…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…

…inflammation and other systemic influences. The severity of myocardial injury is determined not only by the epicardial obstruction but also by the vulnerability of the…

…accounting for approximately 80% of cases. Other causes include acute mechanical complications—particularly ventricular septal defect (VSD) and papillary muscle rupture with acute severe mitral…

…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…

…established. The source material identifies chronic intake of approximately 60 g daily in males and 40 g daily in females as capable of causing cardiomyopathy…

…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…

…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…

…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…

…are numerous other causes of chest pain, but the other causes are either subacute or non acute. The history taking must be systematic and accurate…

…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…

…others. It is a novel, broad spectrum hydroxamic acid based inhibitor of histone deacetylase... <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Abexinostat+AND…

…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…

…is thought to involve the sensitization of sensory nerve endings due to the accumulation of bradykinin. ACE is responsible for metabolizing bradykinin and other tachykinins…

…or other major adverse cardiovascular events. Complete revascularization is therefore considered an important therapeutic objective, particularly in patients with left ventricular dysfunction and/or MVD…

…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…

…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…

…prolongation increases the length of the refractory period and the subsequent early impulse will therefore encounter refractory fibers. Thus, Ashman's phenomenon requires a long…

…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…

…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…

…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…

…A history of increasing frequency of hospitalizations and visits for heart failure without disease recognition in the 3 years preceding diagnosis is also a notable…

…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…

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

…fracture of the leads. External causes are less common and include electrolyte disorders, metabolic disorders, hypoxemia, antiarrhythmic drugs, or electromagnetic disturbance caused by other machines…

…beats per minute. Note that with a paper speed of 25 mm/s, which is standard in the US and many other countries, a 2…

…a long time and be detected randomly when investigating other conditions. More dramatic onset of symptoms can be seen in arrhythmogenic tumors of the myocardium…

…the result of a perfect storm scenario , where ischemia, hemodynamics, the autonomous nervous system, electrolyte concentrations, and other factors (potentially also genetic predisposition) interact to…

…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…

ECG Myocardial ischemia and infarction Myocardial ischemia: cellular changes, ECG signs and development of infarction Like all other cells in the human body, cardiac myocytes…

…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…