…interneurons in the pretectal area activate the Edinger–Westphal nuclei. Parasympathetic fibers (carried by CN III) then prompt sphincter muscles in the iris to constrict…

…altering lipid concentrations, blood pressure or other conventional risk factors. Colchicine is an established anti inflammatory drug that may inhibit inflammasome activity, reduce interleukin 1…

…structural heart disease). AVNRT, AVRT (WPW syndrome) and other conditions involving an accessory pathway. Paroxysmal atrial fibrillation in patients with severe symptoms, provided that first…

…Chronic coronary syndromes (CCS) comprise the clinical manifestations of chronic structural and/or functional disease involving the epicardial coronary arteries and/or the coronary microcirculation…

…of these have atherosclerotic heart disease (coronary artery disease) as the underlying cause. Other common causes are cardiomyopathy (hypertrophic or dilated), arrhythmogenic right ventricular cardiomyopathy…

…VF) and pulseless ventricular tachycardia (VT). The bradyarrhythmias include all bradyarrhythmias, pulse less electrical activity (PEA), and asystole. Bradyarrhythmias are discussed in the chapter Management…

…when recording during chest pain is not consistent with myocardial ischemia. In other words, chest pain caused by ischemia will always result in ischemic ST…

…radiotracers emit positrons. When a positron collides with an electron, they annihilate each other, producing two gamma photons emitted in opposite directions. PET scanners detect…

…An ECG lead is a graphical description of the electrical activity of the heart and it is created by analyzing several electrodes. In other words…

…from each other. This condition is referred to as atrioventricular (AV) dissociation. Importantly, for the ventricles to have any electrical (and thus pumping) activity at…

…alcohol, a missed meal, physical activity and any other precipitating factor. Thresholds The thresholds below are used above all in diabetes. The severity of the…

…of error is believing that it is. Twitching of the chest muscles and spikes on the screen mean nothing. Capture is verified only when every…

…activity may lead to progressive functional decline, sedentary behaviour and loss of independence. Identification of PAD also provides an opportunity to recognise atherosclerosis in other…

…activity. Patients with VA are generally younger than those with atherosclerotic non ST elevation acute coronary syndromes. Cigarette smoking is a prominent association, whereas other…

…High altitude sickness Aspiration Chronic obstructive pulmonary disease (COPD) Bronchospasm (asthma) Other : Coma Central hypoventilation syndromes Neuromuscular diseases Anemia The natural course of asphyxia Should…

…may precede the full tachycardia. It is characterized by short, rapid bursts of atrial activity. In the majority of cases, the arrhythmia is self limiting…

…of the nine parameters listed above. Many of the diagnoses mentioned below are discussed in detail in other chapters, to which links are provided throughout…

…fibrillation, ventricular tachycardia, and other tachyarrhythmias with discernible QRS complexes. Shockable rhythm : Tachyarrhythmias that can be treated with defibrillation (ventricular fibrillation) or cardioversion (ventricular tachycardia)…

…multiple arterial territories. The arterial wall is biologically active. Endothelial and smooth muscle cells normally regulate vascular tone, preserve an antithrombotic surface, and control the…

…organ hypoperfusion. In severe cases, bradycardia may progress to bradyarrhythmic arrest or pulseless electrical activity (PEA), presenting as cardiovascular collapse and cardiac arrest. Evaluation and…

…via the autonomic nervous system. It attenuates carotid sinus baroreceptor activity and acts centrally and peripherally to enhance vagal tone. These sympatho inhibitory effects decrease…

…Other causes include acute mechanical complications—particularly ventricular septal defect (VSD) and papillary muscle rupture with acute severe mitral regurgitation—predominant right ventricular (RV) infarction…

…environmental factors and genetic background. Thrombotic susceptibility is likewise affected by inflammation and other systemic influences. The severity of myocardial injury is determined not only…

…hypertension, dyslipidaemia, obesity, smoking and other conventional risk factors, together with diabetes specific vascular and metabolic abnormalities. Diabetes is associated with inflammation, thrombosis and accelerated…

…metabolic disorders, hypoxemia, antiarrhythmic drugs, or electromagnetic disturbance caused by other machines/devices. Below follows ECG tracings demonstrating each type of failure. Figure 1. Failure…

…scarce). Indeed, the strongest risk factor for developing atrial fibrillation is age. Other significant risk factors are as follows: male sex, hypertension, left ventricular hypertrophy…

…it is exhaled. The final partial pressure of carbon dioxide in exhaled air represents the sum of ventilation, metabolic activity, and perfusion. Increased aerobic metabolism…

…which is synonymous with tachyarrhythmia. Except for sinus tachycardia during physical activity, all tachycardias should be considered pathological and the task is to clarify the…

…under baseline conditions. Raw Image Analysis : Raw images are reviewed to identify potential artifacts, extracardiac tracer activity, and assess image quality and patient motion. Alignment …

…the lowest heart rate allowed by the pacemaker; intrinsic cardiac activity below the base rate will trigger pacing. The base rate is usually set to…

…of sinus tachycardia are as follows: Normal (physiologic) sinus tachycardia: The automaticity (rate of spontaneous depolarization) in the sinoatrial node is increased during physical activity…

…part via NMDA receptors. With prolonged alcohol exposure the nervous system adapts through reduced GABA mediated inhibition and increased glutamatergic activity. When the alcohol level…

…tends to occur in vessels with little or no lipid core, rich proteoglycans, and many smooth muscle cells, leading to a white, platelet rich thrombus…

…into ventricular fibrillation at any age. Exercise, or any other activity causing adrenergic stimulation, increase the risk of syncope, ventricular arrhythmias and sudden cardiac arrest…

…arrest. Within the context of pregnancy, hypovolemia and other etiologies of hypotension remain the predominant causes of cardiac arrest. Should cardiac arrest occur postpartum, hemorrhage…

…in these scenarios, it should not be considered abnormal. On the other hand, sinus bradycardia developing during physical exercise is considered abnormal, because heart rate…

…cases, the likelihood of ROSC is higher as compared to other etiologies and presentations. Asystole and pulseless electrical activity (PEA) often have other etiologists, but…

…complex fibroatheroma. Smooth muscle cells (SMCs) migrate from the tunica media into the intima, driven by platelet derived growth factor (PDGF) and other cytokines. Within…

…His Purkinje fibers), abnormal automaticity (in contractile myocardium), re entry (anywhere) or triggered activity (anywhere) may all cause ventricular arrhythmias. Indeed, any cell type in…

…with other forms of ventricular tachycardia. Mechanisms of ventricular tachycardia Ventricular tachycardia (VT) may emerge due to increased/abnormal automaticity, re entry or triggered activity…

…the leads. Some leads may display all waves, whereas others might only display one of the waves. Regardless of which waves are visible, the wave…

…Akutsjukvård Lathundar Key messages Two things set the COPD exacerbation apart from many other causes of acute dyspnoea: oxygen must be titrated cautiously and the…

…plaque. Upon such damage, the plaque exposes highly thrombogenic materials which activate circulating platelets and coagulation factors, which results in thrombus formation (Figure 1). Disruption…

…risk of symptomatic intracerebral haemorrhage or death [3]. Acute overview 1. Activate the stroke call. 2. Establish the time of symptom onset or the time…

…and perforation occur. If you find one magnet, actively look for another , in the other nostril, in the ears and in the mouth. Nose 1…

…or suspected variceal bleeding, also contact a gastroenterologist with hepatology expertise 9 Activate the local major haemorrhage protocol in uncontrolled bleeding, shock or a rapid…

…aerobic activity; or 75–150 minutes per week of vigorous intensity aerobic activity; or An equivalent combination of moderate and vigorous intensity activity. Muscle strengthening…

Arrhythmias and arrhythmology Pharmacology & dosing Definition and Pathophysiology Sotalol is a nonselective beta adrenoceptor blocker devoid of intrinsic sympathomimetic activity that also prolongs cardiac repolarization…

…minutes is the practical threshold for treatment, known as t1. After about 30 minutes of continuous convulsive activity, t2, the risk of permanent neuronal injury…

…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…

…pattern. However, this well recognized pattern can be significantly altered when atrial activation is modified by cardiac surgery involving atrial tissue, extensive prior radiofrequency ablation…

…anxiety Depression or psychological distress Loss of confidence in resuming normal activity Difficulty returning to work or recreational exercise Frailty or loss of muscle mass…

…clearance of circulating LDL cholesterol (LDL C). Increased PCSK9 activity therefore contributes to higher LDL C concentrations. The genetic evidence provides the rationale for therapeutic…

…and drug induced reactions. Approximately 90% of anaphylactic cardiac arrests present with pulseless electrical activity (PEA) as the initial rhythm, while the remainder manifest ventricular…

…spontaneous cardiac rhythm. The likelihood of achieving spontaneous cardiac activity is a function of the duration of circulatory standstill and the underlying cause, as elaborated…

…arrhythmia unit. Assessment of the effect of adenosine, which can be given during the recording and unmask the atrial activity. The investigation is diagnostic, not…

…The hypotensive effect of enalaprilat depends on plasma volume and plasma renin activity. Volume depletion and high plasma renin activity increase the effect of enalaprilat…

…activates vascular smooth muscle potassium channels to produce vasodilation. Although primarily defined by these mechanisms, levosimendan also exhibits some type 3 phosphodiesterase inhibitor (PDEI) activity…

…nervous system activity Improvement in cardiac metabolic efficiency, including increased oxygen delivery and beta hydroxybutyrate oxidation Reduced sodium hydrogen exchanger subtype 3 activity Attenuation of…

…plaque stability, thrombogenic responses and immune activity. Statin intolerance refers to adverse effects attributed to statin treatment that improve or resolve after reducing the dose…