…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…

…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…

…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…

…messages Two things set the COPD exacerbation apart from many other causes of acute dyspnoea: oxygen must be titrated cautiously and the blood gas determines…

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…

…Skin symptoms may be absent, and circulatory shock does not have to be present for the condition to be serious [1]. Intramuscular adrenaline (epinephrine) is…

…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…

…is given. The serious incidents almost always arise when the principle of titration is abandoned — when a fixed dose is given without assessment, when a…

…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…

…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…

…Note that unstable angina pectoris and acute myocardial infarction are categorized under acute coronary syndromes (ACS). Aortic dissection Pneumothorax Pulmonary embolism Mediastinitis (rare condition) In…

…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…

…nephrology early in anuria, in a dialysis patient, in severe acute kidney injury, in treatment failure or in ongoing massive potassium release. In cardiac arrest…

…with frequent reassessment. Give blood according to the circulatory response and the transfusion principles below 6 Stop anticoagulants in serious ongoing bleeding. Reverse selectively according…

…ventricular function The amount of residual viable myocardium exposed to ischaemic risk Susceptibility to serious ventricular arrhythmias Cardiac rehabilitation addresses these determinants indirectly and comprehensively…

…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…

…Low dose aspirin is also preferred in patients with intracoronary stents. In acute ACS, aspirin should be administered as soon as possible in the absence…

…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…

Arrhythmias and arrhythmology Cardiology Definition and Pathophysiology Vasovagal syncope represents the most common form of neurally mediated syncope (NMS), a disorder of autonomic reflexes. It…

…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…

…is suspected. 7. Review all medication, including over the counter preparations, herbal remedies, contrast media and recently stopped drugs. 8. Treat sepsis, bleeding, shock, hypoxia…

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…

…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…

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…

…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…

…initiating mechanism, the exposure of thrombogenic material triggers a rapid cascade of platelet adhesion (mediated by von Willebrand factor and Glycoprotein Ib IX V), activation…

…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…

…V7, V8 and V9 in patients with high suspicion of posterior acute myocardial infarction (e.g due to reciprocal ST segment depressions in V1, V2…

…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…

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

…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…