…adenosine triphosphate) as the primary energy source. ATP is produced by metabolizing carbohydrates (glucose), fats or proteins, whichever is available. ATP fuels all cellular functions…

…the deep learning model. Predicting sudden cardiac arrest Sudden cardiac death (SCD) remains one of the most intractable challenges in clinical cardiology. Hundreds of thousands…

…right bundle branch then runs deeper into the myocardium, where roughly one third of its length is located. It then runs closer to the endocardium…

…As mentioned before, the subendocardium of the left ventricle has the poorest prerequisites in case of ischemia. The infarction process starts in the subendocardium from…

…of cardiovascular disease. It has been the number one killer in Western and high income countries for more than half a century, causing approximately 20…

…for now, it is sufficient to note that the more myocardium supplied by an artery, the greater the ischemic area in case of occlusion. Ischemic…

…circumferential cast , and the patient must leave with clear information about the symptoms that should make them seek help immediately. Indications An undisplaced or reduced…

…is in a cast or has extensive wounds so that the cuff cannot be applied. Place the cuff over a protective dressing, or measure at…

…arrow), with subsequent asystole. ECG 10 . Recurrence of supraventricular complexes (red arrows). ECG 11 . Relapse of VF and new shock. ECG 12 . Sinus rhythm. ECG…

…ventricular tachycardia (VT) emerges. As evident, ventricular tachycardia may appear more polymorphic in one lead (the upper lead). ECG 2 . Although the signal in the…

…complexes are seen, with the latter two having similar QRS morphology. These beats may originate from the ventricles or atria. ECG 2. The initial part…

…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…

…that case add toe pressure measurement. Absolute: ABI < 0.5 or toe pressure < 30 mmHg. Decompensated heart failure — compression of both legs acutely…

…thickness unmeasurable and staging therefore impossible; a superficial punch in a case of bullous dermatosis misses the subepidermal split. Choose the technique according to the…

…in meters. BMI is relevant for medical prognostication as it serves as a quick, low cost, and reliable screening tool for body composition, risk of…

…cost. The pathophysiological substrate of angina may differ between patients. Myocardial ischaemia may result predominantly from obstructive epicardial coronary disease, coronary vasospasm, microvascular dysfunction, or…

…Biventricular hypertrophy ECG In case the ECG or other examinations suggest left ventricular hypertrophy (LVH), one should suspect concomitant right ventricular hypertrophy (RVH) if the…

…of the pericardium, as well as congenital malformations leading to an incomplete or absent pericardium. In case of suspicion of pericardial disease, it is important…

…1. Sinoatrial arrest. Also note the ST segment elevations (which in this case have no relation to the sinoatrial arrest). As discussed in Chapter 1…

…marked renal failure or on dialysis, where DOACs lack documentation or have only weak evidence. Venous thromboembolism when a DOAC cannot be used (interactions, cost…

…strips, tissue adhesive or a dressing alone. Contraindications Primary closure must be avoided or considered carefully in: Bite wounds — particularly cat and human bites, and…

…contrast, within selected high risk populations, prevalence may be sufficiently high for targeted screening to be cost effective. For asymptomatic stenosis of at least 70%…

…reduce this residual risk without necessarily altering lipid concentrations, blood pressure or other conventional risk factors. Colchicine is an established anti inflammatory drug that may…

…involvement is commonly associated with inferior or lateral myocardial infarction. Consequently, posterior infarction should not be regarded as an isolated electrocardiographic pattern in every case…

…the leads. Some leads may display all waves, whereas others might only display one of the waves. Regardless of which waves are visible, the wave…

…discussed, all cardiac cells—both conduction and contractile cells—must undergo rapid repolarization to ensure they are excitable when the next action potential occurs. If…

…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…

…cardiac arrest Anaphylaxis can develop without dermatological or upper airway manifestations. Anaphylactic cardiac arrest should be suspected among younger patients, in case of known allergy…

…have spread to the heart by metastasis or invasion from surrounding tissue. Differential Diagnostics There are several differential diagnoses in the case of cardiac masses…

…Metabolic equivalents (METs) can be used to estimate the energy cost of physical activity. One metabolic equivalent (1 MET) is defined as the amount of…

…seen in certain causes of cardiac arrest (e.g. pulmonary embolism) or in case of long no flow or low flow periods. Under such circumstances…

…the muscle layer closest to the endocardium. The subendocardium has the poorest prerequisites in the case of myocardial ischemia. All myocardial infarctions affect the subendocardium…

…only be used if the flow (Q) is constant, which is not the case in the heart. Blood flow is pulsatile during the cardiac cycle…

…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…

…common cause. Ebstein's anomaly The prevalence of Ebstein's anomaly is approximately 1 case per 200.000 live births (Atthenhofer et al) . Figure 1…

…of these have atherosclerotic heart disease (coronary artery disease) as the underlying cause. Other common causes are cardiomyopathy (hypertrophic or dilated), arrhythmogenic right ventricular cardiomyopathy…

…days or benzylpenicillin 1–3 g × 3 IV Extensive furunculosis flucloxacillin 1 g × 3 10 days Wound infection flucloxacillin 1 g × 3 7 days Cat…

…salicylate into the central nervous system. Discuss the case early with the poison control centre and with anaesthesia or intensive care. If intubation is necessary…

…hepatic metabolism, yielding desethylamiodarone as a major active metabolite. Both the parent drug and its metabolite accumulate extensively in various tissues, including the liver, lung…

…syndrome remains fundamentally one of impaired cardiac performance, in which the heart cannot provide blood flow commensurate with the body’s requirements or can do…

…130 msec in females , along with slurring or notching of the mid QRS in at least two left facing leads [7]. These stricter parameters correlate…

Cardiology Endocrinology & metabolism Definition and pathophysiology Primary aldosteronism (PA), also termed primary hyperaldosteronism or Conn syndrome, comprises disorders in which aldosterone secretion is inappropriately increased…

…P wave will be visible, either before or after the QRS complex. In either case it will be retrograde (in lead II, III and aVF)…

…Confirm cardiac arrest In case of a collapse (out of hospital or in hospital) the first task is to determine if a cardiac arrest has…

…resulting in obstruction. Central nervous system (CNS) injuries might cause apnea or hypoventilation. Respiratory conditions : Tension pneumothorax Drowning Airway obstruction Hanging Pneumonia High altitude sickness…

…spread entirely or partly outside of the conduction system (which is slow). However, WCTs may be supraventricular, if the tachycardia is accompanied by one of…

…as great a risk. Although two times the risk may seem very much, it only amounts to one extra case. So, even if the relative…

…cavity and affect heart valves that have some kind of damage, change or degeneration. Endocarditis with alpha streptococcus is most often subacute and can develop…

…or 90 mm Hg diastolic (140/90 mm Hg). The discordance between optimal blood pressure and the definition of hypertension is explained by a cost…

…60 beats per minute. In case of sinus arrest (or any scenario in which atrial impulses do not reach the atrioventricular node), junctional escape rhythm…

…of AV blocks aims to restore atrioventricular conduction either pharmacologically or by means of artificial pacemakers. Both methods may be used in the acute setting…

…T changes. They may occur in both NSTEMI and STEMI. QTc prolongation The QT (QTc) interval may be prolonged, shortened or unchanged in ischemia. R…

…11 yr) · FAME 3 Non hyperemic ratios (iFR / RFR / Pd Pa / dPR) Resting Pd/Pa during the diastolic “wave free period” (iFR) or the lowest…

…that PISA can be used to quantify regurgitation volume. In the case of mitral regurgitation (MR), the regurgitant area can be calculated using the following…

…the presence of right ventricular load. This condition implies that the right ventricle is pressure and/or volume loaded. The load itself leads to impaired…