…definitive or interim therapeutic solution can be reached. There is no consensus regarding the criteria for ECMO initiation. However, frequently used criteria include the following…

…causes include: Mechanism or clinical setting Examples Acute coronary atherothrombosis Plaque disruption or erosion with thrombosis Reduced myocardial perfusion Coronary spasm, microvascular dysfunction, coronary embolism…

…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…

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

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

…the following ECG changes.: Low voltage: large amounts of pericardial effusion will diminish the QRS amplitudes. Electrical alternans: The amplitude of the QRS complexes vary…

…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…

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

…of MI. Clinically, UA is defined by one or more of the following patterns: Angina at rest, usually prolonged for more than 20 minutes. New…

…a patient with chest pain the primary task is to exclude or verify the following potentially life threatening causes of chest pain: Ischemic heart disease…

…and arms, sometimes following the trapezius ridge [2]. Distinguishing Features: Recognition may be aided by the pain not being relieved by rest or nitroglycerin, and…

…therapy is genuinely indicated. The strongest established predictors of ischaemic stroke and systemic embolism are previous stroke or TIA and mitral stenosis. In patients with…

…of the following: Symptoms of myocardial ischaemia. New ischaemic ECG changes. New pathological Q waves. Imaging evidence of new loss of viable myocardium or a…

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

…function of the right ventricle is primarily a function of the following parameters: Contractility of the myocardium : all causes of reduced contractility, globally or regionally…

…Low molecular weight heparin with dose adjustment, or warfarin Subsegmental pulmonary embolism without deep vein thrombosis An individual assessment; in selected cases the patient can…

…Mortality in pulmonary embolism is up to 20%, and roughly 30% of patients with pulmonary embolism or deep vein thrombosis experience a second thrombotic event…

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…

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

…of the aorta or arteries supplying the limbs. In adults over 40 years of age, atherosclerosis is the predominant cause. Other mechanisms include thrombosis, embolism…

…systemic embolism. The contemporary understanding of AF has evolved significantly; it is no longer viewed merely as an electrical anomaly but as a progressive, complex…

…Doses in venous thromboembolism Treatment doses in deep vein thrombosis and pulmonary embolism differ from the atrial fibrillation doses and include an initial high dose…

…or ongoing unstable angina. Uncontrolled symptomatic arrhythmia. Symptomatic severe aortic stenosis. Decompensated heart failure. Acute pulmonary embolism or deep vein thrombosis. Acute myocarditis, pericarditis or…

…month after resolution Pulmonary embolism, until anticoagulated and stable An individual assessment Eye, ear, abdominal or thoracic surgery 1 month Neurosurgery or an intracranial aneurysm…

…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…

…ventricular dysfunction caused by pulmonary embolism Infiltrative cardiomyopathies, particularly cardiac amyloidosis Sepsis and other hyperdynamic states In cardiac amyloidosis, BNP or NT proBNP may be…

…rupture or plaque erosion with thrombosis, despite the absence of an angiographically obstructive lesion Coronary embolism or thrombus Epicardial coronary vasospasm Coronary microvascular dysfunction Spontaneous…

…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…

CPR It is commonly stated that approximately 80% of all cardiac arrests are caused by acute or chronic coronary artery disease, with the latter being…

…of sinus tachycardia are as follows: Normal (physiologic) sinus tachycardia: The automaticity (rate of spontaneous depolarization) in the sinoatrial node is increased during physical activity…

…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…

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

…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…

…with a calcified nodule. Epicardial or microvascular coronary spasm. Spontaneous coronary artery dissection. Coronary embolism of cardiac or non cardiac origin. Oxygen supply–demand mismatch…

…the embolus prevents blood from passing from the lungs to the left ventricle, which therefore contracts without pre load (the ventricle is empty or nearly…

…with uncontrolled ventricular rates Acquired advanced or complete heart block Hypertrophic obstructive cardiomyopathy with severe resting gradient Recent stroke or transient ischemic attack Mental impairment…

…coronary artery disease. Assessment of therapeutic response. Exercise testing can be used to evaluate the effect of medications or interventions such as PCI, CABG, CRT…

…a detailed catalogue of specific embolic syndromes. Clinical suspicion should be heightened after: Anterior STEMI. A large or transmural infarction. Persistent apical akinesis or dyskinesis…

…Stent implantation Manipulation of friable SVG lesions Embolic debris obstructs the distal microcirculation and may be accompanied by microvascular constriction and endothelial or myocardial injury…

…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…

Echocardiography Cardiac tumors Cardiac tumors are rare. They can occur anywhere in the heart or surrounding tissue. Tumors can be localized in the myocardium, pericardium…