…disorder characterized by persistently elevated plasma low density lipoprotein cholesterol (LDL C) from early life and a consequent excess risk of premature atherosclerotic cardiovascular disease …

…minute At least 110 per minute Bradycardia or arrhythmia PEF Over 50 percent of personal best or predicted 33 to 50 percent Under 33 percent…

…RATING LEVEL OF EXERTION COMMENT 6 No exertion at all 7 7.5 Extremely light exertion 8 9 Very light exertion For a healthy person…

…3]. A healthy person without diabetes therefore does not normally need investigation on the basis of an isolated, asymptomatic low sensor reading alone. Symptoms Autonomic…

…Severe impairment of gas exchange Hypotension, cool peripheries or rising lactate Circulatory compromise or an alternative diagnosis Silent or nearly silent chest Very severe airflow…

…symptoms are severe, refractory to guideline directed medical therapy, occur at a low level of exertion, or are associated with high event risk. The apparent…

…et al and Marijon et al , long term prevention of cardiac arrest at the population level is very difficult. Future efforts may be more successful…

…levels above 95%. Given the young age of these patients and the typically short periods of no flow and low flow, the early consideration of…

…Always follow the local protocol for exact infusion rates, electrolyte concentrations and level of care. This quick reference is intended primarily for adults and summarises…

…myocardial ischaemia or a falling level of consciousness. Unstable monomorphic VT with a pulse. Pre excitation with atrial fibrillation and a very rapid ventricular rate…

…High Obesity 35.0–39.9 II Very high Extreme obesity ≥40 III Extremely high BMI is useful for screening and population level risk estimation…

…the foundation of lipid lowering treatment for patients with chronic coronary syndrome, acute coronary syndrome (ACS), atherosclerotic peripheral arterial disease, and other very high risk…

…blood pressure reduction sufficient to reduce cardiovascular risk while preserving tolerability and daily function. Decisions should incorporate the confirmed blood pressure level, absolute cardiovascular risk…

…one or more of the following are present: Severe symptoms despite guideline directed antianginal treatment. Typical angina or dyspnoea at a low level of exertion…

…fractions and higher peak biomarker levels, compared to those without such conduction defects [12]. Sudden Cardiac Death (SCD) : In patients with a low ejection fraction…

…failure have preexisting hypertension. The relationship between blood pressure and outcome in older adults is not linear at very low pressures. Excessive reduction in diastolic…

…lipoprotein(a), very low density lipoprotein and chylomicron remnants. It is calculated as: Non HDL C = total cholesterol − HDL C Apolipoprotein B (apoB) reflects…

…rationale Bempedoic acid is an oral, small molecule lipid lowering agent used to reduce low density lipoprotein cholesterol (LDL C), particularly when statins cannot be…

…treatment, with a very low number needed to treat (NNT), indicating high effectiveness. Although BLS is primarily developed for out of hospital cardiac arrest (OHCA)…

…the cause of cardiac arrest, cardiopulmonary resuscitation (CPR) should be performed per standard guidelines. Cardiac arrests due to trauma are characterized by very low survival…

…recommended as the initial study in patients with low to moderate risk of CAD. In patients with a high to very high risk of CAD…

…Lp(a)] Very low density lipoprotein (VLDL) Chylomicrons and other triglyceride rich particles Thus, non HDL C provides a broader estimate of atherogenic cholesterol than…

…with a low muscle mass — the elderly, the undernourished, amputees, patients with hepatic cirrhosis — creatinine based eGFR substantially overestimates renal function. Staging of chronic kidney…

…and acute coronary syndromes (ACS). Its principal therapeutic objective is reduction of low density lipoprotein cholesterol (LDL C), the primary lipid target in contemporary secondary…

…the intensity of reflected sound waves. Structures with high echogenicity will reflect more ultrasound and appear brighter on the image. Structures with low echogenicity reflect…

…by contrast, is not a contraindication; the specimen may be taken even at very low platelet counts, followed by compression. Infection in the skin overlying…

…difficult. In patients with normal renal function, the occurrence of contrast induced AKI is negligible or very low. Risk rises substantially with chronic kidney disease…

…= normal flow; LF = low flow; HG = high gradient; LG = low gradient. Pathophysiology of aortic stenosis As aortic stenosis progresses, pressure conditions…

…to the ventricles. Conduction through the AV node is intentionally slow (due to the low concentration of gap junctions in AV nodal cells), which allows…

…is low. Notably, specificity increases when the septum bulges into the left ventricle (i.e. septal bulging ). Bedside echocardiography allows for immediate recognition of tamponade…

…has very low attenuation, and blood and myocardium have intermediate values. Iodinated contrast increases the attenuation of the blood pool and permits delineation of the…

…These tachyarrhythmias arise in the atria and are very rarely life threatening. Causes of tachyarrhythmia with wide QRS complexes (QRS duration ≥ 0.12 s): the…

… one of the most useful signs Low voltage on the ECG, electrical alternans Supportive; it does not exclude Diastolic collapse of the right atrium and…

…afterwards whether a nerve injury was caused by the injury or by the treatment. Indications A clinically or radiologically confirmed dislocation of the shoulder, elbow…

…0 No treatment Low No treatment High 1 Oral anticoagulation (warfarin or NOAK 1 is considered for male patients with a score of 1 or…

…of the RR interval (the time between two successive R wave peaks). However, it tends to overcorrect at high heart rates and undercorrect at low…

…from selected populations, frequently with low or intermediate ischemic risk and under representation of patients with STEMI or other very high risk features. Noninferiority studies…

…life threatening arrhythmias, and cardiac arrest after presentation are markers of very high risk. They require immediate escalation because the priority is to identify and…

…QTc interval Bazett's formula is several decades old and has been questioned because it performs poorly at low (<50) and high ( 100) heart rates…

…hypertension, cardiomyopathy and coarctation of the aorta. There are several ECG indexes, which generally have high diagnostic specificity but low sensitivity. These indexes were developed…

…individuals have developed a highly efficient left ventricle, capable of generating sufficient cardiac output at low heart rates. During vasovagal syncope (e.g during intense…

…sirolimus In transplantation, corticosteroids can promote insulin resistance, free fatty acid synthesis and very low density lipoprotein production. Cyclosporine raises LDL cholesterol, partly by reducing…

…is of paramount importance. In cardiac arrest due to asphyxia, the probability of return of spontaneous circulation (ROSC) is high but survival is very low…

…of idiopathic ventricular fibrillation and sudden cardiac arrest. This is a rather large increase in relative risk , but the absolute risk is still very low…

…a large change in TSH. During acute illness the TSH can be falsely low or high in the absence of thyroid disease; repeat it once…

…according to national CVD mortality rates: Low risk Moderate risk High risk Very high risk Correct selection of the country risk cluster is therefore essential…

…very late stent thrombosis compared with BMS. Modern DES have substantially lower thrombotic risk; contemporary durable polymer DES have reported stent thrombosis rates as low…

…with signs of life <28 °C Very severe hypothermia No signs of life <24 °C Actions in accidental hypothermia with cardiac arrest or cardiopulmonary depression…

…is very high, which explains the rapid impulse transmission in the network. Cells of the atrioventricular node, on the contrary, have a low density of…

…with low amplitude. Prenodal block is, however, uncommon. Prognosis of first degree AV block Isolated first degree AV block with normal QRS complexes has very…

…vascular calcification; female sex; low body mass index; larger arterial sheaths; greater intensity of procedural anticoagulation; complex coronary anatomy and technically difficult PCI. For peri…

…norepinephrine and/or inotropes are reserved for low output and hemodynamic instability. Evaluation and physical examination The objective of decongestion is clinical euvolemia rather than…

…changes.: Low voltage: large amounts of pericardial effusion will diminish the QRS amplitudes. Electrical alternans: The amplitude of the QRS complexes vary from one beat…

Procedurer Edrophonium is a very short acting cholinesterase inhibitor: the effect appears within less than a minute and has gone after 5–10 minutes. That…

…lavage An unprotected or unsecured airway in a patient with a reduced level of consciousness Gastric lavage Corrosive injury or suspected oesophageal perforation Gastric lavage…

…discussion: the ECG blog Myocardial ischemia and infarction Myocardial ischemia The definition of ischemia may appear trivial but it is actually a very complicated topic…

…adequately increase heart rate Chronotropic incompetence is an independent predictor of overall and cardiovascular mortality. The condition is very common among individuals with heart failure…

…lead (the upper lead). ECG 2 . Although the signal in the upper lead appears very disorganized, there are visible QRS complexes. The signal in the…

…begins in parallel with the diagnostic work up. Obtain an interpretable 12 lead ECG within 10 minutes of first medical contact, attach continuous rhythm monitoring…

…arrest, agonal breathing or cardiac arrest — intubate. Inability to protect the airway: a reduced level of consciousness not attributable to hypercapnia, marked swallowing difficulty, vomiting…