…which in the case of left bundle branch block should lead the clinician to activate the catheterization laboratory (discussed in Left bundle branch block and…

…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…

…supply results in diminished ATP production and subsequently disruption of cellular metabolism. In case of ischemia, cardiac myocytes protect themselves by switching to anaerobic metabolism…

…It lies instead in patient selection. Because implantation entails appreciable cost and procedural risk, the risk benefit balance depends almost entirely on the capacity to…

…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…

…workload leads to increased oxygen demand but the stenosis limits the volume that can be delivered to the heart muscle supplied by the atherosclerotic artery…

Procedurer A cast should hold the fracture still and do nothing else. The two ways in which casting harms the patient are that it is…

…leg — cuff compression should be avoided in the acute phase. A leg that has recently been operated on, is in a cast or has extensive…

CPR Each recording presents two leads recorded simultaneously. Sex : Female Age : 72 years History : heart failure Medications : digoxin, quinidine ECG 1 . The initial beats are…

…Each recording presents two leads recorded simultaneously. Sex : Male Age : 43 years History : None Medications : None ECG 1 . Sinus rhythm interrupted by rapid ventricular tachycardia…

CPR Sex : Male Age : 62 years History : Coronary bypass grafting; history of arrhythmias. Medications : beta blockers ECG 1 . Sinus rhythm interrupted by ventricular tachycardia (VT…

…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…

…else is supportive. But the same compression applied to a limb with arterial insufficiency can cause necrosis and, in the worst case, amputation. The decisive…

…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…

…reducing myocardial ischaemia and relieving anginal symptoms, while maintaining tolerability and adherence. Selection should be individualized according to blood pressure, heart rate, left ventricular function…

…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…

…congenital malformations leading to an incomplete or absent pericardium. In case of suspicion of pericardial disease, it is important to conduct a careful investigation as…

…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…

…lack documentation or have only weak evidence. Venous thromboembolism when a DOAC cannot be used (interactions, cost, adherence, pregnancy after the first trimester under specialist…

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

…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%…

…against interleukin 1β, provided proof of concept but was not developed for routine coronary prevention because of fatal infections and high cost. Low dose…

…Consequently, posterior infarction should not be regarded as an isolated electrocardiographic pattern in every case; it may represent the posterior component of a broader infarct…

…their capital letters (Q, R, S), and small waves are referred to by their lower case letters (q, r, s). Figure 5 shows examples of…

…refractory. In this case ( Figure 1 ) it encounters a refractory right bundle branch and therefore the impulse is conducted with right bundle branch block morphology…

…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…

…should be suspected among younger patients, in case of known allergy, when exposed to potent allergens (e.g. wasp stings, peanuts, etc.) and in case…

…in asystole and sudden death. In echocardiography, tumour should be suspected in case of detection of ecotdense tissue masses. However, the majority of all ecotate…

…to the assessment of exercise capacity. Metabolic equivalents (METs) can be used to estimate the energy cost of physical activity. One metabolic equivalent (1 MET…

…Cannulation should be completed within 60 minutes following the collapse. Preferential consideration is often given to younger patients, typically those below 65 years of age…

…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…

…ECG Case 1: Ventricular tachycardia progressing to ventricular fibrillation Below are sequential ECG recordings during a sudden cardiac arrest in a 43 year old male…

…are taken from the recommendations of Strama Stockholm for the empirical antibiotic treatment of adults in hospital and in residential care homes (SÄBO) 2025/2026…

…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…

…5 µg/mL, though greater arrhythmia suppression may occur up to 3.5 µg/mL at the cost of increased toxicity risk. In routine clinical…

…LVEF ≥50%. The ejection fraction classification is clinically useful but should not be regarded as a series of completely discrete diseases. Heart failure extends across…

…7]. Etiology and Mechanisms LBBB may result from lesser degrees of conduction delay within the left bundle system in the case of incomplete LBBB [7]…

…and cerebrovascular consequences of unrecognized PA make early case detection clinically important. Current European recommendations advise screening adults with confirmed hypertension by measuring renin and…

…Some textbooks use the term "node" instead of "nodal". AVNRT should not be confused with AVRT, which is the result of pre excitation (accessory pathway)…

…NNT to save 1 person Reference Early detection of cardiac arrest Yes 11 Berdowski et al Bystander CPR Yes 15 Hasselqvist et al Early defibrillation…

…asthma) Other : Coma Central hypoventilation syndromes Neuromuscular diseases Anemia The natural course of asphyxia Should ventilation be entirely inhibited (as seen in acute airway obstructions)…

…tachycardia during physical activity, all tachycardias should be considered pathological and the task is to clarify the cause of the tachycardia. The cause may range…

…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…

…be fatal. Approximately 500 Swedes are affected annually by endocarditis and the median age of 70 years at the onset of the disease. Approximately 12…

…90 mm Hg). The discordance between optimal blood pressure and the definition of hypertension is explained by a cost benefit equation. The benefits of interventions…

…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…

…bradycardia and reduced cardiac output. Bradycardia causing hemodynamic instability is a potentially life threatening condition and should be managed urgently. The risk of cardiogenic shock…

…the R wave and/or notch in the descending limb of the S wave In case of complete/incomplete bundle branch block or pacemaker rhythm…

…of any physiological index; lesion specific and largely independent of resting hemodynamics; guideline reference standard. Requires pressure wire + vasodilator (cost, time, patient discomfort); falsely normal…

…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…

…possible, the right leg must be intact. In the case ofblockade of the right bundle of His (RBBB) , the ventricle can not depolarize normally, which…