…biologically active. Endothelial and smooth muscle cells normally regulate vascular tone, preserve an antithrombotic surface, and control the adhesion and migration of inflammatory cells. Dyslipidaemia…

…Low body mass index Asian ancestry Previous muscle disease or a personal or family history of muscle disorders Acute infection Renal or hepatic impairment Hypothyroidism…

…connective tissue disorders (Marfan syndrome, Ehlers Danlos syndrome), osteogenesis imperfecta typically causes prolapse of P2 (Figure 1). Myocardial ischemia affecting the papillary muscles or the…

…a young age in the patient or family Hypertensive first degree relatives of patients with PA Patients with hypokalaemia may develop weakness, muscle cramps or…

…muscle cells, leading to a white, platelet rich thrombus. Myocardial vulnerability, largely driven by coronary microvascular dysfunction, also contributes to the extension and severity of…

…respiratory disorders, notably obstructive sleep apnoea (OSA) and obesity hypoventilation syndrome, which further increase cardiovascular burden. Obesity may be a particularly important cause of HF…

…vomiting, muscle cramps, apathy, confusion, impaired reflexes. Severe <115 mmol/L Seizures, coma, respiratory arrest, brainstem herniation and death. Table 2. Grading of hyponatremia. Hypernatremia…

…Causes of hyperkalaemia Severe hyperkalemia is usually the result of several interacting factors, such as renal failure, insufficient corticosteroid substitution, acidosis, hemolysis and massive muscle…

…adventitial disease and trauma. Atherosclerotic PAD is a manifestation of systemic arterial disease rather than an isolated disorder of the lower limbs. Patients frequently have…

…antenatal hypertensive disorders, but it may also arise de novo after delivery. New onset postpartum preeclampsia is increasingly recognized as a significant cause of maternal…

…include electrolyte disorders, metabolic disorders, hypoxemia, antiarrhythmic drugs, or electromagnetic disturbance caused by other machines/devices. Below follows ECG tracings demonstrating each type of failure…

…Myocardial ischemia and infarction Definition and pathophysiology Myocardial infarction (MI) is a clinical diagnosis that integrates myocardial injury, evidence of acute myocardial ischaemia, electrocardiographic findings…

…Skipping a step is a common reason why mixed acid base disorders are missed. The blood gas describes the physiology at the moment of sampling…

…during the examination. Work related musculoskeletal disorders are a common cause of pain and sickness absence for ultrasound practitioners (Harrison et al). When performing emergency…

…on QT prolongation or risk of torsade de pointes in PubMed. Drug with neuroleptic and anti histamine properties. Sleep disorder Aceprometazine is often used in…

…the presence of an abnormal amount of fluid in the pericardial space. It can be caused by numerous local and systemic disorders. Accumulation of fluid…

Cardiology Definition and purpose Cardiovascular risk assessment estimates an individual’s probability of experiencing cardiovascular disease (CVD) over a defined period. SCORE2 and SCORE2 Older…

…conduction disorders frequently present with presyncope or syncope. Diagnosing transient or paroxysmal AV block in these individuals can be challenging. A high suspicion of intermittent…

…with later cardiovascular risk include: Premature menopause Premature ovarian insufficiency Hypertensive disorders of pregnancy Preeclampsia Preterm delivery Gestational diabetes Small for gestational age delivery Placental…

…Severe heart failure. Doses 100 mg/day during the third trimester of pregnancy. Dosage Acute myocardial infarction: Initial loading dose: 300–500 mg as soon…

…and thromboembolic disorders. Most recognised heritable cardiovascular conditions demonstrate autosomal dominant transmission, in which an affected heterozygous individual has a 50% risk of transmitting the…

…assessed. QT prolongation may be congenital (due to genetic mutations) or acquired (secondary to medications, electrolyte disorders). QT duration is inversely related to heart rate…

…impairment to develop, leaving persistent hypertension despite correction of the initiating disorder. Earlier diagnosis is associated with a greater likelihood of cure. When to investigate…

…predominant cause, accounting for approximately 60% of HFrEF cases in Western populations [14] . Non ischemic etiologies encompass a highly heterogeneous group of disorders. Idiopathic dilated…

…and miscellaneous conditions A novel potentially life threatening cardiac arrhythmia syndrome identified with ECG The ECG may be used to diagnose several cardiac genetic disorders…

…antiphospholipid syndrome (APS). Collectively, these disorders are associated with excess cardiovascular disease (CVD), although the cardiovascular phenotype varies substantially between diseases. Cardiovascular involvement extends beyond…

…dissection (SCAD) is an acute coronary disorder caused by separation within the coronary arterial wall, usually through formation of an intramural haematoma that compresses the…

…caused by abnormal repolarization . This is seen in ischemia, electrolyte disorders (calcium, potassium), tachycardia, increased sympathetic tone, drug side effects etc. Secondary ST T changes…

…also present in individuals without identifiable cardiac disease. Contributing factors include pulmonary disorders, particularly obstructive pulmonary disease, the use of theophylline, and elevated catecholamine states…

…Electrolyte disorders, acidosis, hypoxemia and ischemia all aggravate the risk of developing ventricular fibrillation, in any situation. ECG features of ventricular fibrillation The ECG shows…

…after reperfusion in an occluded coronary artery. It also occurs as side effect of drugs, hypoxia, myocarditis and electrolyte disorders. Because the rate (60–100…

…electrolyte disorders , congenital heart disease and catecholamine induced ventricular tachycardia . The vast majority of patients with ventricular tachycardia either have coronary artery disease (ischemic heart…

…be considered anginal equivalents. The emergency evaluation of non traumatic chest discomfort is structured around three principal diagnostic categories: Myocardial ischaemia , particularly acute coronary syndrome…

…coronary disorders. The investigation should be undertaken when its diagnostic or therapeutic consequences are likely to outweigh procedural risks. This balance forms part of shared…

…in this pattern. Endothelial dysfunction may contribute to both microvascular and epicardial vasomotor disorders. Endothelial activation can promote the release of adhesion molecules, inflammatory cytokines…

…are not apparent on conventional angiography. Coronary vasomotor disorders may involve epicardial spasm or abnormalities of the coronary microcirculation. Microvascular angina reflects myocardial ischaemia caused…

…Brugada syndrome. This disorder is easy to diagnose with a simple blood test and the ST segment elevations resolve after normalization of potassium levels. Brugada…

…Malignancy: A history suggesting an autoimmune disorder or known malignancy may suggest specific, nonidiopathic etiologies [2]. Summary of Pain Characteristics The following table synthesizes the…

Arrhythmias and arrhythmology Cardiology Definition and Pathophysiology Vasovagal syncope represents the most common form of neurally mediated syncope (NMS), a disorder of autonomic reflexes. It…

Cardiology Respiratory medicine Definition and Pathophysiology Pulmonary hypertension (PH) is a heterogeneous pathophysiological disorder characterized primarily by elevation of pulmonary arterial pressure. It may arise…

…an inherited disorder characterized by persistently elevated plasma low density lipoprotein cholesterol (LDL C) from early life and a consequent excess risk of premature atherosclerotic…

…the absence of a flow limiting epicardial coronary stenosis. It is therefore a disorder of coronary microvascular perfusion rather than persistent obstruction of the treated…

…4. Monitoring at the appropriate level of care , with readiness for respiratory support. 5. Treatment of the alcohol use disorder and planned follow up , not…

…Cardiac Amyloidosis Definition and Pathophysiology Cardiac amyloidosis (CA) is a protein misfolding disorder characterized by the extracellular deposition of misfolded fibrillar proteins in the myocardium…

Echocardiography Hypertrophic cardiomyopathy (HCM): from pathophysiology to echocardiography Hypertrophic cardiomyopathy is a genetic disorder that causes left ventricular hypertrophy under normal loading conditions. Hypertrophic cardiomyopathy…

…to second hand smoke. Use of cannabis, electronic cigarettes or other inhaled products. Readiness to attempt cessation. Depression, schizophrenia, schizoaffective disorder, HIV infection or other…

Endokrinologi & metabolism Akutsjukvård Lathundar Emergency overview Measure the plasma glucose immediately in everyone with a reduced level of consciousness, seizures, confusion, a change in behaviour…

…rise can cause osmotic demyelination syndrome [1,2]. Hyponatraemia is primarily a disorder of water balance. The plasma sodium reflects the ratio between the body…

…ECG examples of each condition are presented below. The ECG in Brugada syndrome Brugada syndrome is a rare channelopathy (an electrical disorder caused by mutations…

…follow. Consider people with the genetic disorder familial hypercholesterolemia (FH), which is caused by genetic mutations affecting the elimination of LDL cholesterol from the blood…

…on left ventricular ejection fraction (LVEF). Heart failure with reduced ejection fraction (HFrEF) is defined by the combination of symptoms, with or without physical signs…