…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…

…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…

…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…

…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…

…In acute PE, obstruction of pulmonary blood flow increases RV pressure load and may impair RV filling and forward output. The resulting syndrome may progress…

…it further. Starting doses in acute pain in an opioid naive adult Agent Route Starting dose Comment : : : : Morphine IV 2.5–5 mg, repeated after…

…factors. Plaque erosion Plaque erosion is increasingly recognized and is present in at least one third of acute coronary syndromes in the cited material. Eroded…

Cardiology Respiratory medicine Definition and Pathophysiology Pulmonary hypertension (PH) is a heterogeneous pathophysiological disorder characterized primarily by elevation of pulmonary arterial pressure. It may arise…

…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…

…and an ECG all come before complete identification of the substance. Treatment of acute poisoning consists of four parallel components: supportive treatment, a targeted antidote…

…to mechanisms other than myocardial ischaemia. Acute myocardial injury may arise from conditions such as sepsis, myocarditis, or takotsubo syndrome, while chronic myocardial injury may…

…leading to unconsciousness. The myocardium responds to hypoxia by downregulating metabolism and thus contractility (a consistent finding in acute coronary syndromes). Between 3 8 minutes…

…respiratory or circulatory compromise in the higher ones [5]. For acute clinical use the following simplification can be used: Grade Clinical picture Management : : : Mild allergic…

…failure where high flow nasal oxygen is insufficient and the carbon dioxide is normal. Bilevel NIV: Acute exacerbation of COPD with respiratory acidosis , that is…

…must be corrected in a controlled fashion, since too rapid a rise can cause osmotic demyelination syndrome [1,2]. Hyponatraemia is primarily a disorder of…

…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…

…why, or the patient at risk of carbon dioxide retention is given 15 litres on a reservoir mask and drifts off into a respiratory acidosis…

…Moreover, there may also be an increased risk of myocarditis, given the similarities between COVID 19 and MERS (Middle East Respiratory Syndrome, coronavirus). Recent studies…

…Examples Acute coronary atherothrombosis Plaque disruption or erosion with thrombosis Reduced myocardial perfusion Coronary spasm, microvascular dysfunction, coronary embolism, coronary dissection, hypotension, shock, respiratory failure…

…Findings that suggest acute organ dysfunction Organ or system Finding : : CNS New confusion, disorientation, agitation, drowsiness or a reduced GCS Respiration A respiratory rate of…

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

…osmotic demyelination syndrome (ODS), previously known as central pontine myelinolysis. Excessively rapid correction of sodium can result in catastrophic demyelination of pontine neurons. Acute Hyponatremia…

…if hypoxaemic. Use a bag and mask if ventilation is inadequate. Monitor the saturation, respiratory rate, blood pressure, heart rate and a continuous ECG. Establish…

…transfusion requirement. A normal haemoglobin early on does not exclude major bleeding. In acute blood loss, plasma and red cells are lost simultaneously, which means…

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

…electrode). Lead III occasionally displays a large isolated Q wave; this is called a respiratory Q wave, because its amplitude varies with respiration. Lead III…

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…

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…

…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…

…Pathophysiology Acute aortic syndromes comprise classic aortic dissection, intramural haematoma (IMH), and penetrating atherosclerotic ulcer (PAU). Aortic dissection accounts for approximately 80%–90% of acute…

Emergency medicine Myocardial ischemia and infarction Definition and pathophysiology Acute coronary syndrome (ACS) comprises a spectrum of clinical presentations caused by suspected acute myocardial ischaemia…

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…

…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…

…disease and advanced CKD. The clinical course is often more rapidly reversible than that of other forms of acute tubular necrosis, although the complication remains…

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…

…ACS is the acronym for Non ST Elevation Acute Coronary Syndrome. This category includes all acute coronary syndromes without significant ST segment elevations on ECG…

…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…

…or fully occlusive intraluminal thrombus [5] . ACS Classification The clinical spectrum of Acute Coronary Syndromes encompasses Unstable Angina (UA), Non ST Elevation Myocardial Infarction (NSTEMI)…

…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

…pressure in both arms at the first assessment, particularly in chest pain, back pain or suspected acute aortic syndrome. 5. Use the correct cuff size…

…the most current recommendations for the management of acute coronary syndromes with persistent ST segment elevations (i.e STEMI, ST segment elevation acute myocardial infarction)…

Myocardial ischemia and infarction Definition and pathophysiology In acute coronary syndrome (ACS) with multivessel coronary artery disease (MVD), revascularization may be directed exclusively at the…

…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…

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…

…improved when they were treated as acute STEMI cases. Management of left bundle branch block (LBBB) in patients with acute coronary syndromes (ACS) For many…

…the onset of myocardial infarction. This is utilized in clinical practice by detecting troponins in patients with suspected acute coronary syndromes. Several manufacturers have developed…

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…

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…

…changes and clinical implications is provided. The reader should already be familiar with the classification of acute coronary syndromes. Subsequent chapters will deal with ST…

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…