…bridge. Clinical Presentation and Symptoms Symptoms of STEMI The usual symptom is severe, prolonged ischemic discomfort. It is commonly described as heavy, squeezing, or crushing…

…a few hours of awakening. Pain is the most common presenting complaint. The pain is deep and visceral, frequently described as heavy, squeezing, and crushing…

…frequent presenting symptom. It is generally deep and visceral, often described as heavy, squeezing or crushing, although stabbing or burning descriptions may occur. The discomfort…

…of the nose. The resistance at the posterior pharyngeal wall after about 10–15 cm is expected. 5. Ask the patient to flex the head…

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

…myocardial ischaemia, though abnormal cardiac troponin (cTn) values in the setting of acute or chronic heart failure are often better categorised as myocardial injury. Clinical…

…In patients with pericarditis complicated by constriction, symptoms and signs of right sided heart failure may predominate. Pericardial effusions associated with post infarction pericarditis are…

…of myocardial infarction. Cardiac troponin T and troponin I have emerged as the preferred biomarkers because they are extremely sensitive and specific for myocardial injury…

…in myocardial oxygen consumption associated with exercise. Chronic myocardial injury Long term heavy consumption can produce a cardiomyopathy, although the exact exposure threshold and duration…

…chest pain the primary task is to exclude or verify the following potentially life threatening causes of chest pain: Ischemic heart disease : stable angina pectoris…

…income countries for more than half a century, causing approximately 20% of all deaths in these regions. Mortality rates and case fatality in coronary artery…

Info A comprehensive list of conditions and drugs that may prolong the QT interval, and cause torsade de pointes (TdP) and long QT syndrome (LQTS…

…heart of the pericardium. Source. Rapid diagnosis of cardiac tamponade is possible via bedside echocardiography. This reveals pericardial fluid, suggesting hemorrhage in the context of…

…cases of STE ACS lead to myocardial infarction (elevated troponin levels), whereafter the condition is classified as ST Elevation Myocardial Infarction (STEMI) . The thrombus causing…

…million deaths annually worldwide. The most common cause of sudden cardiac death is acute or chronic coronary artery disease (ischemic heart disease). Cardiomyopathies (dilated or…

…symptomatic effusion causing pain or restricted movement (therapeutic aspiration). Intra articular corticosteroid injection in verified inflammatory or osteoarthritis related joint disease. Contraindications Infection of the…

…the drainage is stopped for coughing, chest pain, or when the volume limit is reached. Indications Diagnostic aspiration: a new pleural effusion of unclear cause…

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

…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…

…length of at least 20 mm. These characteristics are incorporated into the J CTO score, which estimates the likelihood of successful antegrade guidewire crossing within…

…observed clinical effects. Cardiovascular and renal disease associations Diabetes substantially increases the risk of atherosclerotic cardiovascular disease, myocardial infarction, stroke, heart failure, atrial fibrillation and…

…occlusion causing transmural ischemia and requiring urgent reperfusion, even in the absence of classic ST elevation. Multiple studies have demonstrated the superior sensitivity of OMI…

…However, left bundle branch block morphology is more common (regardless of heart rate) among persons with heart disease. Alternating block (right and left bundle branch…

…g skeleton, calcifications, mechanical heart valves) and reflect virtually all sound waves, leaving too few waves to explore the area behind the reflector. This results…

…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…

…hyponatremia. Degree of hyponatremia P/S Na + Common effects Mild 130 125 mmol/l Cognitive disorders, vertigo, balance disorder. Moderate 115 125 mmol/L Headache…

…Bradycardia causing hemodynamic instability is a potentially life threatening condition and should be managed urgently. The risk of cardiogenic shock is high and pharmacological interventions…

…min/g of myocardial tissue During hyperemia (maximum stress): Approximately 3.58 ± 1.14 mL/min/g Total hyperemic flow for the whole heart: Approximately…

…of all individuals with Noonan syndrome have pulmonic stenosis. The stenosis is subvalvular, causing a narrowing of the RVOT (right ventricular outflow tract). Carcinoid heart…

…be caused by any tachyarrhythmia leading to prolonged periods of rapid ventricular rate (Table 1). Children and healthy adults may also develop tachycardia induced cardiomyopathy …

…particularly with continuing ischaemia, heart failure, electrical instability or a large area of myocardium at risk. Over 48 hours: urgent PCI is still indicated with…

…the ECG machine. Lidocaine spray for the pharynx and lidocaine gel for the electrode. A glass of water with a straw, a vomit bowl, tissues…

…with ECG, central vein catheter and intra arterial catheter (A line) is warranted. Overview of vasopressors and inotropes Inotropes and vasopressors. Table 1. Drug manual…

…drug induced arrhythmias in patients receiving agents known to alter the electrical properties of the heart (inducing QRS or QT prolongation) or causing electrolyte abnormalities…

…antihypertensives, should prompt clinical suspicion [1]. Cardiac Signs and Symptoms Patients often present with symptoms of predominant right heart failure, including lower extremity edema, ascites…

…Lesions causing only mild obstruction may rupture, thrombose and occlude. Many acute myocardial infarctions arise from lesions that previously obstructed less than 50% of the…

…chest discomfort; symptoms suggestive of myocardial ischaemia despite normal or non obstructive coronary arteries; dyspnoea; fatigue; and recurrent symptoms causing impaired quality of life. Women…

…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…

…the anticoagulation indication. Previous stroke or TIA. The presence of mitral stenosis, a mechanical heart valve or hypertrophic cardiomyopathy. Heart failure, hypertension, diabetes and vascular…

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

…at any age. Exercise, or any other activity causing adrenergic stimulation, increase the risk of syncope, ventricular arrhythmias and sudden cardiac arrest. ARVC can cause…

ECG Pacemaker malfunction, troubleshooting and ECG Conventional surface ECG can reveal the following types of pacemaker dysfunction: Failure to capture (FTC) , which means that the…

…atrial flutter. As compared with several other supraventricular tachyarrhythmias, atrial flutter does not occur among otherwise healthy individuals. Atrial flutter causes characteristic ECG changes, as…

…the heart) are appropriate investigative options. Three dimensional (3D) echocardiography is likely to have increased significance in these studies in the future. Hemodynamic effects of…

…which has recorded causes of cardiac arrest with a separate category for cardiac etiologies. Cause Definition Medical cause Includes cardiac arrest caused by heart disease…

…with ECG, central vein catheter and intra arterial catheter (A line) is warranted. Overview of vasopressors and inotropes Inotropes and vasopressors. Table 1. Drug manual…

…circulation, causing pulmonary hypertension (PH). Additionally, pulmonary hypertension can propagate further backward to the right ventricle and right atrium, leading to right heart hypertrophy, dilation…

…cardiac myocytes require aerobic metabolism (oxygen) to produce sufficient quantities of ATP. This implies that the heart requires continuous blood flow to maintain cellular function…

…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…