Introduction to Coronary Atherosclerosis, Plaques, Atherothrombosis Coronary atherosclerosis is a chronic, progressive, and highly dynamic inflammatory disease of the arterial wall. It is characterized by…

…severe airflow obstruction pH below 7.35 with raised pCO₂ Acute or acute on chronic hypercapnic respiratory failure Rapidly falling pH An urgent ventilatory problem…

…the criteria for ischaemic myocardial infarction. It may be acute, when serial troponin values show a dynamic change, or chronic, when troponin elevation persists without…

…chronic obstructive pulmonary disease, renal insufficiency, systemic hypertension, and concomitant abdominal aortic aneurysm. Clinical Presentation and Symptoms Acute chest and/or back pain is the…

…requiring hospitalization. Progressive sodium and fluid retention is described as a frequent mechanism of clinical deterioration and acute decompensation despite apparently effective chronic treatment. Functional…

…or exercise threshold. Potential anginal equivalents include: Dyspnoea on exertion. Fatigue. Dizziness during exertion. Discomfort in the arm, jaw, neck, or upper back. Chest discomfort…

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

…can help distinguish new abnormalities from chronic baseline findings, but comparison with an earlier tracing must not delay treatment when acute coronary occlusion is suspected…

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…

…elevations on the ECG. Virtually all patients with STE ACS exhibit elevated troponin levels, and are thereby diagnosed as ST elevation myocardial infarction (STEMI) . Chronic…

…young individuals. The severity of symptoms and presence of high risk arrhythmias on ECG guides the management of non acute or asymptomatic bradyarrhythmia. In patients…

…elevations on the ECG. Virtually all patients with STE ACS exhibit elevated troponin levels, and are thereby diagnosed as ST elevation myocardial infarction (STEMI) . Chronic…

…70–79 Chronic kidney disease 130–139 70–79 Avoid a systolic pressure < 120 mmHg and a diastolic pressure < 70 mmHg on treatment…

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

…ischemia and infarction Pharmacology & dosing Definition and therapeutic objectives Antianginal therapy in chronic coronary syndrome (CCS) is directed primarily at reducing myocardial ischaemia and relieving…

…The electrocardiographic appearance depends on several interacting factors: The stage of the ischaemic process: acute, evolving or chronic The severity of ischaemia and whether infarction…

…demand). The most common causes of acute aortic regurgitation are aortic dissection , endocarditis and trauma . Chronic aortic regurgitation If aortic regurgitation develops gradually, then the…

…Staging of chronic kidney disease Stage eGFR Description : : : G1 ≥ 90 Normal or high G2 60–89 Mildly reduced G3a 45–59 Mildly to moderately reduced…

…steroids and controlled oxygen. Acute on chronic hypercapnic failure in obesity hypoventilation and neuromuscular disease. Hypercapnic failure in cardiogenic pulmonary oedema that does not improve…

…ischaemia. Acute myocardial injury may arise from conditions such as sepsis, myocarditis, or takotsubo syndrome, while chronic myocardial injury may be seen in heart failure…

…is made without reduction for incomplete cross tolerance. Indications Acute severe nociceptive pain where paracetamol and a COX inhibitor are not enough: fracture, renal colic…

…1.73 m². Advantages of MDRD eGFR Clinical utility: The MDRD equation has been instrumental in identifying and staging chronic kidney disease (CKD), facilitating early…

…shock Vasodilatory shock Heart failure (HF), acute Heart failure (HF), chronic Bradycardia (second line alternative) Medium dose : 3.0 10.0 μg/kg/min. + ++++…

…Acute Heart Failure and Early Post Discharge Management The STRONG HF trial demonstrated the safety and efficacy of an approach based on starting and titrating…

…material does not provide information on biomarkers or laboratory findings specific to the evaluation of bradycardia. Treatment and Management, Including Acute and Long Term Strategies…

…denotes treatment with aspirin plus a P2Y12 receptor inhibitor. In the setting of acute coronary syndrome (ACS), DAPT is used to reduce recurrent myocardial infarction…

…therapy General treatment sequence High intensity statin therapy remains the foundation of lipid lowering treatment for patients with chronic coronary syndrome, acute coronary syndrome (ACS)…

…collateral circulation. A first or anterior infarction. Single vessel disease without collateral support. Chronic kidney disease, particularly in relation to VSR. Large infarction, especially for…

…including chronic coronary syndromes and acute coronary syndromes HF across the spectrum of left ventricular ejection fraction AF and other arrhythmias Ischaemic stroke PAD CKD…

…severity (Table 2), and temporal onset. Distinguishing between acute and chronic hyponatremia, based on the rapidity of onset, is of paramount importance. The primary concern…

…Trauma Acute Care Surg 2016;81:27 33. Wallmuller C, Meron G, Kurkciyan I, et al. Causes of in hospital cardiac arrest and influence on…

…It is uncommon for chronic pericardial effusions to cause sudden cardiac arrest since these cases tend to be recognized and managed before circulatory collapse occurs…

…shock Vasodilatory shock Heart failure (HF), acute Heart failure (HF), chronic Bradycardia (second line alternative) Medium dose : 3.0 10.0 μg/kg/min. + ++++…

…million deaths annually worldwide. The most common cause of sudden cardiac death is acute or chronic coronary artery disease (ischemic heart disease). Cardiomyopathies (dilated or…

…Comment : : : MAP ≥ 65 mmHg 80–85 mmHg in chronic hypertension or when there are signs of inadequate perfusion Urine output 0.5 mL/kg/h…

…ankle brachial index before the first bandage is applied . Indications Venous leg ulcer — about 70% of all leg ulcers. Chronic venous oedema, lipodermatosclerosis, stasis dermatitis…

…when urethral injury is suspected. Indications Acute urinary retention. Chronic urinary retention with renal impairment or a large residual volume. A need for accurate measurement…

…is indicated for the prevention of atherothrombotic events in adult patients with acute coronary syndrome (ACS) or a prior heart attack and a high risk…

…by disease in the treated segment. The clinical implications range from asymptomatic angiographic disease to chronic coronary syndrome (CCS), acute coronary syndrome (ACS), myocardial infarction…

…territory at risk has been described as approximately 75–100%, depending on coronary dominance. Significant left main stenosis is generally defined as a diameter reduction…

…2), obesity, smoking, obstructive sleep apnea and chronic obstructive pulmonary disease (COPD). Moreover, certain other tachyarrhythmias predispose to developing atrial fibrillation: atrial flutter, AVNRT and…

…atrial fibrillation, atrial flutter can be classified into the following types: Acute atrial flutter (includes newly diagnosed cases). Paroxysmal atrial flutter. Chronic atrial flutter. The…

…hemorrhagic pericarditis). Symptoms of acute pericarditis/myocarditis There are two forms of pericarditis: acute and chronic. This article will focus on the former, as it…

…abnormalities. Assessment of wall motion abnormalities is particularly important in the setting of chronic or acute coronary artery disease. All types of ischemia– chronic, acute…

…surgery 80 g/L Acute coronary syndrome 80 g/L; a higher threshold may be considered individually in ongoing ischaemia Upper gastrointestinal bleeding that has…

…on the clinical picture Moderate 6.0 to 6.4 mmol/L ECG and cardiac monitoring. Emergency treatment is often warranted, particularly in an acute…

…preferred for coronary angiography and PCI because it is associated with fewer vascular and bleeding complications than femoral access. In patients with acute coronary syndrome…

…of obstructive CAD on ICA should therefore not automatically be interpreted as evidence that the patient’s symptoms are non cardiac. In acute coronary syndrome…

…multivessel CAD varies from stable angina or exertional limitation to acute coronary syndrome (ACS), ventricular arrhythmia, heart failure or cardiogenic shock. In chronic coronary disease…

…the pulmonary valve into the main pulmonary artery. Depending on the size and form of the thrombus, it will occlude the main pulmonary artery or…

…shock. Vasodilatory shock. Heart failure, acute or chronic. Bradycardia (second line option). 3.0–10.0 μg/kg/min + ++++ + +++++ Intermediate dose dopamine activates β1…

Njurmedicin Lathundar Acute management on call Acute kidney injury, AKI, is a syndrome of rapidly deteriorating renal function. Management is governed not by the creatinine…

Neurologi Akutsjukvård Lathundar About this quick reference This is a practical quick reference for emergency physicians in suspected acute ischaemic stroke. It covers time windows…

…2]. STEMI and other ECG patterns suggesting acute coronary occlusion are time dependent conditions. The decision on immediate reperfusion is based on symptoms, the ECG…

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

…Patients without haemodynamic instability require more detailed prognostic evaluation using two complementary domains: Indicators of acute PE severity , including clinical findings, RV dysfunction on imaging…

…of breathing, level of consciousness and PEF improve at the same time. Acute severe asthma is characterised by bronchospasm, mucosal oedema and mucus plugging. Expiratory…

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…

…experience. Studies have demonstrated that a significant proportion of patients with acute coronary occlusion (ACO) do not exhibit classic ST segment elevation on ECG, leading…

…on the other hand, may only display ST depressions and/or T wave inversions. STE ACS (ST Elevation Acute Coronary Syndrome) & STEMI (ST Elevation Myocardial…