…zone. Coronary Occlusion and Myocardial Injury STEMI generally results from abrupt reduction in coronary blood flow caused by thrombotic occlusion of a previously atherosclerotic artery…

…extent and degree of myocardial involvement The anatomical territory, including anterior, inferoposterolateral or right ventricular involvement Pre existing abnormalities such as prior infarction, left bundle…

…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…

…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…

…may be subclinical. Progressive dilation can subsequently impair left ventricular ejection fraction. Enlargement of the left ventricle predisposes to atrial and ventricular arrhythmias. In advanced…

…also contributes to the extension and severity of ischemic injury. In its most severe form, known as no reflow, structural and functional impairments sustain vascular…

…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…

…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…

…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…

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

…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…

…before cleaning the skin. 2. Clean and let it dry. Do not palpate the puncture site again with an unsterile hand. 3. Insert the needle…

…arm abducted and the hand behind the head. All drains are inserted within the safe triangle (Figure 1). Outside it the risk of injuring the…

…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…

…objective, particularly in patients with left ventricular dysfunction and/or MVD. Nevertheless, the optimal extent and timing of intervention depend on the clinical setting, haemodynamic…

…left ventricular ejection fraction, procedural factors and anticipated outcomes. The supplied material does not describe specific physical signs of CTO or a dedicated physical examination…

…Endocrinology & metabolism Pharmacology & dosing Definition and pharmacological basis Sodium glucose cotransporter 2 (SGLT2) inhibitors are a class of oral agents initially developed for glucose lowering…

…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…

…Alternating block (right and left bundle branch block alternating from one beat to another) is uncommon. Ashman's phenomenon : This type of aberration occurs when…

…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…

…an indicator of cardiac hemodynamic status and may be estimated with echocardiography. The PASP is an independent predictor of survival and for elevated left ventricular…

…restoration of sinus rhythm (or any other rhythm with normal ventricular rate and activation). Recovery may, however, take several months. Table 1. Arrhythmias causing tachycardia…

…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…

…upwards towards the bridge of the nose. 7. When the tip reaches the pharynx: let the patient take a mouthful of water and hold it…

…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…

…of Cardiac Amyloidosis Demographic and Clinical Context Cardiac amyloidosis should be suspected in patients older than 65 years presenting with heart failure and increased left…

…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…

…becomes thinner and the ventricle begins to dilate. Approximately 50% of cases exhibit biventricular cardiomyopathy, although the disease is less pronounced in the left ventricle…

…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…

…gradually leads to atrial hypertrophy and dilation. Atrial dilation causes a significantly increased risk of atrial fibrillation. The increase in left atrial pressure may also…

…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…