The NICE guidelines would advocate the use of fondaparinux in this scenario. Given the clinical details in this case it is unlikely that angiography will be performed in the next 24 hours and hence unfractionated heparin is not required. Acute …
The CHA2DS2-VASc for this patient is 3 – 2 for the transient ischaemic attack and 1 for being female. She should therefore be offered anticoagulation with warfarin. Atrial fibrillation: anticoagulation The European Society of Cardiology published updated guidelines on the …
Hypertension – step 4 K+ < 4.5 then spironolactone K+ > 4.5 then higher-dose thiazide-like diuretic This patient has reached step 4 in the NICE hypertension guidelines. As their potassium is less than 4.5 mmol/l spironolactone 25mg od should be …
By day four the CK-MB levels should have returned to normal from the initial myocardial infarction. If the CK-MB levels are elevated it would indicate a further coronary event Cardiac enzymes and protein markers Interpretation of the various cardiac enzymes …
Hypokalemia is the most important cause of ventricular tachycardia (VT) clinically, followed by hypomagnesaemia. Severe hyperkalaemia may cause VT in certain circumstances, for example in patients with structural heart disease, but it is not as common a cause as hypomagnesaemia. …
The echocardiogram shows a degree of left ventricular impairment. It is important an ACE inhibitor is started in such patients. This will help to both control her blood pressure and also slow the deterioration in her cardiac function. A beta-blocker …
If the patient has a prosthetic valve and endocarditis is suspected the initial therapy should consist of intravenous vancomycin + rifampicin + gentamicin. Infective endocarditis: prognosis and management Poor prognostic factors Staph aureus infection (see below) prosthetic valve (especially ‘early’, …
Slow influx of calcium is responsible for the plateau phase of the action potential Electrical activity of the heart Myocardial action potential Phase Description Mechanism 0 Rapid depolarisation Rapid sodium influxThese channels automatically deactivate after a few ms 1 …
These are classical findings of a circumflex occlusion. The table below shows how the changes correspond to the cardiac anatomy: ST elevation greater in lead II than in lead III with abnormal Q waves in II, III, and aVF Inferior …
The average reading is above the treatment threshold for patients below the age of 80 years. Treatment with a calcium channel blocker should therefore be started. Hypertension: diagnosis and management NICE published updated guidelines for the management of hypertension in …