…portion of the chest or the epigastrium and occasionally radiates to the arms. Less common sites of radiation include the abdomen, back, lower jaw, and…

…chest or epigastrium. Radiation may occur to one or both arms and less commonly to the abdomen, back, neck or lower jaw. Discomfort may extend…

…and less often to the abdomen, back, lower jaw, neck, or occipital region. It typically occurs at rest, lasts longer than ordinary angina, and does…

…capillary refill and pulse, and active movement of every tendon crossing the wound. A tendon injury can be painless and gives normal passive movement — test…

…6. Stop immediately in the event of coughing, stridor, cyanosis or marked breathlessness — withdraw the tube to the pharynx and start again . If the tube…

…ischaemic myocardial injury may coexist, and certain disease entities can span both categories; for example, acute heart failure may occur in the context of acute…

…which is a manifestation of post cardiac injury syndrome (PCIS). PCIS is an umbrella term that also includes post pericardiotomy syndrome and post traumatic pericarditis…

…biomarkers because they are extremely sensitive and specific for myocardial injury. Elevated levels of cardiac troponins is firm evidence of myocardial necrosis (i.e infarction…

…implications of lower alcohol intake remain controversial. Epidemiological studies have often described a J shaped association between consumption and cardiovascular outcomes, with apparently lower overall…

…a crushing sensation across the precordium and may radiate to the neck, shoulder, jaw, back, upper abdomen, and left or right arm. Onset and evolution…

…same level of myocardial workload and the symptoms disappear within minutes after stopping the activity. The greater the stenosis, the lower the level of myocardial…

…broad spectrum hydroxamic acid based inhibitor of histone deacetylase... <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Abexinostat+AND+(%22QT%22+OR+Torsad " PubMed…

…intrapericardial pressure due to the tamponade. The increased pressure causes compression of the atria and the ventricles (particularly the former). Even small pressure elevations on…

…ACS) and acute myocardial infarction (AMI) Acute coronary syndromes occur when atherosclerotic plaques disrupt, resulting in the activation of thrombocytes and coagulation factors causing the…

…Ventricular fibrillation is the result of numerous re entry circuits , causing rapid and chaotic ventricular depolarizations, rendering the left ventricle incapable of generating effective contractions…

…important indication and an emergency procedure . An unclear arthritis, as part of the diagnostic work up. Haemarthrosis after trauma. A symptomatic effusion causing pain or…

…close to the upper border of the rib, never at the lower border where the neurovascular bundle lies, and the drainage is stopped for coughing…

…concept of a distinct "cough hypersensitivity syndrome" has emerged, emphasizing the putative role of sensitized sensory nerve endings and afferent neural pathways in causing chronic…

…lesions causing ischaemia have been treated. Conversely, angiographically satisfactory stenting may leave clinically relevant residual ischaemia, particularly after complex coronary intervention. The clinical importance of…

…guidewire crossing within 30 minutes. The clinical rationale for CTO PCI is principally the reduction of myocardial ischaemia and improvement of symptoms and quality of…

…contract plasma volume and modestly lower blood pressure. Increased sodium delivery to the macula densa restores tubuloglomerular feedback, causing afferent arteriolar vasoconstriction and reducing glomerular…

…and angiographic findings. OMI is defined by acute coronary artery occlusion causing transmural ischemia and requiring urgent reperfusion, even in the absence of classic ST…

…The length of the refractory period (see Basic Cardiac Electrophysiology) varies with heart rate. The length is shortened as heart rate increases and vice versa…

…that of reverberations. Figure 4. Mirror image artifact. Side lobe artifact A 2D image is formed by allowing the ultrasound beam to sweep back and…

…or coughing before cardiac arrest also speak for anaphylaxis (airway obstruction caused by a foreign body is an important differential). Treatment of anaphylaxis and cardiac…

…threatening arrhythmias and cardiac arrest, with hyperkalemia being the most prevalent electrolyte disturbance observed in cardiac arrest scenarios. Hypocalcemia, although capable of causing cardiac arrest…

…Treatment of AV block in the acute setting Treatment in the acute setting is directed at managing bradycardia and reduced cardiac output. Bradycardia causing hemodynamic…

…range of 50 120 mmHg. This process is primarily mediated by local metabolic mechanisms, which adjust vascular tone in response to myocardial oxygen demand, and…

…narrowing of the RVOT (right ventricular outflow tract). Carcinoid heart disease : Carcinoid syndrome is a paraneoplastic syndrome that occurs due to carcinomas secreting kallikrein and…

…of cardiomyopathy. Pathophysiology Prolonged tachyarrhythmias lead to the following hemodynamic effects: Tachyarrhythmia results in reduced preload, diminished stroke volume, and subsequently lower blood pressure and…

…thrombolysis and PCI wire crossing. Exact times are needed for continued management and quality follow up. STEMI: time targets and choice of reperfusion Primary PCI…

…Suspected base of skull fracture or marked coagulopathy argues against the nasal route; the oral route may then be considered. Preparation and equipment A 12…

…therapy) Bradycardia causing torsade de pointes Brugada syndrome 2.0–10.0 μg/min Safe for peripheral use 0 +++++ +++++ 0 Powerful chronotropic and inotropic…

…agents known to alter the electrical properties of the heart (inducing QRS or QT prolongation) or causing electrolyte abnormalities, such as thiazide and loop diuretics…

…1]. Cardiac Signs and Symptoms Patients often present with symptoms of predominant right heart failure, including lower extremity edema, ascites, and hepatic enlargement [8, 10…

…events Angiographic stenosis severity is an imperfect predictor of future myocardial infarction or sudden death. Lesions causing only mild obstruction may rupture, thrombose and occlude…

…symptoms causing impaired quality of life. Women with suspected angina are more likely than men to have non anginal symptoms such as dyspnoea and fatigue…

…separate chapter discusses Long QT syndrome (LQTS). A complete list of drugs causing QT prolongation can be found here. Corrected QT intervals (QTc) can be…

…is often haemodynamically tolerated and may require no specific acute therapy beyond appropriate anticoagulation and management of ventricular rate. However, AF causing acute haemodynamic instability…

…long QT, and bundle branch block. Cardiac monitoring is indicated for patients with a high pretest probability of arrhythmia causing syncope. In hospital monitoring is…

…other activity causing adrenergic stimulation, increase the risk of syncope, ventricular arrhythmias and sudden cardiac arrest. ARVC can cause ventricular tachycardia, ventricular fibrillation and sudden…

…most common cause of failure to capture is insufficient stimulus energy. Modern pacemakers have built in functions to calibrate the stimulus amplitude and width according…

…flutter. The observant will notice that the classification differs slightly from that of atrial fibrillation. Acute and paroxysmal cases are common in clinical practice. Chronic…

…Hemodynamic effects of cardiac tumors The hemodynamic effect of the tumor depends on its size and location. Tumors can reduce cardiac output by causing obstruction…

…The discrepancy between traditional figures and recent studies is due to the dramatic decrease in the incidence of acute coronary syndromes over the past decades…

…therapy) Bradycardia causing torsade de pointes Brugada syndrome 2.0–10.0 μg/min Safe for peripheral use 0 +++++ +++++ 0 Powerful chronotropic and inotropic…

…leaflet of the mitral valve. The anterior leaflet is anatomically divided into three segments referred to as A1 (anterior segment), A2 (middle segment), and A3…

…increased workload STATUS OF CORONARY ARTERY SETTING EFFECT ECG REACTION Normal coronary artery (no atherosclerosis) At rest Oxygen supply is adequate and ischemia cannot occur…

…causing vasodilation. Dobutamine Dobutamine is a chronotropic and inotropic agent. It increases heart rate, myocardial contractility, and blood pressure, thereby simulating the effects of exercise…

…causing minimal radiation exposure. It is metabolically inert and diffuses freely across cell membranes, allowing for precise quantification of myocardial blood flow and assessment of…