…clinical relationship between AF and acute deterioration is often bidirectional. AF with a rapid ventricular response may precipitate or aggravate haemodynamic decompensation, whereas acute illness…

…below the target range, or a PaO2 below 8 kPa on an arterial blood gas. Acute critical illness during initial stabilisation — cardiac arrest, shock, sepsis…

…such as amyloidosis or sarcoidosis Other cardiac procedures Chemotherapeutic agents Catheter ablation Critical illness Defibrillator shocks Strenuous exercise Cardiac contusion The diagnosis should therefore distinguish…

Clinical chemistry & laboratory medicine Myocardial ischemia and infarction Definition and Pathophysiology Myocardial injury Myocardial injury is a biochemical diagnosis defined by at least one cardiac…

…and infarction ECG Definition and Pathophysiology Acute coronary syndromes (ACS) encompass a spectrum of clinical conditions characterized by a recent change in symptoms or signs…

…respiratory arrest. A venous blood gas can give useful information about pH and the trend in carbon dioxide, but in critical illness, marked hypoxaemia, or…

…patients. Frailty is characterized by reduced physiological reserve and increased vulnerability to adverse outcomes. It is dynamic and may improve or worsen with illness, treatment…

…cognitive impairment, and reduced physiologic reserve may dominate clinical outcomes and limit tolerance of otherwise evidence based interventions. Hypertension and vascular disease Hypertension is the…

…support . At the same time, exacerbation is a clinical syndromic diagnosis, not a sufficient explanation for all acute dyspnoea in a patient with COPD. Pneumonia…

…marked distress. Delirium is an acute neuropsychiatric syndrome and a clinical diagnosis, often described as acute brain failure. It is precipitated by somatic illness, drugs…

…important measures in severe or complicated withdrawal are: 1. A benzodiazepine in a sufficient and repeated dose , titrated against clinical effect. 2. Parenteral thiamine early …

…TdP). Drug induced LQTS and TdP represent a multifactorial clinical entity that typically emerges when multiple modifiable and non modifiable risk factors converge. The electrophysiological…

…or gastroenteritis at home Double or triple the oral daily dose during the days of illness (the patient's sick day rules) Vomiting or diarrhoea…

…a high risk of hypoglycaemia 8–12 mmol/L The critically ill patient in intensive care According to the local protocol Avoid tight targets in…

…leaning forward. The frequency with which a rub is detected varies among clinical descriptions. It may be present intermittently during the illness and, in some…

…rapidly, since the calculation assumes a steady state. Dosing and clinical decisions should therefore be based on the whole course, not on a single eGFR…

…branch block, Wolff–Parkinson–White patterns or ventricular pacing STEMI and non ST segment elevation myocardial infarction (NSTEMI) are contemporary clinical and electrocardiographic categories. Earlier…

…Clinical features Occlusion of the left main coronary artery (LMCA) abruptly interrupts blood flow to both the left anterior descending (LAD) and left circumflex (LCx…

Critical care Myocardial ischemia and infarction Definition and Pathophysiology Cardiogenic shock is a state of inadequate tissue and end organ perfusion caused by cardiac insufficiency…

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 Pharmacology & dosing Definition and Pathophysiology Bradycardia and conduction disorders arise from dysfunction within the sinus node, the atrioventricular node (AVN…

CPR Time is the most critical factor for survival in cardiac arrest. Life saving interventions must be initiated momentarily to maximize the probability of survival…

…calc_aorta] Sinus of Valsalva (SOV) and Aortic Root Assessment The sinus of Valsalva diameter (SOVd) is a critical measurement in evaluating aortic root morphology…

…no significant shunt. Clinical Relevance of Shunt Fraction Diagnosis of Shunt Severity : Quantifies the magnitude of intracardiac shunts, distinguishing hemodynamically significant defects from incidental findings…

…leaves no specimen . That makes the choice of lesion the critical point: never freeze anything whose diagnosis you have not established. Indications Lesion Freeze time…

…cycle, encompassing both systole and diastole. It is a critical parameter in cardiovascular physiology, providing insight into the perfusion pressure experienced by organs and tissues…

…and childbirth All healthcare units capable of managing pregnant women in cardiac arrest should engage in specialized clinical training to manage cardiac arrest during pregnancy…

…and hypoperfusion manifesting as hypotension. The high mortality associated with sepsis underscores the critical importance of timely and appropriate interventions. In patients presenting with concurrent…

…whom life sustaining treatment is withdrawn and total brain infarction is not expected to occur Death is confirmed by Direct criteria: clinical neurological examination and…

…osteomyelitis and poor healing. Check the ankle brachial index and the foot status before any procedure on a toe. Critical ischaemia. Immunosuppression. Suspicion of another…

…superior vena cava. A critical area of slow conduction is consistently located in the posterolateral to posteromedial inferior region of the right atrium. This circuit…

…the enzyme. By inhibiting this pump, digoxin affects multiple cellular processes critical to cardiac myocyte function, ultimately exerting a mild positive inotropic effect. Beyond its…

…Rebel EM Rebel EM is a high quality emergency medicine blog covering a myriad of topics, primarily focusing on evidence based clinical topics, ECG cases…

…can immediately and safely restore sinus rhythm, obviating slow drug titration and rendering the supraventricular versus ventricular distinction less critical. Performance involves sedation (e.g…

…For cardiologists – particularly interventional cardiologists – this knowledge is of critical importance as they must be able to directly pinpoint where the coronary artery occlusion is…

Cardiology Definition and terminology Heart failure (HF) is a complex clinical syndrome characterized by symptoms and signs resulting from structural or functional impairment of ventricular…

…providing absolute quantification. The resting myocardium rarely reveals evidence of significant coronary artery stenosis unless the stenosis is severely critical, potentially causing angina during rest…

…in knowledge, with some of the most critical components of current guidelines being based on observational data ( e.g compression rate and depth). With current…

…fail to generate stroke volumes. Consequently, addressing reversible causes of cardiac arrest becomes more critical than performing chest compressions. Hemorrhages, either manifesting externally or concealed…

…high resolution cardiac magnetic resonance (CMR) imaging, and landmark clinical trials, the field has transitioned from a predominantly pharmacological strategy to one that heavily integrates…

…This corresponds to the so called critical administration threshold and identifies rapid bleeding better than the retrospective definition of at least 10 units of red…

…1.73 m². Advantages of MDRD eGFR Clinical utility: The MDRD equation has been instrumental in identifying and staging chronic kidney disease (CKD), facilitating early…

…relation to ACE inhibitor therapy. Biomarkers and Laboratory Findings Monitoring renal function and potassium is a critical component of ACE inhibitor therapy. Blood pressure (including…

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…

ECG Introduction to ECG interpretation Lathundar The Cardiac Electrical Axis: Definition, Clinical Implications, and Deviations Definition and Mechanism of the Electrical Axis The heart's…

…Relief of Triggers Addressing the underlying precipitating factors is a critical component of acute management [4]: Electrolyte Management : Correction of electrolyte derangements is essential [4…

…activation and coagulation, with formation of an intraluminal thrombus. The clinical spectrum includes unstable angina, non ST segment elevation myocardial infarction (NSTEMI), and ST segment…

…Sudden Unexplained Nocturnal Death Syndrome (SUNDS) [4] . The clinical presentation is notoriously heterogeneous, ranging from lifelong asymptomatic ECG anomalies to electrical storm and sudden cardiac…

…infants, around six will have critical CHD, and the pulse oximetry test will correctly identify five of these with critical CHD ( Plana et al ). Minor…

…are identified and categorized. A critical aspect of this evaluation is the determination of reversibility , which involves comparing stress and rest images to distinguish between…

…regular wards and rehabilitation facilities. Depending on the cause of the arrest, other units may be critical (e.g. trauma unit). Careful and evidence based…

…the anterior and posterior fascicles. The bundle branches and fascicles play a critical role in disseminating the impulse throughout the ventricles. Dysfunction in the bundle…

…postpones or mitigates cerebral injuries. No flow time and low flow time are critical parameters for determining the probability of survival. No flow longer than…

…et al (2002) . The existence of these stages is supported by a wide range of experimental and clinical studies. The electrical phase and circulatory phase…

Cardiology Clinical chemistry & laboratory medicine Definition and Pathophysiology B type natriuretic peptide (BNP) and N terminal pro BNP (NT proBNP) are circulating markers of myocardial…

Cardiology Clinical chemistry & laboratory medicine Definition and structure Lipoprotein(a), abbreviated Lp(a), is an LDL like circulating lipoprotein particle. It contains one molecule of…

…vary, making biochemical reassessment after treatment initiation or intensification necessary. Clinical evidence for cardiovascular benefit CLEAR Outcomes CLEAR Outcomes was a randomized, double blind, placebo…

…elevated blood pressure and impaired glucose regulation. Diagnosis is based on the coexistence of defined clinical and laboratory components; the diagnostic criteria themselves are not…

…Books that claim to make it "simple" can provide a quick entry point but fail to delve into the crucial depths needed for clinical practice…