Cardiology Emergency medicine Definition and pathophysiology Acute pulmonary embolism (PE) is classified according to haemodynamic status, clinical severity, evidence of right ventricular (RV) dysfunction, and…

…a sufficient explanation for all acute dyspnoea in a patient with COPD. Pneumonia, heart failure, pulmonary embolism, pneumothorax and acute coronary syndrome must be actively…

…increases cardiac output, and lowers pulmonary artery pressure without increasing myocardial oxygen consumption. The inotropic effect of levosimendan is not affected by the concurrent use…

…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…

…Epidemiology of pulmonary embolism Venous thromboembolism (VTE) is the third leading cardiovascular cause of death worldwide. Only stroke and acute myocardial infarction are more common…

…recommended criterion for precapillary PH, partly because this value has been used in therapeutic studies of pulmonary arterial hypertension (PAH). The threshold is not absolute…

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…

…care in patients with pulmonary arterial hypertension (PAH), progression of right heart failure may indicate the need for inodilator therapy. Furthermore, acute heart failure and…

…patient denial, often leads to a mistaken impression of indigestion. STEMI pain can simulate pain from acute pericarditis, pulmonary embolism, acute aortic dissection, costochondritis, and…

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…

…< 90 mmHg caused by the arrhythmia. Ongoing myocardial ischaemia with chest pain and ECG changes. Acute pulmonary oedema. Impaired consciousness. Synchronised cardioversion under sedation…

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…

…not given another hour. Indications CPAP: Acute cardiogenic pulmonary oedema with hypoxaemia and marked work of breathing — the strongest indication, with a rapid effect on…

…acute target organ damage. Common manifestations are hypertensive encephalopathy, intracerebral haemorrhage, acute coronary syndrome, acute left ventricular failure with pulmonary oedema, acute aortic syndrome, acute…

…reserved primarily for instability. Evaluation and physical examination Initial assessment should establish whether AF is associated with acute haemodynamic compromise, pulmonary oedema, or evidence of…

…lower BP in acute stroke requires attention to the type of stroke and the possibility of thrombolytic treatment. Cardiac and pulmonary complications Acute hypertension may…

…Myocardial ischemia and infarction Definition and pathophysiology Myocardial infarction (MI) is a clinical diagnosis that integrates myocardial injury, evidence of acute myocardial ischaemia, electrocardiographic findings…

…stroke volumes. Failure to increase cardiac output sufficiently will result in the following compilations: Pulmonary edema develops due to rising LAP and LVEDP. Cardiogenic shock…

…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…

…Absolute: Acute coronary syndrome within 48 hours, or ongoing unstable angina. Uncontrolled symptomatic arrhythmia. Symptomatic severe aortic stenosis. Decompensated heart failure. Acute pulmonary embolism or…

…death. Papillary muscle rupture Papillary muscle rupture causes abrupt severe MR. Its typical presentation is: Sudden severe dyspnoea. Acute pulmonary oedema. Hypotension. Progressive heart failure…

…investigations. The emergency differential also reflects distinct mechanisms of acute cardiopulmonary disease: Pulmonary embolism and spontaneous pneumothorax may produce abrupt chest pain and respiratory distress…

…Normal in newborns. Right ventricular hypertrophy. Acute cor pulmonale (pulmonary embolism). Chronic cor pulmonale (COPD, pulmonary hypertension, pulmonary valve stenosis). Lateral ventricular infarction. Pre excitation…

…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…

…COVID 19 relies on small samples of hospitalized patients. Most reports have suggested that comorbidities – e.g. cardiovascular disease, pulmonary disease, advanced age, smoking, diabetes…

…dysfunction, or both. The clinical consequences of extracellular volume expansion include elevated cardiac filling pressures, pulmonary congestion, systemic venous hypertension, and peripheral interstitial edema. These…

…pulmonary embolism, pneumothorax). Hypertension. Smoking. Dyslipidemia (hyperlipidemia). Obesity and/or diabetes. Psychosocial stress. Alcohol abuse. Physical inactivity. Unhealthy diet. Cerebral / peripheral vascular disease. Cancer. Acute…

…thoracic surgery, acute myocardial infarction, pericarditis/myocarditis or pulmonary embolism is often a reversible arrhythmia with low risk of recurrence. Atrial fibrillation in other circumstances…

…conditions : Tension pneumothorax Drowning Airway obstruction Hanging Pneumonia High altitude sickness Aspiration Chronic obstructive pulmonary disease (COPD) Bronchospasm (asthma) Other : Coma Central hypoventilation syndromes Neuromuscular…

…cardiovascular societies, defines HF as a clinical syndrome corroborated by elevated natriuretic peptide levels and/or objective evidence of pulmonary or systemic congestion [3] . Within…

…windows might be feasible, particularly during brief pauses. An enlargement of the right ventricle is suggestive of pulmonary embolism, though its specificity is low. Notably…

…severe aortic stenosis Decompensated heart failure Acute pulmonary embolism, pulmonary infarction, or deep vein thrombosis Acute myocarditis or pericarditis Acute aortic dissection Physical disability that…

…target Doses in venous thromboembolism Treatment doses in deep vein thrombosis and pulmonary embolism differ from the atrial fibrillation doses and include an initial high…

…not a treatment review. For a fuller account of two of the commonest acute drug problems, see Warfarin therapy and Opioid therapy in severe pain…

…below the target range, or a PaO2 below 8 kPa on an arterial blood gas. Acute critical illness during initial stabilisation — cardiac arrest, shock, sepsis…

…vasodilation. Mild pulmonary vasodilation. No effect on CO. Ventricular arrhythmias Cardiac ischemia Hypertension Hypotension Phenylephrine Typically used as emergency bolus to correct acute hypotension. Hypotension…

…risk anatomical features include an interarterial course between the aorta and pulmonary artery, a slit like orifice, a high coronary origin, acute angle take off…

…alternative to invasive coronary angiography (ICA) for excluding non ST segment elevation acute coronary syndrome (NSTE ACS) in patients with a low to intermediate likelihood…

…particularly useful when symptoms suggest HF but the diagnosis remains uncertain. Acute HF generally produces higher BNP and NT proBNP concentrations than chronic, stable disease…

…of acute coronary syndrome. The physical examination should include: Assessment of all major peripheral pulses. Blood pressure measurement in both arms. Cardiac auscultation. Pulmonary auscultation…

…ventricular free wall, interventricular septum, or mitral valve apparatus. These lesions can cause acute severe regurgitation, a left to right shunt, tamponade, or sudden loss…

…valve disease, pulmonary pressure, or haemodynamics Stress imaging is not recommended in patients undergoing urgent non cardiac surgery or those with an unstable clinical condition…

…bacterial, and tuberculous infections. Post pericardiotomy syndrome. Acute transmural myocardial infarction. Rupture of the free ventricular wall. Neoplasms (particularly breast and lung cancer). Inflammatory conditions…

…Pulmonary infarction in acute phase – due to risk of aggravating the condition. Perimyocarditis (myocarditis) in acute phase – due to risk of arrhythmias Severe aortic stenosis…

…vasodilation. Mild pulmonary vasodilation. No effect on CO. Ventricular arrhythmias Cardiac ischemia Hypertension Hypotension Phenylephrine Typically used as emergency bolus to correct acute hypotension. Hypotension…

…Normal in newborns. Right ventricular hypertrophy. Acute cor pulmonale (pulmonary embolism). Chronic cor pulmonale (COPD, pulmonary hypertension, pulmonary valve stenosis). Lateral ventricular infarction. Pre excitation…

…involvement — lower it orally over days. Hypertensive emergency: raised pressure with acute organ damage (encephalopathy, pulmonary oedema, aortic dissection, acute renal failure, pre eclampsia) — intravenous…

…associations include: Idiopathic or viral pericarditis Malignant pericardial disease Tuberculosis Purulent or bacterial pericarditis Trauma Cardiac surgery and other iatrogenic cardiovascular procedures Acute aortic disease…

…disease modifying strategy applies to symptomatic HFrEF. Clinical presentation and symptoms Typical manifestations reflect pulmonary and systemic congestion, reduced forward cardiac output and limited exercise…

…features include: An interarterial course between the aorta and pulmonary artery A slit like orifice A high origin Acute angle take off An intramural course…

…holds true for cardiac arrests caused by chronic or acute ischemic heart disease, it is often not true in other circumstances (e.g. pulmonary embolism…

…the aorta. Thus, acute regurgitation results in a sudden increase in preload, which the ventricle counteracts by increasing heart rate and stroke volume (Preload, Afterload…

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…

…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…

…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…

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…