…a stable pulmonary embolism is a diagnostic pathway. The unstable patient Hypotension (systolic < 90 mmHg for 15 minutes, or a need for a vasopressor)…

…blood pressure. Management of hypertension requires careful consideration of other cardiovascular risk factors and coexisting conditions. Therapy must be tailored to each patient. Optimal blood…

…decision threshold. It can move estimated cardiovascular risk upward or downward and may assist decisions concerning lipid lowering therapy and broader preventive management. The test…

…and management of narrow and wide complex tachycardia All clinically significant supraventricular and ventricular tachyarrhythmias have been reviewed in previous sections. However, given that each…

…which must be tapered in a controlled fashion). The management is the opposite in each case. Equivalent doses Agent Equivalent glucocorticoid dose Mineralocorticoid effect Biological…

…ECG Third degree (complete) AV block: ECG criteria, clinical characteristics and management This chapter discusses third degree AV block, which is synonymous with AV dissociation…

…change in flow profile results in the formation of a hemisphere with several layers. Flow velocity is equal within each layer (Figure 1). Figure 1…

…for each condition. Diabetes related AF may be accompanied by a greater symptom burden and AF burden, although improved metabolic and risk factor management has…

…before each QRS complex then it is 2:1 block. In typical cases of atrial flutter, the atrial rate is around 300 beats per minute…

…cardiology ward. Each component must function cohesively to ensure timely and effective treatment. This chapter provides an overview of the entire care continuum, from prehospital…

…block): definition, causes, diagnosis & management This article covers the fundamental principles of atrioventricular (AV) blocks, which are classified into three types: first degree, second degree…

…lipoprotein cholesterol (LDL C) is the principal therapeutic target in lipid management because LDL and other apolipoprotein B containing lipoproteins play a causal role in…

…cardiac death (SCD) and a major cause of morbidity in patients with structural heart disease, VT necessitates a nuanced, multidisciplinary approach to diagnosis and management…

…When to Initiate Pharmacological Treatment Lifestyle intervention is an essential component of care. In adults with elevated blood pressure, nonpharmacological management should be actively implemented…

…medical system (EMS), as well as the hospital cardiac arrest team (CAT) and intensive care units and other units caring for resuscitated patients. Figure 1…

…diabetes care in the hospital. Endocrine Society clinical practice guideline on the management of hyperglycaemia in hospitalised adults. The summary of product characteristics for each…

…atrial tachycardia is induced by the drug. Management of all other cases aligns with the approach used for atrial fibrillation and atrial flutter. Beta blockers…

…attention. Therefore, management of sinus tachycardia always requires that each of these causes be assessed thoroughly, as many of the causes require prompt treatment. Inappropriate…

…be documented when the drug is started. Sources WHO guidelines on the pharmacological management of pain. The summary of product characteristics for each opioid preparation.

…and severe bradycardia. Patients should be monitored for arrhythmias and QT prolongation with each dose adjustment, typically waiting 2 to 3 days to attain a…

Conduction defects ECG Management and treatment of AV blocks (AV block 1, 2 & 3) Evaluation of patients with suspected AV blocks requires a thorough medical…

…or family Hypertensive first degree relatives of patients with PA Patients with hypokalaemia may develop weakness, muscle cramps or, in severe cases, periodic paralysis. Nevertheless…

…an inadequate minute ventilation can rapidly worsen the acidaemia and increase the entry of salicylate into the central nervous system. Discuss the case early with…

…regular (as is the atrial) with a rate ranging between 150 and 250 beats per minute. The P wave is not visible in most cases…

…miscellaneous conditions The early repolarization pattern and syndrome: from ECG criteria to management Although the early repolarization pattern has been recognized for almost 50 years…

…seconds. Case reports have indicated that the risk of high degree AV block and ventricular arrhythmias is greater in patients on digoxin or verapamil, although…

Akutsjukvård Lathundar Basic principle Anaphylaxis is a rapidly developing systemic hypersensitivity reaction that can cause life threatening compromise of the airway, breathing or circulation. Skin…

…Post resuscitation care requires expertise and resources to diagnose, monitor and manage neurological injuries, hemodynamic and respiratory instability, multiorgan failure, infections, seizures and temperature management…

…Management is governed not by the creatinine value alone but by the course, urine output, volume status, electrolytes, acid base status and the underlying cause…

…15 minutes and repeat treatment until the patient has recovered. 7. Follow up with a meal or with continued glucose administration adapted to the cause…

…Initial diagnosis of STEMI ECG Management Recommendation Level of evidence A 12 lead ECG should be interpreted immediately (within 10 minutes) at first medical contact…

…associated with increased ASCVD risk. Management in this range therefore focuses principally on ASCVD prevention and reduction of LDL C, non HDL C and apolipoprotein…

…than 24 hours from symptom onset. Acute: 1–14 days. Subacute: 15–90 days. Chronic: more than 90 days. The central clinical danger is progressive…

…trial shortens the time on the ventilator. See the article on confusion for the management of delirium in intensive care. Renal replacement therapy Absolute indications:…

…management early — within the first hour after ROSC, in parallel with coronary angiography, the search for the cause and the rest of the intensive care…

…medicine, widely utilized for the management of hypertension, chronic ischemic heart disease, heart failure with reduced ejection fraction (HFrEF), and post myocardial infarction (MI) care…

…UA is defined by one or more of the following patterns: Angina at rest, usually prolonged for more than 20 minutes. New onset severe angina…

…the cornerstones of management of patients with chest pain. A 12 lead ECG recording must be registered and interpreted within 10 minutes of arrival at…

…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…

…set to be triggered by the atrial impulse. Another cause of pacemaker mediated tachycardia is endless loop tachycardia, which also depends on the ventricular stimulation…

Kardiologi Lathundar Three questions determine the management: is the patient unstable, how long has the fibrillation lasted, and does the patient need an anticoagulant? The…

…and nicardipine in hypertensive emergencies. Time to onset of action 2 4 minutes Duration of action 5 15 minutes Delivery IV (infusion). Dose Initial dose:…

…established collateral circulation, particularly an occluded bypass graft; in such cases, clinical manifestations may be less dramatic despite a sudden deterioration in function. The severity…

…of the aorta or arteries supplying the limbs. In adults over 40 years of age, atherosclerosis is the predominant cause. Other mechanisms include thrombosis, embolism…

…pressures are reduced. The central management principle is preservation of adequate right ventricular preload while supporting left ventricular performance and systemic circulation. Improvement in left…

…Early reperfusion, reduction of myocardial energy requirements and mitigation of reperfusion injury are complementary objectives of initial STEMI management. The principal acute complications fall into…

…causes & management Definition of sinus bradycardia Sinus bradycardia fulfills the criteria for sinus rhythm but the heart rate is slower than 50 beats per minute…

…empirical antibiotics [1]. A practical target: give the first dose of broad spectrum antibiotics within 60 minutes of triage or arrival. This is supported by…

…and potentially aldosterone levels. Clinical Presentation and Symptoms In the management of heart failure, digoxin improves hemodynamics without increasing heart rate or decreasing blood pressure…

…sudden cardiac death Hence, the Brugada syndrome is a highly malignant disorder that must be recognized by any health care provider. A family history of…

…grouped. The chain of care in NSTEMI and unstable angina Management of patients with acute coronary syndromes is permeated by the mantra time is myocardium…

Cardiology Critical care Pharmacology & dosing Definition and Pathophysiology In the management of acute heart failure and cardiogenic shock, intravenous vasoactive agents are categorised according to…

Arrhythmias and arrhythmology Critical care Definition and pathophysiology Atrial fibrillation (AF) is the most frequent supraventricular arrhythmia in patients with acute coronary syndromes (ACS) and…

…exhaustion and, in the most severe cases, hypotension, pneumothorax and respiratory arrest [1]. The first few minutes 1. Sit the patient up and minimise physical…

Akutsjukvård Kirurgi & trauma Lathundar Immediate management In massive haemorrhage it is rapid control of the bleeding that determines the outcome. Transfusion restores circulating volume, oxygen…

…guidelines [1,3]. Level Plasma potassium Management : : : Mild 5.5 to 5.9 mmol/L Confirm the value, address the cause, assess renal function and…

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…

…portal hypertension? Variceal and ulcer bleeding are managed differently from the first minute. Peptic ulcer remains the commonest cause of upper gastrointestinal bleeding, but the…

…management, and clinical characteristics. Ventricular tachycardia is a highly nuanced arrhythmia that originates in the ventricles. A wide range of conditions may cause ventricular tachycardia…

Njurmedicin Lathundar The main clinical rule Two questions determine the initial management: 1. Does the patient have severe neurological symptoms that may be due to…