…is CCS, usually with recurrent angina. Approximately one fifth of clinically recognized ISR presentations are ACS. ISR may occasionally be associated with myocardial infarction. The…

…intervention while limiting major and clinically relevant bleeding. Long term antiplatelet therapy after STEMI is associated with approximately a 25% reduction in recurrent infarction, stroke…

…denotes treatment with aspirin plus a P2Y12 receptor inhibitor. In the setting of acute coronary syndrome (ACS), DAPT is used to reduce recurrent myocardial infarction…

…several overlapping processes: Recurrent or extensive MI with necrosis and scar formation Diffuse myocardial fibrosis Reversible ischemic dysfunction Chronic hypoperfusion with hibernating myocardium Post ischemic…

…and from secondary prevention, which addresses patients with established disease to reduce recurrent events and mortality. Risk factor modification is therefore directed at identifying individuals…

…diagnostic ECG, the ECG must be repeated, particularly with ongoing or recurrent pain [1,3,4]. This quick reference gives internationally established doses. Drug availability…

Procedurer Almost all nosebleeds arise from Kiesselbach's plexus on the anterior septum and stop with correctly performed compression. The reason compression nevertheless so often…

…left behind — which is the commonest cause of recurrence. Indications Condition Procedure : : Acute paronychia with fluctuance or visible pus Incision and drainage Acute paronychia without…

…Suspected atrial flutter with a rapid, regular ventricular rhythm in which the flutter waves are concealed. A recurrent unclear wide or narrow complex tachycardia in…

…Before audiometry or the fitting of a hearing aid. Recurrent otitis externa in which the wax retains moisture. Contraindications Absolute contraindications to irrigation: A known…

…pancreatic ascites. Therapeutic paracentesis: Tense ascites with abdominal discomfort, early satiety or respiratory compromise. Diuretic refractory or diuretic intolerant ascites, as recurrent treatment. Contraindications There…

…drainage: empyema, complicated parapneumonic effusion with a pH below 7.20, haemothorax, a symptomatic or large pneumothorax, recurrent malignant effusion (often combined with pleurodesis), and…

…to reduce a fracture dislocation or to miss a posterior dislocation. The exceptions are an obvious recurrent dislocation in a patient with known instability and…

…specific mutation present. For patients at elevated risk—such as those with a history of cardiac arrest, recurrent syncope despite beta blocker therapy, or markedly…

…specific mutation present. For patients at elevated risk—such as those with a history of cardiac arrest, recurrent syncope despite beta blocker therapy, or markedly…

…also influence prognosis. Major depression after infarction is associated independently with increased mortality, while inadequate emotional support is associated with recurrent cardiac events. One possible…

…associated with structural and functional ventricular abnormalities and progressive neurohormonal activation. The therapeutic rationale for disease modifying treatment is to reduce mortality, prevent recurrent hospitalization…

…recurrent symptoms, myocardial infarction, or other major adverse cardiovascular events. Complete revascularization is therefore considered an important therapeutic objective, particularly in patients with left ventricular…

…reduced repeat revascularization, and broadened the range of lesions amenable to PCI. Stent selection must nevertheless be integrated with lesion anatomy, clinical presentation, bleeding risk…

…in this setting. The duration of therapy requires an individualized balance between: Ischaemic risk, including recurrent myocardial infarction and stent thrombosis. Bleeding risk, particularly major…

…with first and recurrent atherosclerotic cardiovascular disease events. The strongest observed associations are with myocardial infarction and aortic valve stenosis; associations are less pronounced with…

…the absence of persistent ST segment elevation. This does not imply low risk: patients with NSTE ACS may have substantial myocardial ischaemia, dynamic ECG abnormalities…

…premature death, recurrent infarction and limb threatening complications. Among patients with established peripheral artery disease, those who stop smoking have approximately twice the five year…

…of cardiac arrest. Recurrent VT or VF after ROSC in a patient with a coronary risk profile should lead to consideration to perform early angiography.

…cause of left ventricular dysfunction among patients with atrial fibrillation and other supraventricular tachyarrhythmias. Moreover, ventricular tachyarrhythmias (including recurrent episodes of ventricular tachycardia) can also…

…of acute myocardial infarction. acute heart failure recurrent dynamic ST segment or T wave changes, particularly with intermittent ST segment elevation. I C Angiography within…

…which can be a manifestation of recurrent reflux to the level of the throat, though it remains a nonspecific finding. In patients presenting with angioedema…

…level, producing atrioventricular (AV) or intraventricular blocks. Isolated sinus bradycardia in the early hours following infarction may be associated with hemodynamic compromise. More broadly, bradyarrhythmic…

…vascular lesions. The interleukin 1β pathway, with downstream effects involving interleukin 6 and C reactive protein, has been a major therapeutic target. This concept…

…and reflects excessive retention of sodium and water, with expansion of both the intravascular and extravascular compartments. Heart failure is defined physiologically by the inability…

…syndrome lipid lowering recommendations. Acute coronary syndrome The period immediately following ACS is associated with particularly high risk of recurrent cardiovascular events. Intensive LDL C…

…with persistent or recurrent chest pain require repeat blood sampling even when an accelerated algorithm has already been initiated. Evaluation and Physical Examination Patients with…

…aorta: Stanford type A: involves the ascending aorta, with or without extension into the arch or descending aorta. Stanford type B: does not involve the…

…when treatment decisions remain uncertain. Secondary prevention Individuals with established clinical ASCVD require LDL C lowering to reduce recurrent major cardiovascular events, including myocardial infarction…

…heart failure. Recurrent ischemia or reinfarction. Ventricular tachyarrhythmia. Features suggesting systemic embolization. In patients with recurrent chest pain and hemodynamic compromise after MI, mechanical complications…

…major cardiovascular events. Acute coronary syndromes The period immediately after ACS is particularly vulnerable, with recurrent cardiovascular events concentrated early after discharge. Consequently, lipid lowering…

…ischaemia. The absence of obstructive disease therefore does not establish a benign diagnosis. ANOCA/INOCA is associated with recurrent symptoms, impaired quality of life, repeated…

…The phenomenon occurs in approximately 2%–3% of PCI procedures overall. It is particularly associated with intervention on degenerated saphenous vein grafts (SVGs), rotational atherectomy…

…maximally tolerated statin therapy and ezetimibe. For patients with a recurrent atherothrombotic event while receiving maximally tolerated statin therapy, an LDL C goal below 1…

…tear commonly develops at the interface between infarcted and viable myocardium. The incidence has fallen substantially with contemporary reperfusion, particularly primary percutaneous coronary intervention (PCI)…

…particularly when the clinical presentation is compatible with acute coronary syndrome. Recurrent or persistent symptoms should prompt repeat ECG acquisition and consideration of additional leads…

…attempted recanalization of a chronic total coronary occlusion. Angina or ischaemia with non obstructive coronary arteries (ANOCA/INOCA), after appropriate investigation has identified the relevant…

…these events. Clinical presentation and symptoms Most patients with stent thrombosis present with ACS. Clinical manifestations therefore commonly include recurrent myocardial ischaemia, recurrent infarction, or…

…ischemia and infarction Definition and Pathophysiology Unstable angina (UA) is an acute coronary syndrome characterized by myocardial ischaemia occurring at rest or with minimal exertion…

…with recurrent syncope of unknown etiology. This test should be performed under continuous ECG and blood pressure monitoring and must be avoided in patients with…

…neurological injuries. 30% die from hemodynamic failure and multiorgan dysfunction. 10% die from recurrent arrhythmias. To monitor and evaluate the victim after ROSC, the following…

…prophylaxis to prevent recurrence of cerebrovascular diseases, such as: Transient ischemic attacks (TIA). Stroke Contraindications Cross reactivity: Do not administer to patients with a history…

…fibrillation (VF). ECG 6 . Delivery of shock, followed by asystole. ECG 7 . Asystole after shock. ECG 8 . Recurrence of supraventricular rhythm. ECG 9 . Supraventricular rhythm.

…tachycardia. ECG 3 . Spontaneous termination of the ventricular tachycardia. ECG 4 . Recurrence and spontaneous termination of ventricular tachycardia. ECG 5 . Polymorphic ventricular tachycardia, self terminating…

…stasis dermatitis. Prevention of recurrence after a healed venous ulcer. After deep vein thrombosis with post thrombotic syndrome. Differential diagnosis Feature Venous ulcer Arterial ulcer…

…Lathundar Definition and aims of treatment Convulsive status epilepticus in adults is present with: an ongoing generalised tonic clonic seizure lasting at least 5 minutes…

…perform systematic interpretation may actually be detrimental. We have therefore compiled a pocket guide with a universal interpretation algorithm. These 22 pages includes all you…

…acute myocardial infarction, pericarditis/myocarditis or pulmonary embolism is often a reversible arrhythmia with low risk of recurrence. Atrial fibrillation in other circumstances (particularly those…

…ECG 9 . Delivery of shock (red arrow), with subsequent asystole. ECG 10 . Recurrence of supraventricular complexes (red arrows). ECG 11 . Relapse of VF and new…

…when the shock is delivered, and that the thromboembolic risk has been dealt with before the atria begin to contract again. An unsynchronised shock that…

…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…

…a pause. Position the patient semi recumbent with the chin slightly towards the chest — an extended neck directs the tube towards the larynx. Procedure 1…

…the only absolute indication, and always urgent. A large pericardial effusion with symptoms despite medical treatment. Diagnostic drainage in suspected purulent pericarditis, tuberculosis or malignancy…

…mmHg for 15 minutes, or a need for a vasopressor), obstructive shock or cardiac arrest with suspected pulmonary embolism. Urgent bedside echocardiography, looking for right…

…AF with rapid ventricular response is particularly important. Cardioversion is generally not immediately indicated if the patient remains significantly decompensated, because recurrence is frequent while…