…been excluded. Causes of extreme axis deviation Rare. Most likely due to misplaced limb electrodes. If the rhythm is tachycardia with wide QRS complexes, then…

…extreme axis deviation Extreme axis deviation is rare. It is most likely due to misplaced limb electrodes. If the rhythm is tachycardia with wide QRS…

…common sustained cardiac arrhythmia and a profound driver of global cardiovascular morbidity and mortality, primarily due to its association with ischemic stroke and systemic embolism…

…due to embolization. Approximately 30% of all ischemic strokes are caused by cardiac embolism. This figure does not include paradoxical embolism (discussed below) and emboli…

…pulmonary embolism, pulmonary hypertension, septum defects, etc. Right ventricular load is thus an issue that is raised both in outpatient and emergency care. To evaluate…

…Yet, autopsies are often not performed due to the high costs. The difficulties in determining the cause of out of hospital cardiac arrest are reflected…

…and nervousness. This is due to altered tone in the autonomic nervous system, with increased sympathetic input (leading to stimulation of beta adrenergic receptors) and…

…between myocardial oxygen supply and demand, which is not related to acute coronary atherothrombosis. By definition, acute atherothrombotic plaque disruption is not a feature of…

…is too often discovered first at hospital admission due to its complications (stroke, thromboembolism, heart failure, dyspnea). Most individuals, however, do experience symptoms and th

…circulatory collapse and arrhythmias Pulmonary embolism in acute phase – due to risk of aggravation of the condition. Pulmonary infarction in acute phase – due to risk…

…and therefore the worse the prognosis. This does not always hold true. For example, in cardiac arrest due to pulmonary embolism the initial rhythm is…

…This is due to the swinging back and forth of the heart in the pericardial space. Note that tachycardia, pulmonary embolism and ischemia may also…

…smooth surface and a nucleus that often exhibits cavities, which consist of hemorrhages in the tumor. Polypoid myxoma usually causes haemodynamic complications due to obstruction…

…negative D dimer excludes pulmonary embolism Likely CT pulmonary angiography straight away. A D dimer must not be used to rule it out The age…

…hypercoagulability, and pregnancy are common risk factors (see Risk factors below). A significant proportion of cases with pulmonary embolism require thrombolysis to dissolve the occlusion…

…medicine Definition and pathophysiology Acute pulmonary embolism (PE) is classified according to haemodynamic status, clinical severity, evidence of right ventricular (RV) dysfunction, and myocardial injury…

…not a sufficient explanation for all acute dyspnoea in a patient with COPD. Pneumonia, heart failure, pulmonary embolism, pneumothorax and acute coronary syndrome must be…

…cerebral embolism or haemodynamic compromise leading to transient ischaemic attack (TIA) or stroke. The risk associated with asymptomatic disease depends substantially on stenosis severity and…

…assessment should include functional status and walking capacity, because these may reveal “masked” PAD in patients who do not exert themselves sufficiently to provoke symptoms…

…Failing to ask when the last dose was taken. It matters more than the laboratory value. A normal INR and a normal APTT do not…

…Known — perform the test only on a clear indication and with full preparedness Moderate to severe aortic stenosis without symptoms Individual assessment Hypertrophic cardiomyopathy with…

…would not be prepared to show a colleague. Indications Investigation of chronic cough, dyspnoea, wheeze or reduced exercise capacity. Suspected asthma or COPD — diagnosis and…

…pulmonary embolism, aortic emergencies, and pneumothorax. Non cardiopulmonary causes , including gastrointestinal, musculoskeletal, and anxiety related disorders. The immediate objective is not simply to establish whether…

…and ambulatory presentations, but the appropriate thresholds differ substantially according to the clinical setting. Values obtained in the emergency department for acute dyspnoea should not…

…may fail to demonstrate plaque disruption, intraluminal thrombus, or dissection. Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) can reveal lesions that are not apparent…

…URL). It is considered acute when there is a rise and/or fall in cTn values. An elevated cTn alone does not establish MI, because…

…or without ECG abnormalities and with or without an elevation in cardiac troponin. The underlying pathological mechanism is not restricted to a single lesion or…

…angina pectoris and acute myocardial infarction are categorized under acute coronary syndromes (ACS). Aortic dissection Pneumothorax Pulmonary embolism Mediastinitis (rare condition) In addition to these…

…g. pulmonary embolism) or in case of long no flow or low flow periods. Under such circumstances, the efficacy of compressions and defibrillation diminishes considerably…

…of ventricular contractions and the status of the pericardium by an experienced clinician. The examination is typically as brief as the intervals required for rhythm…

…and can radiate to the neck, shoulders, and arms, sometimes following the trapezius ridge [2]. Distinguishing Features: Recognition may be aided by the pain not…

…rise and/or fall. A stable elevation indicates chronic myocardial injury . Myocardial injury is not synonymous with myocardial infarction. Cardiac troponin identifies injury to myocardial…

…pulmonary embolism, acute aortic dissection, costochondritis, and gastrointestinal disorders. Radiation of discomfort to the trapezius ridge is not seen in STEMI and suggests pericarditis instead…

…and less commonly to the abdomen, back, neck or lower jaw. Discomfort may extend superiorly as far as the occipital region but typically does not…

…drugs predisposing to bleeding and alcohol use. A high bleeding risk score should prompt correction of modifiable risk factors and closer surveillance; it does not…

…ventricular hypertrophy (RVH) and right atrial enlargement [8]. RAD is present in most cases of significant RVH, although it is not typically classified as a…

…contribute to activation of coagulation. Plaque rupture is typically associated with a fibrin rich, red thrombus. The size and persistence of the thrombus depend not…

…failure Acute pulmonary embolism, pulmonary infarction, or deep vein thrombosis Acute myocarditis or pericarditis Acute aortic dissection Physical disability that precludes safe and adequate testing…

…thrombus is attached to infarcted myocardium, superficial components may detach and embolize systemically. Observational data indicate approximately a fourfold greater risk of embolic events in…

…procedures overall. It is particularly associated with intervention on degenerated saphenous vein grafts (SVGs), rotational atherectomy, and procedures performed for acute myocardial infarction. In SVG…

…refill and venous filling Pulses proximal and distal to the suspected obstruction Arterial and venous Doppler signals Evidence of systemic disease or a potential embolic…

…thrombus can fragment, embolize to other coronary branches or vascular beds, propagate through gaps between stent struts, and compromise the treated lumen. Conventional angiography has…