…include paradoxical embolism (discussed below) and emboli from the proximal aorta. Stroke and TIA (Transient Ischemic Attack) Ischemic stroke constitutes 87% of all stroke cases…

…objective assessment may include directly observed treatment or detection of prescribed medications in blood or urine samples. In patients with an estimated glomerular filtration rate…

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

…Myocardial Infarction) Acute coronary syndromes with significant ST segment elevations are classified as STE ACS . Virtually all cases of STE ACS lead to myocardial infarction…

…a very strong predictor of survival. This is because cardiac arrest presenting with ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT) can be defibrillated to…

…approximately 30% of all cases of OHCA in 1990, as compared with 78% of all cases in 2020. Figure 3. Rates of bystander CPR in…

…the community to establishing advanced post resuscitation care. Since the majority of all sudden cardiac arrests occur outside hospitals, the chain of care includes laymen…

…Wave Maven includes over 500 ECG cases, all interpreted by experts in electrocardiology. Dr Smith's ECG blog This blog is one of the most…

…all patients with suspected CHD. Echocardiography provides detailed morphological and functional information. The vast majority of cases can be characterized by echocardiography. In comparison with…

…of: Malaise Fever Pericardial or chest discomfort Leukocytosis Elevated erythrocyte sedimentation rate Pericardial effusion Pericardial pain is often sharp and pleuritic. It may worsen with…

…only present with atrial flutter. Similar to atrial fibrillation, atrial flutter can be classified into the following types: Acute atrial flutter (includes newly diagnosed cases)…

…myocardial ischemia. Other symptoms include dyspnea, pain radiating to the left arm/shoulder/throat, palpitations, back pain and selected cases of upper abdominal pain. An…

…practitioner in selected cases, but surgery is the standard. Dark skin: a risk of permanent hypopigmentation. Areas with poor circulation, above all the lower leg…

…include: Arrhythmias : Ventricular or supraventricular arrhythmias (bradyarrhythmia or tachyarrhythmia). Atrial or ventricular rupture : In severe cases, there can be a rupture of the atria or…

…adult patients with severe pulmonary stenosis, alongside right ventricular hypertrophy (RVH) and right atrial enlargement [8]. RAD is present in most cases of significant RVH…

…Can you spot them? Note that negative delta waves may simulate pathological Q waves (and thus be confused with previous myocardial infarction). ECG examples of…

…coronary care unit (CCU), or catheterization laboratory. A 12 lead ECG must be obtained immediately after ROSC in order to identify cases with ST segment…

…arrest. Evaluation and Physical Examination The source material does not provide specific details regarding the physical examination or general evaluation of patients with bradycardia. Diagnostics…

…populations or those with acute kidney injury. Influence of Muscle Mass and Diet: Serum creatinine levels, a key component of the MDRD equation, can be…

…national or regional poison control centre, and activate the emergency medical response system using your local emergency number. Contact the nearest intensive care unit with…

…neurological deficits. Neurological involvement Hypertensive encephalopathy may present with somnolence, lethargy, tonic–clonic seizures, cortical blindness, and, in advanced cases, loss of consciousness. Focal neurological…

…etc. Most cases of malfunction are associated with the electronics in the pulse generator or dislodgement or fracture of the leads. External causes are less…

…for approximately 80% of cases. Other causes include acute mechanical complications—particularly ventricular septal defect (VSD) and papillary muscle rupture with acute severe mitral regurgitation…

…include: Traumatic injuries (blunt force, lacerations, gunshot wounds) Asthmatic episodes Iatrogenic events (e.g., during central venous catheter insertion) Underlying lung pathologies In cases of…

…cardiac arrest Cardiac arrest associated with tamponade has an exceptionally poor prognosis. In the vast majority of these cases, the tamponade develops acutely or subacutely…

…overlap with risk factors for DVT; immobilisation, surgery, hypercoagulability, and pregnancy are common risk factors (see Risk factors below). A significant proportion of cases with…

…include bradyarrhythmias or tachyarrhythmias, AV block, acute myocardial ischemia, old myocardial infarction, long QT, and bundle branch block. Cardiac monitoring is indicated for patients with…

…severe preeclamptic phenotype or variant. Pathophysiology The precise mechanism of preeclampsia remains incompletely established. Proposed contributors include chronic uteroplacental ischaemia, an exaggerated maternal inflammatory response…

…involvement in the inflammatory process. A broad spectrum of pharmacologic agents can induce bradycardia or conduction disorders. These include beta blockers, non dihydropyridine calcium channel…

…substantially with contemporary reperfusion, particularly primary percutaneous coronary intervention (PCI). In a large epidemiological analysis, mechanical complications occurred in approximately 0.27% of STEMI cases…

…S Ca 2+ 2.6 mmol/L In approximately 90% of cases, hypercalcemia is attributed to primary hyperparathyroidism or neoplastic etiologies. Other causes include immobilization…

…number of cases, the rhythm is non shockable, as seen in certain causes of cardiac arrest (e.g. pulmonary embolism) or in case of long…

…SCA) if the underlying cardiac disease is unknown or if disease progression is suspected. Reversible causes may account for up to 50% of SCA cases…

…mellitus and increases with age. STEMI may present as sudden onset breathlessness. Other less common presentations, with or without pain, include sudden loss of consciousness…

…These disruptions may initiate or complicate the haematoma. IMH most frequently involves the descending thoracic aorta, which is affected in approximately 60%–70% of cases…

…to demonstrate an intramural haematoma or double lumen Type 1 is reported in fewer than one third of cases in the pregnancy related source material…

…proportion of cases. The cardiorenal and cerebrovascular consequences of unrecognized PA make early case detection clinically important. Current European recommendations advise screening adults with confirmed…

…weight heparin with dose adjustment, or warfarin Subsegmental pulmonary embolism without deep vein thrombosis An individual assessment; in selected cases the patient can be observed…

…and may include: Chest discomfort Fatigue Weakness Presyncope or syncope Exercise intolerance Symptoms of shock in advanced cases The presentation may be abrupt or subacute…

…the vascular territory involved and may include manifestations of coronary, cerebral or peripheral arterial disease, although the source material does not specify symptom patterns in…

…cannot be pursued. Patients receiving digoxin may present with symptoms of digitalis toxicity, which manifests across multiple organ systems. Non cardiac symptoms include headache, nausea…

…risk individuals with a family history of premature coronary artery disease. CAC findings incidentally identified on a chest CT performed for another indication can also…

…platelet rich because they form under high shear conditions. Disruption of an atherosclerotic plaque or injury associated with PCI exposes thrombogenic material, promoting platelet activation…

…source material. Delayed help seeking is associated with older age, female sex, Black race, lower socioeconomic or uninsured status, a history of angina or diabetes…

ECG Introduction to ECG interpretation QT duration and corrected QT (QTc) duration ECG interpretation always includes an assessment of the QT interval (QT duration). The…

…BLS) includes rapid recognition and treatment of life threatening conditions or injuries, including cardiac arrest, drowning, trauma, asphyxia and respiratory arrest. BLS can be provided…

…sound waves can only propagate through a physical medium. This medium may consist of any matter, e.g air, water, metal, or tissue and fluids…

…The action potential includes a depolarization (activation) followed by a repolarization (recovery). The action potential occurs in all cardiac cells but its appearance varies depending…

…in: a reduced level of consciousness with inadequate protective reflexes active major haematemesis severe agitation respiratory failure an anticipated difficult or prolonged endoscopic intervention a…

…a spectrum of clinical presentations caused by suspected acute myocardial ischaemia. It includes patients with recent changes in symptoms or clinical signs, with or without…

…Female specific or female predominant factors associated with later cardiovascular risk include: Premature menopause Premature ovarian insufficiency Hypertensive disorders of pregnancy Preeclampsia Preterm delivery Gestational…

…severe pain, often radiating to the back. Pericarditis may produce pleuritic or positional pain. Myocarditis and pericarditis can present with chest pain, ECG abnormalities, and…

…reduction required is greater than can reasonably be obtained with a statin alone but does not necessarily require the larger effect of a PCSK9 inhibitor…

…and cardiac imaging Cardiovascular imaging modalities have developed rapidly in the past few decades. The repertoire of available methods includes echocardiography, cardiovascular magnetic resonance (CMR)…

…or discomfort is the most common symptom initiating evaluation for ACS. Features that increase the likelihood of ACS include: Sudden symptoms at rest or with…

…antegrade or, less commonly, retrograde. Distal re entry tears may allow blood to return to the true lumen, whereas disruption of the adventitia can result…

…are all necessary to become confident in ECG interpretation and making clinical decisions using the ECG. Interestingly, none of the books reviewed include all these…

…rare, the arrhythmia is precipitated by an extensive list of "torsadegenic" or "QT liability" drugs. This includes Class III antiarrhythmic agents such as quinidine, sotalol…

…Peripheral intravenous (IV). Alternative route : Central venous administration of adenosine is suitable in the intensive care unit or coronary care unit. Adenosine injection must be…

…device that communicates wirelessly with the pacemaker. A wide range of settings can be adjusted. These settings include the base rate of the pacemaker (the…