…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…

…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…

…influences. The severity of myocardial injury is determined not only by the epicardial obstruction but also by the vulnerability of the myocardium and coronary microcirculation…

…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…

…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…

…threatening causes of chest pain: Ischemic heart disease : stable angina pectoris, unstable angina pectoris, acute myocardial infarction (AMI). Note that unstable angina pectoris and acute…

…persisted in; and, that on stopping, the distress immediately abates, or altogether subsides; have . . . formed a constituent part of the character of Angina Pectoris. Atherosclerosis…

…prolongation and torsade de pointes reported to the FDA in postmarketing studies. Anti androgen Cancer (Prostate) Abiraterone is an antiandrogen used in the treatment of…

…JE, Gwyther R, Kirkman E. Closed chest compressions reduce survival in an animal model of haemorrhageinduced traumatic cardiac arrest. Resuscitation 2019; 140:37 42. Endo…

…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…

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

…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…

…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…

Arrhythmias and arrhythmology ECG Aberrant ventricular conduction (aberrancy, aberration) Aberrant conduction is not a mechanism of arrhythmia; it is a ventricular conduction disturbance . It is…

…main beam. As the ultrasound beam sweeps back and forth, multiple side lobe artifacts can be generated on both sides of the true reflector. If…

…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…

…intraluminal pressure. Coronary blood flow is also influenced by sympathetic and parasympathetic influences; sympathetic stimulation leads to vasoconstriction through the release of norepinephrine, while parasympathetic…

…is usually thickened and during systole leaflet doming appears. The proximal part of the pulmonary artery is frequently dilated. The maximum and mean pressure gradient…

…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…

…and makes it visible even when it lies buried in the QRS complex or the T wave. The whole value of the investigation lies in…

…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…

…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…

…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…

…the vulnerability caused by marked local differences in repolarization. This article is part of the comprehensive chapter: How to read and interpret the normal ECG

…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…

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…

…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…

…and P3 (posterior or lateral scallop). Figure 1. Anatomy of the mitral valve The leaflets are connected to the papillary muscles via chordae tendineae (Figure…

…These two measures – i.e switching to anaerobic metabolism and discontinuing the contractions – enables the myocardium to endure 20 to 30 minutes of severe ischemia…

…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…