خطوات فى طريق السعادة
https://tatwwiraldhat.blogspot.com/2024/08/blog-post_22.html

تريد دخل يومي ادخل 💲💲💸💲

https://www.tg-me.com/RichQuestBot/app?startapp=7016834231

اسرع دواء وريد لخفض الضغط في الطوارئ هو ال
Nitroprusside

وأبطأ دواء هو ال
Labetalol
بياخد حوالي ١٠ دقايق حتى يبدا مفعوله

#cardionotes

New 2024 ESC guidelines

1-AF

https://drive.google.com/file/d/15nQsJjk8pXTF9qkRxjpBrI-HecWBqjd-/view?usp=drivesdk

2-Aortic and PAD

https://drive.google.com/file/d/15ojoMmxYnU7vqyQA3IwwwkiBUcIBKTTu/view?usp=drivesdk

3-HTN

https://drive.google.com/file/d/15jdVZujdw-qvT-F74gCZ2kXS4z-XIAqQ/view?usp=drivesdk

4-CCS

https://drive.google.com/file/d/15pbRJRtNzNOhqjWTYqg5QGln8MwxdnUi/view?usp=drivesdk
New ESC GUIDLINES
Published Today during ESC CONGRESS, LONDON

#DKA_HHS treatment

#Clinical_Practice guidelines:
#Cardiogenic_shock (CS)
is a clinical syndrome characterized by a primary cardiac disorder that results in both clinical and biochemical evidence of tissue hypoperfusion due to an inadequate cardiac output (CO), that may result in multi-organ failure and death.

✅ The presence of clinical signs of hypoperfusion (i.e. cold clammy extremities, oliguria, mental confusion, dizziness and narrow pulse pressure)

✅ biochemical manifestations of hypoperfusion (i.e. elevated serum creatinine, metabolic acidosis and elevated serum lactate)👉 is crucial for the diagnosis, while hypotension (systolic blood pressure [BP] <90mmHg), 👉that is often the primary clinical manifestation of CS.

اي مريض AF بترجعه ل sinus rhythm بيمشي على AC على الاقل لمدة اربع اسابيع ثم يتم تقييم الحالة علشان نحدد هتوقف دواء السيولة ولا يكمل حسب ال
CHA2DS2VA score

المريض الوحيد اللي ممكن مياخدش دواء سيولة
هو المريض اللي بيرجع في خلال ٢٤ ساعه والاسكور بتاعه زيرو

#cardionotes

🔴 Finerenone in Heart Failure with Mildly Reduced or Preserved Ejection Fraction
https://www.nejm.org/doi/full/10.1056/NEJMoa2407107

⚫️ Background
• Steroidal antagonists improve outcomes in HFrEF.
• Efficacy in mildly reduced or preserved ejection fraction is unknown.

⚫️ Methods
• Double-blind trial with patients having ejection fraction ≥40%.
• Patients were randomly assigned to finerenone (20 or 40 mg daily) or placebo.
• Primary outcome: composite of worsening heart failure events and cardiovascular death.

⚫️ Results
• Median follow-up: 32 months.
• Primary outcome events: 1083 (finerenone) vs. 1283 (placebo); rate ratio 0.84 (P=0.007).
• Worsening heart failure events: 842 (finerenone) vs. 1024 (placebo); rate ratio 0.82 (P=0.006).
• Cardiovascular deaths: 8.1% (finerenone) vs. 8.7% (placebo).

⚫️ Conclusions
• Finerenone significantly reduced heart failure events and cardiovascular deaths compared to placebo.
• Increased risk of hyperkalemia, reduced risk of hypokalemia.

@Cardiology_Updates

​​🔴 2024 ESC Guidelines on management of Atrial Fibrillation

The 2024 guidelines stress the importance of optimal care according to the new AF-CARE pathway, which has been designed to ensure that each and every patient with AF can benefit from recent scientific advances:

▪️ C - Comorbidity & risk factor management
▪️ A - Avoid stroke and thromboembolism
▪️ R - Reduce symptoms by rate & rhythm control
▪️ E - Evaluation & dynamic reassessment. 


@ESC_2024

Interpretation Carcinoembryonic Antigen, CEA

Normal
Non-smokers: <2.5 mg/ml
Smokers: <5 ng/ml

Increased
Benign disease unlikely if >10 ng/ml
Distant metastasis most likely if >100 ng/ml

13#_حاله يفضل فيها الماريفان عن الادويه الحديثه
#Conditions_where warfarin is still preferred over DOACs
1.mechanical valve
2. Rheumatic Mitral valve stenosis (MS) with Atrial Fibrillation
3. Rheumatic MS with previous cardioembolic episode
4. Rheumatic MS with left atrial thrombus
5. Non Rheumatic MS (moderate/severe) with Atrial Fibrillation
6.Switching from DOAC for anticoagulation in pregnancy if managed with a dose of warf <5mg/day.
7. Very High BMI
8. Frail elderly who is stable on warf to be continued on warf ( FRAIL-AF & AGS Beers 2023)
9. DOAC failure
10.Antocoagulation during breastfeeding.
11. Anticougulation for thromboembolism in CIRRHOSIS Child Pugh C- warfarin
For Child Pugh A & B - DOAC
12.Antiphospholipid syndrome
13. post LVAD


#تعال_استفيد

فضلا وليس امرا تابعو هذي صفحه معلومات طبية 👇

https://www.facebook.com/share/p/b7Gt4uRFnM1mtY2U/?mibextid=WC7FNe

#Just_remember
#Hypokalaemia_with_hypertension
 🔰 Cushing's syndrome    
 🔰Conn's syndrome (primary  hyperaldosteronism)  
 🔰 Liddle's syndrome  autosomal dominant disorder that mimics hyperaldosteronism
 🔰renal artery stenosis
 🔰11-beta hydroxylase  deficiency*
 🔰Carbenoxolone, an anti ulcer drug, and liquorice excess can potentially cause hypokalaemia associated with  hypertension

#Hypokalaemia_without_hypertension
 ✏️diuretics
 ✏️GI loss (e.g. Diarrhoea,  vomiting)
 ✏️renal tubular acidosis (type 1 and 2 )
 ✏️Bartter's syndrome
 ✏️Gitelman syndrome



Protect your kidneys ,save your heart ❤️.
#Love_Medicine

@Mmaqqy777_bot
@Medical_Channel_222