Procedurer For many patients a gynaecological examination is associated with a sense of exposure, and technically correct performance is only half the task. The examination…

…cerebrovascular disease. PA is associated with cardiac hypertrophy, myocardial fibrosis, diastolic dysfunction and heart failure. Compared with patients with primary hypertension matched for age, sex…

…Determination of symptom onset time and anticipated time to primary PCI. Patients with STEMI should be monitored in a setting capable of continuous rhythm surveillance…

…Primary prevention refers to individuals without established atherosclerotic cardiovascular disease (ASCVD), coronary artery disease, cerebrovascular disease, or peripheral artery disease. Secondary prevention concerns patients with…

…Secondary prevention Although outside the principal scope of primary prevention, secondary prevention provides an important contrast. Patients with manifest clinical disease are at high risk…

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…

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…

…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…

…and pathophysiology Lipid lowering therapy is a central component of cardiovascular prevention, particularly in patients with established atherosclerotic cardiovascular disease (ASCVD), chronic coronary syndrome (CCS)…

…more drugs. Screening for primary aldosteronism Screening for primary aldosteronism with renin and aldosterone measurements should be considered in all adults with confirmed hypertension, defined…

…when encountering a patient with chest pain the primary task is to exclude or verify the following potentially life threatening causes of chest pain: Ischemic…

…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…

…Pilonidal abscess, hidradenitis abscess and paronychia with a collection of pus. Persistent painful induration after a few days of antibiotics — suggests that an abscess has…

…moment of sampling, but does not by itself identify the cause. The result must always be weighed together with the clinical picture, medication, fluid balance…

…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…

…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…

…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…

…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…

…with neuropathy, immunosuppression, and high dose corticosteroids. The time limit and the choice of closure strategy The classical limit of 6–8 hours for primary…

…risk in patients with non valvular atrial fibrillation (AF). It is a modification of the widely used CHA₂DS₂ VASc score, with the primary distinction being…

…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…

…chest discomfort requires a systematic differential diagnosis, as the syndrome associated with ischemic heart disease is broader than chest pain itself, encompassing symptoms like tightness…

…making it a consideration for patients with low blood pressure secondary to a low cardiac output. Its primary clinical utility in contemporary practice is late…

…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…

…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…

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

Cardiology Clinical medicine Definition and cardiovascular rationale Smoking cessation is the complete discontinuation of tobacco smoking, with avoidance of second hand smoke and, where possible…

…infarction (STEMI) is a working diagnosis based on persistent ST segment elevation or an equivalent electrocardiographic pattern in a patient with symptoms of myocardial ischaemia…

…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…

…attributed to primary hyperparathyroidism or neoplastic etiologies. Other causes include immobilization, sarcoidosis, thyrotoxicosis, familial hypocalciuric hypercalcemia, Addison's disease, renal insufficiency, therapeutic interventions with tamoxifen…

…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…

…of the myocardium; in these cases, the tumor can debut with ventricular arrhythmias that result in asystole and sudden death. In echocardiography, tumour should be…

…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…

…For instance, administering nitroglycerin to alleviate ischemic chest pain may lead to hemodynamic collapse in patients with right ventricular ischemia or infarction. Recognizing ECG signs…

…Lim et al ). Approximately 90–95% of individuals with hypertension have essential hypertension , also referred to as primary hypertension . Essential hypertension is defined as hypertension…

…defect in the left ventricle is more significant, as compared with a defect affecting the right ventricle. This is due to the fact that the…

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

…depolarize and repolarize the ventricles ( Figure 1 ). The length of the QT interval correlates strongly with the risk of potentially life threatening ventricular arrhythmias. 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…

…half of the heart, it is important to familiarize yourself with the principles of hemodynamics and conditions prevailing on the right side. Echocardiography is the…

…ST T changes; the absence of such changes should lead to suspicion of ischemia (if the patient has symptoms consistent with ischemia). The same is…

…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])…

…choice of reperfusion Primary PCI is the method of choice if PCI can be performed within 120 minutes of the STEMI diagnosis. With a longer…

…below apply to adults unless otherwise stated, and paediatric doses are given per kilogram with the stated maximum. Always check against the local guideline and…

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

…severe piperacillin–tazobactam 4 g × 4 IV Exacerbation of COPD with an indication for antibiotics amoxicillin 750 mg × 3 PO 5–7 days or doxycycline…

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

…cardiac death (SCD) in young individuals and during exercise. The risk of ventricular arrhythmias correlates with the degree of hypertrophy, the extent of ventricular fibrosis…

…primary PCI is indicated in patients with symptoms suggestive of acute myocardial infarction and at least one of the following criteria present: haemodynamic instability or…

…Evaluation and Physical Examination A comprehensive evaluation is mandatory for patients presenting with sudden cardiac arrest (SCA) if the underlying cardiac disease is unknown or…

…statin therapy reduced LDL C by approximately 16.5%; the reduction in a subgroup with diabetes was approximately 19.1%. The drug also lowers hsCRP…