…reliably be attributed to acute procedural injury. Even then, it may not be possible to determine precisely how much of the postprocedural increase results from…

…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…

…grafting (CABG). Definition and Pathophysiology From balloon angioplasty to coronary stents Balloon angioplasty was initially limited by acute vessel closure and later restenosis. Coronary stents…

…In contemporary practice, ISR remains the most frequent cause of PCI failure, despite its substantially lower incidence with drug eluting stents (DES) than with bare…

…shock, serious arrhythmia or acute heart failure. Routine opening of a persistently occluded infarct related artery in a stable and asymptomatic patient is by contrast…

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

…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…

…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…

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…

Neurologi Akutsjukvård Lathundar Rapid overview Acute dizziness is managed most safely by first establishing the time course and precipitating circumstances , and then selecting a targeted…

…abdominal aortic aneurysm. Clinical Presentation and Symptoms Acute chest and/or back pain is the predominant symptom of both IMH and PAU. PAU pain may…

…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…

…evidence of hypotension Heart rate and tachycardia Respiratory rate and oxygenation Evidence of systemic congestion or acute RV failure Syncope or altered clinical status Comorbid…

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…

…in old age or in renal failure, reduce it further. Starting doses in acute pain in an opioid naive adult Agent Route Starting dose Comment…

…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…

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…

…ST segment depressions and/or T wave inversions. Most patients with NSTE ACS will develop acute myocardial infarction, which is then classified as NSTEMI (Non…

…Diagnostic criteria for acute myocardial infarction A diagnosis of myocardial infarction is based on the following three components: Cardiac troponins – Elevation of cardiac troponins in…

…be counteracted with simultaneous administration of norepinephrine. All patients with severe acute heart failure who receive levosimendan should be monitored invasively (e.g. arterial line…

…thickness. Macrophage derived matrix metalloproteinases (MMPs) degrade the interstitial collagen of the cap, leading to structural failure. Rupture exposes highly thrombogenic subendothelial matrix components, notably…

…be studied in detail. Figure 2. The electrocardiographic natural course in STEMI (ST elevation myocardial infarction). Pitfalls Acute transmural ischemia located in the basal portio

Kardiologi Akutsjukvård Lathundar Key message The distinction that determines management is: is there acute hypertension mediated organ damage or not? A single blood pressure value…

…medical treatment life threatening arrhythmias or cardiac arrest mechanical complications of acute myocardial infarction. acute heart failure recurrent dynamic ST segment or T wave changes…

…anatomy is suitable. In cardiogenic shock, the principal precipitating mechanisms include ischaemia related heart failure, acute severe mitral regurgitation, and other mechanical complications. Shock occurs…

…receptor inhibitor. It is central to the prevention of platelet mediated coronary thrombosis after acute coronary syndrome (ACS) and percutaneous coronary intervention (PCI). Aspirin irreversibly…

…spasm, microvascular dysfunction, embolism, dissection, hypotension or shock, respiratory failure, severe anaemia, sustained bradyarrhythmia, tachyarrhythmia, or severe hypertension with or without left ventricular hypertrophy. Among…

ECG Myocardial ischemia and infarction Use of ECG in acute coronary syndromes & chest pain patients An ECG must be performed on all patients seeking medical…

…Myocardial ischemia and infarction Factors that modify infarct size and the natural course in acute myocardial infarction (AMI) The traditional distinction between NSTE ACS (NSTEMI…

…such as heart failure, structural heart disease, fibrosis of the conduction system and acute myocardial infarction (particularly anterior STEMI). Hence, an acute myocardial infarction may…

…patients with renal failure, this is more pronounced for troponin T ( Seng et al ). Troponin I rises faster than troponin T in acute myocardial infarction…

…Severe heart failure. Doses 100 mg/day during the third trimester of pregnancy. Dosage Acute myocardial infarction: Initial loading dose: 300–500 mg as soon…

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…

ECG Myocardial ischemia and infarction ECG in acute myocardial ischemia: ischemic ST segment & T wave changes This chapter discusses typical and atypical changes in the…

…Management of acute bradycardia in the emergency setting. Parameter Assessment A Airway Voice Breath sounds B Breathing Respiratory rate (12–20 / min) Chest wall movements…

ECG Myocardial ischemia and infarction Acute myocardial infarction (AMI) always affects the left ventricle Myocardial infarction is virtually synonymous with left ventricular infarction . All myocardial…

Myocardial ischemia and infarction Pharmacology & dosing Definition and pathophysiology Atherosclerosis and acute coronary syndromes have important inflammatory components. Inflammation contributes to atherothrombosis through activation of…

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…

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

ECG Myocardial ischemia and infarction Non ST Elevation Acute Coronary Syndromes (NSTE ACS): Non ST Elevation Myocardial Infarction (NSTEMI) and Unstable Angina (UA) The focus…

ECG Myocardial ischemia and infarction ST segment depression due to acute myocardial ischemia ST segment depressions caused by ischemia are characterized by a horizontal or…

…7 STEMI Example 8 STEMI Example 9 STEMI Example 10 STEMI Example 11 STEMI Example 12 ECG examples of acute STEMI (ST elevation myocardial infarction)…

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…

Emergency medicine Lathundar Differential Diagnosis of Chest Pain: A Clinical Overview The evaluation of acute chest discomfort requires a systematic differential diagnosis, as the syndrome…

…Important presentations include: Hypotension or shock Acute severe aortic regurgitation with heart failure Cardiac tamponade from haemopericardium Myocardial ischaemia from coronary ostial compromise Focal neurological…

Cardiology Critical care Pharmacology & dosing Definition and Pathophysiology In the management of acute heart failure and cardiogenic shock, intravenous vasoactive agents are categorised according to…

…Myocardial ischemia and infarction Definition and pathophysiology Spontaneous coronary artery dissection (SCAD) is an acute coronary disorder caused by separation within the coronary arterial wall…

…Angina occurring after a recent myocardial infarction. UA belongs to the broader spectrum of acute coronary syndromes, which may present with recent changes in symptoms…

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

…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…

…infarction may indicate an increased long term risk of stroke. In patients with acute decompensated heart failure, AF with rapid ventricular response is particularly important…

…acute heart failure, or pulmonary oedema. Patients may present with chest pain, severe breathlessness, hypoxaemia, rales, or respiratory distress. In patients with HFpEF, acute hypertension…

…ischemia and infarction Definition and pathophysiology Post infarction pericarditis encompasses two temporally and clinically distinct complications of acute myocardial infarction (AMI): Early infarct associated pericarditis …

…myocardial infarction as the final diagnosis. The underlying process usually involves acute thrombotic obstruction of an epicardial coronary artery. A vulnerable atherosclerotic plaque and thrombogenic…

…of a 12 lead ECG. Assessment for haemodynamic instability, acute severe heart failure and cardiogenic shock. Identification of life threatening arrhythmias. Assessment for high risk…

…occlusion, likely because most such occlusions result in prehospital cardiac arrest and death. As in other acute coronary events, the thrombotic process is dynamic, with…

…heart disease and acute myocardial infarction has been reduced by approximately 50% during the past few decades, the incidence of heart failure has remained stable…