…LDL C reduction required is greater than can reasonably be obtained with a statin alone but does not necessarily require the larger effect of a…

…angiography or PCI; cardiogenic shock; ST segment elevation myocardial infarction; extensive vascular calcification; female sex; low body mass index; larger arterial sheaths; greater intensity of…

…conceptual framework Acute coronary occlusion is the abrupt or progressive reduction of coronary blood flow sufficient to produce myocardial ischaemia and, when prolonged or severe…

…left ventricle is many times larger than the vector generated by the right ventricle, the QRS complex is actually a reflection of left ventricular depolarization…

…to patients with symptoms. Current guidance supports revascularisation for significant left main stenosis irrespective of symptomatic status or the documented ischaemic burden. In chronic coronary…

…many studies, although the relative advantage of apoB over non HDL C or standard lipid testing remains unsettled. In a large population study, LDL C…

…due to diminished automaticity (pacemaker function) in the sinoatrial node or conduction defects (e.g. second degree AV block) as a result of ischemia/infarction…

…a one quarter reduction in major cardiovascular events over 7 years compared with a low fat diet. In primary prevention, a large randomized trial involving…

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

…symptoms Typical SAMS consists of: Symmetric muscle pain Muscle aching or soreness Weakness, often perceived or functional Predominant involvement of large proximal muscle groups Symptoms…

…Atherosclerotic lesions commonly arise at sites of disturbed flow, including branch points in the epicardial coronary arteries. Early lesions may undergo positive or compensatory remodelling…

…The first half of the P wave is therefore a reflection of right atrial activation and the second half is a reflection of left atrial…

…the extent of reduction in cardiac output and arterial pressure and may include: Chest discomfort Fatigue Weakness Presyncope or syncope Exercise intolerance Symptoms of shock…

…parameter of the stress test. The ECG reaction is indeed important but several other parameters are equally important. In fact, a large body of evidence…

…negligible, and doses do not require reduction in patients with renal disease; neither amiodarone nor desethylamiodarone is dialyzable. The volume of distribution is large, averaging…

…Indications Acute urinary retention. Chronic urinary retention with renal impairment or a large residual volume. A need for accurate measurement of urine output in a…

…In a large network meta analysis, 3 month DAPT, but not 6 month DAPT, was associated with higher rates of myocardial infarction or stent thrombosis…

…or supranormal ejection fraction , despite manifest heart failure and severe symptoms. These individuals exhibit pronounced hypertrophy, resulting in a reduction of ventricular volume and subsequently…

…from the conjunctiva or the cornea. Never use a cotton bud on an embedded corneal foreign body — it scrapes away a large area of epithelium…

…haemorrhage control) planned in advance. A history of a severe transfusion reaction: contact transfusion medicine before transfusing again. Preparation and equipment Compatibility testing Test What…

…G, 25 mm 90° 1–2 mL Deltoid, BMI 35 or a large arm 23 G, 38 mm 90° 1–2 mL Vastus lateralis, infant…

…the left ventricle is usually considerably larger than the right ventricle, the QRS complex is actually a reflection of the electrical potentials generated by the…

…blood pressure reduction may also occur in selected people whose pressure is elevated but below the conventional hypertension threshold. The traditional diagnostic threshold of 140…

…The first half of the P wave is therefore a reflection of right atrial depolarization and the second half is a reflection of left atrial…

…generally results from abrupt reduction in coronary blood flow caused by thrombotic occlusion of a previously atherosclerotic artery. Plaque erosion or rupture exposes thrombogenic material…

…artery. Depending on the size and form of the thrombus, it will occlude the main pulmonary artery or its branches. The larger the thrombus, the…

…is weak, particularly for intermediate lesions. Even lesions with a visual diameter reduction of 50–70% may or may not produce ischaemia. Conversely, some lesions…

…Refraction artifact Reflection and refraction occur when ultrasound passes tissue boundaries. Tissue boundaries represent acoustic reflectors at which some of the ultrasound energy is reflected…

…imbalance Hypercalcemia Definition : P/S Ca 2+ 2.6 mmol/L In approximately 90% of cases, hypercalcemia is attributed to primary hyperparathyroidism or neoplastic etiologies…

…compromise or skin tenting — reduce promptly, before radiography. The longer a joint remains dislocated, the harder the reduction becomes and the greater the risk of…

…a fairly good estimate of the actual workload. The perceived exertion may be graded from 0 (none) to 10 (maximal exertion) or according to the…

…or partial, depending on the size of the thrombus and the plaque. The patient will experience severe chest pain due to the abrupt reduction of…

…designed to identify ischemic areas of the myocardium by highlighting regions with reduced blood flow. Radiotracers for SPECT Technetium 99m (Sestamibi or Tetrofosmin): With a…

…or even reduce infarct size, which is generally attributed to its reduction of heart rate and contractility. But as it turns out, [2] the reduction…

…risk of hypercapnia has been assessed. 3. Take an arterial blood gas in respiratory compromise, low saturation, suspected carbon dioxide retention, reduced consciousness, or when…

…and parasympathetic influences; sympathetic stimulation leads to vasoconstriction through the release of norepinephrine, while parasympathetic activation can cause vasodilation via acetylcholine release. These mechanisms collectively…

Echocardiography Generating the ultrasound image The ultrasound transducer generates short bursts (pulses) of ultrasound waves. Reflected ultrasound waves are analyzed by the machine during the…

…are complementary objectives of initial STEMI management. The principal acute complications fall into two broad categories: Electrical complications , particularly ventricular arrhythmias. Mechanical or pump failure…

…apex (which is fixed to the diaphragm via the pericardial sack), while the myocardium travels towards the center of the cavity and the entire ventricle…

…inversion of the T waves. These T waves are called post ischemic T waves and they indicate that the infarction process is more or less…

…lowering alone. Meta analyses have shown that the risk reduction in MACE is largely independent of baseline HbA1c or the magnitude of HbA1c reduction. 7…

…occurs after an abrupt reduction or cessation of prolonged and heavy alcohol intake. The condition can develop despite a measurable or high blood alcohol concentration…

…Assessment should integrate the history, physical examination, laboratory data and diagnostic testing. Examination for congestion Useful bedside indicators of persistent or improving congestion include: J

Akutsjukvård Lathundar Basic principle Anaphylaxis is a rapidly developing systemic hypersensitivity reaction that can cause life threatening compromise of the airway, breathing or circulation. Skin…

…of hypertension is not made on a single reading. It requires repeated measurements on at least two occasions, and preferably confirmation by home measurement or…

…a cerumen loop. Suction with Frazier tips of various sizes. A balloon catheter (a 5–6 Fr Fogarty or a Katz extractor). A local anaesthetic…

…crisis. Mechanism of action Phentolamine is a non selective alpha adrenergic blocker. Phentolamine reduces blood pressure while increasing catecholamine activity. Effects Primarily causes afterload reduction…

…pathophysiology Acute limb ischaemia (ALI) is an abrupt reduction in arterial perfusion of an upper or lower limb that causes tissue metabolic requirements to exceed…

…effect of a coronary lesion depends on more than its visual diameter reduction. Relevant determinants include: Lesion eccentricity Vessel tortuosity Calcification Plaque rupture or asymmetric…

…was related to the magnitude of heart rate reduction. Ivabradine is also a reasonable consideration when a beta blocker cannot be tolerated or is contraindicated…

…mm Hg systolic or 90 mm Hg diastolic (140/90 mm Hg). The discordance between optimal blood pressure and the definition of hypertension is explained…

…May therefore induce or worsen angina pectoris. The rapid reduction of afterload is desired in conditions requiring afterload reduction. Time to onset of action 10…

… and A reduction of at least 50% from baseline. In patients who experience a recurrent atherothrombotic or cardiovascular event within 2 years while receiving maximally…

…the unit. Preparation and equipment A device capable of both CPAP and bilevel ventilation, or alternatively flow generated CPAP with a PEEP valve. Masks in…

…associated with increased ASCVD risk. Management in this range therefore focuses principally on ASCVD prevention and reduction of LDL C, non HDL C and apolipoprotein…

…Indications Decompression in ileus, subacute obstruction or gastric retention — the commonest indication on a surgical ward. Decompression in severe vomiting where the stomach does not…

…benefits of cessation The principal benefits relevant to clinical cardiology include: Clinical setting or outcome Reported benefit of cessation Cardiovascular disease overall Substantial reduction in…

…a drop in blood pressure, and finally a reduction in heart rate. This sequence is characteristic of neurally mediated hypotension. Clinical Presentation and Symptoms Vasovagal…

…mutations in SCN5A lead to a reduction in the inward sodium current ($I {Na}$) and are identified in 20% to 30% of probands [7] …

…initiation of an ACE inhibitor to prevent symptomatic hypotension. Diagnostics The source material does not cover specific diagnostic modalities such as ECG, imaging, or electrophysiology…