Kardiologi Akutsjukvård Lathundar Overview Acute coronary syndrome comprises STEMI, NSTEMI and unstable angina. Management begins in parallel with the diagnostic work up. Obtain an interpretable…

…and circulation. 2. Give controlled oxygen with a target of 88 to 92 percent until the risk of hypercapnia has been assessed. 3. Take an…

…Definition and staging according to KDIGO Acute kidney injury is present when at least one of the following criteria is met [1]: A rise in…

…Moderate attack Acute severe attack Life threatening attack : : : : Speech Full sentences Cannot complete a sentence in one breath Single words or unable to speak Position…

…non inferior to alteplase with respect to an excellent functional outcome, without an increased risk of symptomatic intracerebral haemorrhage or death [3]. Acute overview 1…

…Syndrome Typical course Common or important causes Targeted examination : : : : Acute vestibular syndrome Acute or subacute onset, continuous dizziness lasting hours to days, often with nausea…

…Compared with classic type A dissection, aortic regurgitation, pulse deficits, and malperfusion are less frequent in type A IMH. IMH is classified anatomically according to…

…with or without diagnostic electrocardiographic abnormalities and with or without an acute rise in cardiac troponin. The spectrum ranges from symptom free presentation to persistent…

…adequate. For example, a patient with acute graft occlusion may report an abrupt reduction in walking distance before claudication, accompanied by moderate pain or paresthesia…

…are used to assess clinical risk. These instruments incorporate haemodynamic and respiratory variables such as tachycardia and hypoxaemia, together with age and comorbidities including active…

…occasionally difficult to differentiate right ventricular hypertrophy (RVH) from posterior acute ischemia. Both these conditions cause ST segment depressions in V1–V3 along with large…

…per day. Patches have no place in acute, unstable pain: the onset takes 12 to 24 hours and the offset just as long. Breakthrough dose…

…Bold text indicates agents commonly used to prevent or treat acute and subacute ventricular arrhythmias Classification of ventricular tachycardia (VT) Ventricular arrhythmia Definition and classification…

…to 17% when eGFR is below 30 mL/min/1.73 m2. In patients with relatively normal renal function, defined in the source material as…

…substantial proportion of patients with acute coronary occlusion (ACO) who present without diagnostic ST elevation, often resulting in delayed treatment. In response to these limitations…

…Myocardial Infarction) Acute coronary syndromes with significant ST segment elevations are classified as STE ACS . Virtually all cases of STE ACS lead to myocardial infarction…

…may be used to diagnose myocardial ischemia and infarction. Symptoms – Patients with acute myocardial infarction may present with typical ischemic chest pain, or with dyspnea…

…Milrinone as Compared with Dobutamine in the Treatment of Cardiogenic Shock. N Engl J Med 2021; 385:516 525 Indications Severe left ventricular failure, acute…

…a process known as atherothrombosis [2] . Atherothrombosis represents the acute, life threatening complication of coronary atherosclerosis. The transition from a quiescent plaque to a highly…

…There are three explanations as to why reciprocal ST segment depressions may be absent: There is no ECG lead with the opposite angle of observation…

…alone [2]. A markedly raised blood pressure without acute organ damage should as a rule not be lowered rapidly with intravenous drugs. Restart or optimise…

…in patients without contraindications. I A In the absence of ST segment elevation, primary PCI is indicated in patients with symptoms suggestive of acute myocardial…

…must also consider acute severe mitral regurgitation, mechanical complications, and ischaemia related ventricular failure as potential causes of shock. Patients with moderate to severe chronic…

…used as a de escalation strategy after a period of DAPT. The therapeutic objective is to reduce coronary thrombotic events without exposing the patient to…

…More than one mechanism may operate simultaneously. Some acute coronary events occur without an identifiable culprit thrombus. NSTE ACS generally reflects an imbalance between myocardial…

…ECG recordings Acute coronary syndromes are dynamic processes. Factors that promote thrombosis ( pro thrombogenic factors ) are constantly in a struggle with factors striving to lysate…

…60%, as compared with directly occluding the LAD. Hence it was believed that the muscle could be preconditioned (acclimatized, adapted) to ischemia from a distance…

…with acute STEMI may therefore display a normal LBBB pattern. LBBB may be caused by ischemia/infarction : There are numerous causes of LBBB, such as…

…to higher levels than cTnT during acute myocardial infarction. cTnI and cTnT have different molecular structures, which may affect their release into the blood as…

Indications Acute myocardial infarction. Unstable coronary artery disease. Stable angina pectoris. Secondary prophylaxis to prevent recurrence of cerebrovascular diseases, such as: Transient ischemic attacks (TIA…

…a 50 mL syringe with a three way tap — intraosseous flow requires pressure ; gravity is not enough. Lidocaine 10 mg/mL to anaesthetise the marrow…

…The T wave The transition from the ST segment to the T wave is smooth, as is the transition between phases 2 and 3 of…

…acute symptoms are dizziness (pre syncope), hypotension (chock), syncope, chest pain, heart failure and cardiac arrest. In cases with intermittent symptoms, it is important to…

…blood flow to the right ventricle, will also affect the inferior wall of the left ventricle in 90% of the cases. As compared with the…

…coronary disease, many of whom have a previous acute coronary syndrome. The available evidence supports consideration of low dose colchicine as an adjunct to, rather…

…and Pathophysiology Acute coronary syndromes (ACS) encompass a spectrum of clinical conditions characterized by a recent change in symptoms or signs, with or without electrocardiographic…

…Patients with previous acute coronary syndromes (ACS) Exercise stress testing is routinely performed after acute myocardial infarction in order to assess the presence of myocardial…

…patients with Non ST Elevation Myocardial Infarction (NSTEMI) and unstable angina (UA), which are collectively referred to as NSTE ACS (Non ST Elevation Acute Coronary…

…chest leads may indicate an acute occlusion in the LAD (left anterior descending artery). This ECG pattern is referred to as de Winter's ECG…

…and is particularly pronounced in patients experiencing acute STEMI. The severity of symptoms in STEMI patients, compared to those with Non ST Elevation Myocardial Infarction …

…T wave inversions without concomitant ST segment deviation (elevation or depressions) – is never a sign of acute ischemia. T wave inversions with concomitant ST segment…

…A Clinical Overview The evaluation of acute chest discomfort requires a systematic differential diagnosis, as the syndrome associated with ischemic heart disease is broader than…

…AAS is classified anatomically according to involvement of the ascending aorta: Stanford type A: involves the ascending aorta, with or without extension into the arch…

…primarily as a vasopressor. While detailed receptor pharmacology is not specified in the source material, it is utilised alongside inotropes in acute heart failure to…

…Clinical presentation and symptoms SCAD generally presents as ACS. Symptoms may therefore include acute chest pain or chest discomfort, with associated manifestations of myocardial ischaemia…

…to the broader spectrum of acute coronary syndromes, which may present with recent changes in symptoms or signs, with or without ECG abnormalities and with…

…commonly stated that approximately 80% of all cardiac arrests are caused by acute or chronic coronary artery disease, with the latter being the most common…

…influenced effects on the cardiovascular system. Acute exposure produces transient haemodynamic and myocardial effects, whereas sustained heavy consumption is associated with hypertension, coronary artery disease…

…pathophysiology Atrial fibrillation (AF) is the most frequent supraventricular arrhythmia in patients with acute coronary syndromes (ACS) and is also a common tachyarrhythmia requiring treatment…

…pressure. Renal and microvascular complications Renal involvement may manifest as deterioration in renal function and urinary abnormalities. Malignant hypertension may cause acute microangiopathy, with renal…

…temporally and clinically distinct complications of acute myocardial infarction (AMI): Early infarct associated pericarditis , which develops from several hours to approximately 4 days after infarction…

…although not every patient with an initial STEMI pattern has myocardial infarction as the final diagnosis. The underlying process usually involves acute thrombotic obstruction of…

…to recognize chest discomfort or dyspnoea as potentially indicating myocardial infarction, particularly in individuals with hypertension, diabetes or previous angina. Patients should be advised to…

…As in other acute coronary events, the thrombotic process is dynamic, with varying degrees of occlusion that may provide a window of opportunity for reperfusion…

…serious condition with a poor long term prognosis. The 5 year survival rate after hospitalization for heart failure is 60%, which is comparable to common…

…serious condition with a poor long term prognosis. The 5 year survival rate after hospitalization for heart failure is 60%, which is comparable to common…

…acute pericarditis (perimyocarditis), constrictive pericarditis, pericardial effusion and tamponade. Less common are cysts and tumors of the pericardium, as well as congenital malformations leading to…

…myocardial ischaemia with chest pain and ECG changes. Acute pulmonary oedema. Impaired consciousness. Synchronised cardioversion under sedation, at an energy level according to the local…