…tamponade The pericardial space (cavity) always contains a small amount of serous fluid which acts as a lubricant that prevents friction during ventricular contraction and…

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

…in more severe attacks, and a systemic steroid given early [2,3]. Grading Grade the severity by the most serious finding. A patient does not…

…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…

…Pneumonia, heart failure, pulmonary embolism, pneumothorax and acute coronary syndrome must be actively considered [1]. Do the following early: 1. Assess airway, work of breathing…

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…

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 The most serious transfusion accidents rarely stem from laboratory errors but from the wrong blood being given to the wrong patient — a mislabelled tube…

Echocardiography Endocarditis Endocarditis implies that a bacterial infection engages the heart valves and this is a serious condition. The focus of infection on the flap…

…present for the condition to be serious [1]. Intramuscular adrenaline (epinephrine) is the first line treatment and must be given early when anaphylaxis is suspected…

…FASS) before administration — concentrations and formulations differ between units, and most serious dosing errors arise at the dilution step, not in the choice of dose…

…no absolute threshold defines the condition. A rapid rise in blood pressure can cause serious organ damage even at lower levels, particularly in pregnancy [1…

…right level is to give a small dose, wait until it has worked, and assess the effect before the next one is given. The serious…

…centre , which in most countries is staffed around the clock for health care professionals. Contact the centre early in serious, unusual or unclear poisoning, with…

…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…

…and scope Coronary angiography is an invasive fluoroscopic procedure in which contrast media are injected selectively into the epicardial coronary arteries through a catheter advanced…

…Chest pain is one of the most nuanced symptoms in clinical practice and it is fundamental to be able to differentiate benign from serious etiologies…

…imbalance. The ECG may be used to estimate the severity of electrolyte imbalances and to judge whether there is a risk of serious arrhythmias. This…

…serious arrhythmias – due to the risk of circulatory collapse. Decompensated heart failure – due to the risk of circulatory collapse and arrhythmias Pulmonary embolism in acute…

…insulin. 7. Contact nephrology early in anuria, in a dialysis patient, in severe acute kidney injury, in treatment failure or in ongoing massive potassium release…

…been started a continuing transfusion requirement. A normal haemoglobin early on does not exclude major bleeding. In acute blood loss, plasma and red cells are…

…recreational or sporting activity Limit recurrent myocardial infarction, cardiovascular morbidity, and mortality The modern concept of rehabilitation has evolved from early post infarction physical activity…

…on degenerated saphenous vein grafts (SVGs), rotational atherectomy, and procedures performed for acute myocardial infarction. In SVG PCI, slow flow or no reflow rates may…

…by inhibiting myosin phosphatase activity. Patients with VA are generally younger than those with atherosclerotic non ST elevation acute coronary syndromes. Cigarette smoking is a…

Myocardial ischemia and infarction Pharmacology & dosing Definition and pathophysiological basis Secondary prevention after myocardial infarction (MI) encompasses long term interventions intended to reduce recurrent infarction…

…appearance may be changed in a wide range of serious conditions. The ST segment is of special interest in the setting of acute myocardial ischemia…

…anxiety, intense emotion, the sight of blood, unpleasant sights and odors, and orthostatic stress. Situational triggers such as acute hemorrhage, cough, defecation, laugh, micturition, sneeze…

…are common differential diagnoses which represent contraindications for thrombolysis. Venous thromboembolism is a chronic and serious condition. Mortality in pulmonary embolism is up to 20…

…Contact nephrology early in severe, progressive or diagnostically unclear AKI. Definition and staging according to KDIGO Acute kidney injury is present when at least one…

…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…

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…

…Intramural haematoma IMH is haemorrhage within the aortic media without an identifiable communication between the aortic lumen and the haematoma and without a visible intimal…

…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…

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…

…from posterior acute ischemia. Both these conditions cause ST segment depressions in V1–V3 along with large R waves ( Figure 2 shows right ventricular hypertrophy…

…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…

…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…

Cardiology Nephrology Definition and terminology Contrast associated acute kidney injury is an acute deterioration in renal function occurring after exposure to iodinated contrast media, particularly…

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…

…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

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…

…with symptoms suggestive of acute myocardial infarction and at least one of the following criteria present: haemodynamic instability or cardiogenic shock recurrent or ongoing chest…

…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…

Cardiology Myocardial ischemia and infarction Definition and conceptual framework Acute coronary occlusion is the abrupt or progressive reduction of coronary blood flow sufficient to produce…

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…

…ECG Myocardial ischemia and infarction Left bundle branch block (LBBB) in acute myocardial infarction (AMI): clinical implications & Sgarbossa criteria Contrary to right bundle branch block…

…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…

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…

…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…

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…