…of ischaemia. Other mechanisms capable of obstructing coronary arteries include embolism, dissection, coronary arteritis associated with systemic vasculitis, extrinsic compression, myocardial bridging and radiation induced…

…Embolic material Cardiac emboli may consist of the following materials: Coagulated blood Tumor tissue Fragments from vegetations (septic or aseptic vegetations) Fragments of calcifications Atherosclerotic…

…pulmonary embolism, pneumothorax and acute coronary syndrome must be actively considered [1]. Do the following early: 1. Assess airway, work of breathing, level of consciousness…

…be approximated manually by judging the net direction of the QRS complex in leads I and II. The following rules apply: Normal axis: Net positive…

…chest pain the primary task is to exclude or verify the following potentially life threatening causes of chest pain: Ischemic heart disease : stable angina pectoris…

…2]. Summary of Pain Characteristics The following table synthesizes the key differential diagnoses and their characteristic pain patterns based on the provided context. Condition Typical…

… and Clinical evidence of acute myocardial ischaemia. At least one of the following provides the required evidence of ischaemia: Symptoms compatible with myocardial ischaemia New…

…the suitability of the proposed anticoagulant dose. Whether concomitant antiplatelet therapy is genuinely indicated. The strongest established predictors of ischaemic stroke and systemic embolism are…

…also be approximated manually by judging the net direction of the QRS complex in leads I and II. The following rules apply: Normal axis : Net…

…99th percentile URL; and Clinical evidence of acute myocardial ischaemia , demonstrated by at least one of the following: Symptoms of myocardial ischaemia. New ischaemic ECG…

…of sympathetic innervation), coronary embolism, and spontaneous coronary artery dissection with or without intramural haematoma. Spontaneous coronary artery dissection is defined as spontaneous dissection of…

…Cannulation should be completed within 60 minutes following the collapse. Preferential consideration is often given to younger patients, typically those below 65 years of age…

…load becomes prolonged. However, most often the cause of the load is the primary problem. Among the causes are pulmonary embolism, pulmonary hypertension, septum defects…

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

…first year after stenting, although the risk is higher after treatment of ST segment elevation myocardial infarction (STEMI) and following complex PCI. Stent thrombosis remains…

…Duration of treatment: at least 3 months. Extended treatment in unprovoked pulmonary embolism, a persisting risk factor, or recurrence. Special situations Situation Comment : : Pregnancy Leg…

…pulmonary embolism overlap with risk factors for DVT; immobilisation, surgery, hypercoagulability, and pregnancy are common risk factors (see Risk factors below). A significant proportion of…

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

…PAD), and other manifestations of systemic atherosclerosis. The principal clinical concern is cerebral embolism or haemodynamic compromise leading to transient ischaemic attack (TIA) or stroke…

…embolism, vasculitis, fibromuscular dysplasia, arterial entrapment, cystic adventitial disease and trauma. Atherosclerotic PAD is a manifestation of systemic arterial disease rather than an isolated disorder…

…AF induces a systemic hypercoagulable state, characterized by elevated biomarkers such as D dimer, von Willebrand factor, and increased thrombin generation. The clinical consequence of…

…Drug Standard dose Reduced dose and criterion : : : Apixaban 5 mg twice daily 2.5 mg twice daily if at least two of: age ≥80 years…

…before revascularisation. Evaluation of treatment effect in stable angina. Exercise induced arrhythmia or exercise induced syncope. Assessment of chronotropic function and pacemaker settings. Preoperative functional…

…coach actively, and do not accept a trace you would not be prepared to show a colleague. Indications Investigation of chronic cough, dyspnoea, wheeze or…

…investigations. The emergency differential also reflects distinct mechanisms of acute cardiopulmonary disease: Pulmonary embolism and spontaneous pneumothorax may produce abrupt chest pain and respiratory distress…

…chemistry & laboratory medicine Definition and Pathophysiology B type natriuretic peptide (BNP) and N terminal pro BNP (NT proBNP) are circulating markers of myocardial wall stress…

…despite the absence of an angiographically obstructive lesion Coronary embolism or thrombus Epicardial coronary vasospasm Coronary microvascular dysfunction Spontaneous coronary artery dissection (SCAD) Standard angiography…

…acute myocardial infarction, pericarditis/myocarditis or pulmonary embolism is often a reversible arrhythmia with low risk of recurrence. Atrial fibrillation in other circumstances (particularly those…

…heart failure or after myocardial infarction). Ventricular arrhythmias are easier to induce in the presence of arrhythmogenic substrates. A substrate is defined as a physiological…

…myocardial ischemia/infarction, pulmonary embolism, pheochromocytoma, hyperthyroidism, hypovolemia, pharmacological substances (alcohol, amphetamine, coffee, anticholinergic drugs, beta adrenergic agonists). In all of these conditions, sinus tachycardia…

…windows might be feasible, particularly during brief pauses. An enlargement of the right ventricle is suggestive of pulmonary embolism, though its specificity is low. Notably…

…or without pain, include sudden loss of consciousness, a confusional state, profound weakness, the appearance of an arrhythmia, evidence of peripheral embolism, or an unexplained…

…with advancing age. Presentations without pain may include: Sudden breathlessness Syncope or sudden loss of consciousness Confusion Profound weakness An arrhythmia Peripheral embolism An ot

…deviations include: Causes of Right Axis Deviation: Pulmonary hypertension (primary or secondary) [9, 16] Severe pulmonary stenosis [8] Right ventricular hypertrophy [8, 17] Pulmonary embolism…

…exposure of thrombogenic material. Superficial plaque erosion. Thrombosis associated with a calcified nodule. Epicardial or microvascular coronary spasm. Spontaneous coronary artery dissection. Coronary embolism of…

CPR Cardiac arrest is a result of tachyarrhythmia, bradyarrhythmia or asystole. The tachyarrhythmias include ventricular fibrillation (VF) and pulseless ventricular tachycardia (VT). The bradyarrhythmias include…

…MI) within 48 hours Ongoing unstable angina Uncontrolled cardiac arrhythmia with hemodynamic compromise Active endocarditis Symptomatic severe aortic stenosis Decompensated heart failure Acute pulmonary embolism…

…Decompensated heart failure – due to the risk of circulatory collapse and arrhythmias Pulmonary embolism in acute phase – due to risk of aggravation of the condition…

…superficial components may detach and embolize systemically. Observational data indicate approximately a fourfold greater risk of embolic events in patients with LV thrombus than in…

…lesions Embolic debris obstructs the distal microcirculation and may be accompanied by microvascular constriction and endothelial or myocardial injury. Antithrombotic therapy may reduce embolization of…

…distal to the suspected obstruction Arterial and venous Doppler signals Evidence of systemic disease or a potential embolic source Neurological assessment is central to triage…

…multiple villi . These myxomas are more likely to embolize (Cardiac Thromboembolism). There are genetic syndromes that result in the emergence of multiple myxomas. Papillary fibroelastoma…