feature that may limit muscle related…