…other ECG changes (see below) should lead to a suspicion of ARVC. The gradual loss of myocardium leads to ventricular dilation and right heart failure…

…requirement for antihypertensives, should prompt clinical suspicion [1]. Cardiac Signs and Symptoms Patients often present with symptoms of predominant right heart failure, including lower extremity…

…replacement therapy Hypoperfusion with persistent organ injury Consider mechanical circulatory support Refractory advanced disease Consider palliative care Right ventricular failure is characterized by increased right…

…after pituitary surgery or radiotherapy, or with suspected suppression of the HPA axis after long term glucocorticoid treatment. A basal morning cortisol in the grey…

…Valve replacement can be performed with biological or mechanical prostheses. The former is preferred due to the lower risk of thrombosis and evidence demonstrating long…

…control centre for advice on the treatment threshold and on whether haemodialysis should be considered. Rhabdomyolysis with marked elevation of CK and threatened kidney injury…

…Commonest early on and at high doses Muscle weakness Steroid myopathy, with proximal weakness Red flags and pitfalls Stopping a corticosteroid abruptly after longer term…

…COPD. Adenosine has caused mild to moderate exacerbation of asthma symptoms. Adenosine should be used with caution in patients with obstructive lung disease or asthma…

…is flexed. The dorsum of the hand is suitable for finer cannulae. Avoid the lower limb in adults. In shock with collapsed vessels, the antecubital…

…with lower temperatures. Electrolyte replacement. Large infusions of fluids are typically needed. Table 1. Grading of hyperthermia. Body temperature should decrease at a rate of…

…Creatinine is a late marker of function and may rise only after a substantial fall in glomerular filtration. The value is affected by muscle mass…

…on the ventilator. See the article on confusion for the management of delirium in intensive care. Renal replacement therapy Absolute indications: refractory hyperkalaemia, refractory acidosis…

…mL/min/1.73 m² Abnormal urinalysis or renal imaging Risk of progression rises with proteinuria and depends on cause 2 60 mL/min/1…

…most patients with severe cardiovascular disease or in those who are otherwise haemodynamically unstable. The benefit of its administration in these patients should be carefully…

…and initiation of renal replacement therapy. The study found no significant differences between the two treatment groups with respect to either the primary or secondary…

…In patients with previous myocardial infarction and residual inflammation, defined by hsCRP ≥2 mg/L, it produced a modest reduction in a composite of cardiovascular…