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…

…the COPD exacerbation apart from many other causes of acute dyspnoea: oxygen must be titrated cautiously and the blood gas determines the need for ventilatory…

…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…

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

…CT of the brain Exclude intracerebral haemorrhage and assess early ischaemic changes CT angiography The standard investigation in acute stroke to identify large vessel occlusion…

…present, neurological examination, gait and truncal stability Acute balance syndrome Acute persistent unsteadiness or ataxia without clear spontaneous nystagmus Cerebellar or brainstem infarction, intoxication, Wernicke…

Cardiology Emergency medicine Definition and Pathophysiology Acute aortic syndromes comprise classic aortic dissection, intramural haematoma (IMH), and penetrating atherosclerotic ulcer (PAU). Aortic dissection accounts for…

…in symptoms or clinical signs, with or without diagnostic electrocardiographic abnormalities and with or without an acute rise in cardiac troponin. The spectrum ranges from…

Clinical medicine Emergency medicine Definition and pathophysiology Acute limb ischaemia (ALI) is an abrupt reduction in arterial perfusion of an upper or lower limb that…

…The classification of acute PE comprises four clinically useful groups: High risk PE , also termed massive PE, is defined by haemodynamic instability and represents approximately…

Myocardial ischemia and infarction ECG Posterior (posterolateral) acute myocardial infarction (STEMI) The heart is rotated 30° to the left in the thorax. This positions the…

…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…

…Williams classification (Table 1). Agents in bold text are commonly used to prevent or treat acute and subacute ventricular arrhythmias. The Singh Vaughan Williams classification…

Adapted from AHA, ACC and ESC guidelines.

…is often more rapidly reversible than that of other forms of acute tubular necrosis, although the complication remains associated with post procedural morbidity and mortality…

ECG Introduction The traditional classification of acute coronary syndromes (ACS) into ST segment elevation myocardial infarction (STEMI), non STEMI (NSTEMI), and unstable angina (UA) has…

…of the thrombus and the plaque. The patient will experience severe chest pain due to the abrupt reduction of coronary blood flow. Acute coronary syndromes…

ECG Myocardial ischemia and infarction Acute Myocardial Infarction: Definition & Criteria Acute myocardial infarction is the most severe complication of coronary artery disease. The most common…

…patients with unknown etiology for acute severe heart failure. A recent echocardiographic examination should be available or performed urgently to evaluate ventricular and valvular function…

…ACS Classification The clinical spectrum of Acute Coronary Syndromes encompasses Unstable Angina (UA), Non ST Elevation Myocardial Infarction (NSTEMI), and ST Elevation Myocardial Infarction (STEMI…

…and infarction ST segment elevation in acute myocardial ischemia ST segment elevations with straight (horizontal, upsloping, or downsloping) or convex ST segment strongly suggest acute…

…blood pressure without acute organ damage should as a rule not be lowered rapidly with intravenous drugs. Restart or optimise oral treatment and ensure follow…

…primary PCI is indicated in patients with symptoms suggestive of acute myocardial infarction and at least one of the following criteria present: haemodynamic instability or…

…haemodynamically unstable patients, evaluation must also consider acute severe mitral regurgitation, mechanical complications, and ischaemia related ventricular failure as potential causes of shock. Patients with…

…aspirin and an oral P2Y12 receptor inhibitor. It is central to the prevention of platelet mediated coronary thrombosis after acute coronary syndrome (ACS) and percutaneous…

…s morphology does not reliably establish that it will cause an acute event. A more clinically useful model considers both the plaque and the patient…

…for interpretation of ischemia. All available ECG criteria for acute myocardial infarction and ischemia are based on conventional 12 lead ECG. Established ECG criteria do…

…In reality, the course in acute myocardial infarction (AMI) is modified by several factors. The most important of these, and their implications, are as follows…

…on ECG. In summary, left bundle branch block (LBBB) can result from, mimic, or obscure acute myocardial ischemia and infarction, creating significant diagnostic challenges. These…

…detecting troponins in patients with suspected acute coronary syndromes. Several manufacturers have developed highly sensitive troponin assays for troponin I (cTnI) and troponin T (cTNT)…

…effects of cyclosporine and tacrolimus. Monitor kidney function. Diuretics and antihypertensives: NSAIDs may reduce the efficacy of diuretics and antihypertensives. Risk of acute kidney injury…

Procedurer In acute circulatory failure it is not the number of cannulae that matters but the flow per unit time . A large bore, short cannula…

…familiar with the classification of acute coronary syndromes. Subsequent chapters will deal with ST segment elevation myocardial infarction (STEMI) and non ST segment elevation myocardial…

…non acute or asymptomatic bradyarrhythmia. In patients presenting with intermittent symptoms of bradycardia, it is fundamental to establish a temporal correlation between the symptoms and…

…The left ventricle is considerably thicker and – except the endocardium – it cannot utilize the oxygen from within the ventricular cavity. The location of acute myocardial…

…and patient populations The evidence for anti inflammatory treatment in coronary disease has principally involved two populations: Patients recently recovering from myocardial infarction or acute…

Myocardial ischemia and infarction ECG Definition and Pathophysiology Acute coronary syndromes (ACS) encompass a spectrum of clinical conditions characterized by a recent change in symptoms…

…stress test Exercise stress testing in patients with previous acute coronary syndromes (myocardial infarction), women, elderly and revascularized individuals Clinicians should be familiar with the…

…angina progress to myocardial infarction within 30 days if left untreated. Moreover, the pathophysiology of NSTEMI and unstable angina is very similar: both are due…

…segment depressions with prominent T waves in the majority of the chest leads may indicate an acute occlusion in the LAD (left anterior descending artery)…

…Management Acute ST Elevation Myocardial Infarction (STEMI) is the most severe manifestation of coronary artery disease. This chapter deals with the pathophysiology, definitions, criteria and…

ECG Myocardial ischemia and infarction T wave changes in acute myocardial infarction & ischemia A thorough discussion regarding the physiology of the T wavewas previously provided…

…5]. 3. Acute Pericarditis Pain Characteristics: The pain is typically pleuritic and tends to worsen when the patient lies flat or moves [2], [5]. Localization…

…Acute: 1–14 days. Subacute: 15–90 days. Chronic: more than 90 days. The central clinical danger is progressive aortic wall disruption, rupture and compromise…

…Presentation and Symptoms Acute heart failure necessitating inotropic or vasopressor support typically manifests in patients with left ventricular systolic dysfunction, low cardiac output, and dyspnea…

…solely as an isolated coronary event. SCAD predominantly affects the left sided coronary circulation and may involve multiple vessels. Pregnancy associated SCAD can occur at…

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

…and recent studies is due to the dramatic decrease in the incidence of acute coronary syndromes over the past decades. Furthermore, early revascularization in acute…

…Acute exposure produces transient haemodynamic and myocardial effects, whereas sustained heavy consumption is associated with hypertension, coronary artery disease, arrhythmias, heart failure and alcohol related…

…during the acute illness The ventricular rate and its relationship to symptoms and haemodynamic status Whether heart failure is present and whether left ventricular systolic…

…Malignant hypertension represents an extreme form in which acute microvascular injury occurs, classically involving fibrinoid necrosis of small arteries in the kidneys, retina, and brain…

…associated pericarditis , which develops from several hours to approximately 4 days after infarction and is usually transient. Late post acute myocardial infarction pericarditis , traditionally termed…

…an equivalent electrocardiographic pattern, suggesting acute coronary occlusion. Most patients with this working diagnosis subsequently develop myocardial necrosis and cardiac troponin elevation, although not every…

…The principal acute complications fall into two broad categories: Electrical complications , particularly ventricular arrhythmias. Mechanical or pump failure complications , including heart failure and cardiogenic shock…

…of acute coronary syndromes. The LMCA supplies a large myocardial territory through the left anterior descending (LAD) and left circumflex (LCx) arteries (Figure 1). Acute…

…problem worldwide. While the incidence of coronary heart disease and acute myocardial infarction has been reduced by approximately 50% during the past few decades, the…

…problem worldwide. While the incidence of coronary heart disease and acute myocardial infarction has been reduced by approximately 50% during the past few decades, the…

Echocardiography Pericardial diseases: effusion and tamponade A long series of conditions can affect the pericardium (pericardium). The most common of these are acute pericarditis (perimyocarditis)…

…acute heart failure and in obstructive airways disease Verapamil or diltiazem When a beta blocker is contraindicated, for example in asthma Contraindicated in impaired left…