…stroke volume produces an exaggerated inspiratory fall in systemic systolic blood pressure, termed pulsus paradoxus. Tamponade is therefore characterized haemodynamically by elevation and near equalization…

…progressive, and highly dynamic inflammatory disease of the arterial wall. It is characterized by the subendothelial accumulation of apolipoprotein B containing lipoproteins, macrophage infiltration, smooth…

…UA) represents myocardial ischaemia without demonstrable acute cardiomyocyte injury or necrosis. It is characterized by prolonged angina at rest, usually lasting more than 20 minutes…

…mitigation of reperfusion injury are complementary objectives of initial STEMI management. The principal acute complications fall into two broad categories: Electrical complications , particularly ventricular arrhythmias…

…world: What is the best ECG book? This question is far from trivial and the stakes are high; mastering ECG interpretation will frequently be a…

…112 mmol/L may be relatively unaffected, while a rapid fall from 140 to 125 mmol/L can cause marked symptoms [4]. Grade Plasma sodium : …

…secondary prevention strategies. By Morphology: Monomorphic VT (MMVT): Characterized by a uniform QRS morphology from beat to beat in each electrocardiographic lead. MMVT strongly indicates…

Procedurer Emptying the stomach has gone from routine to exception. Activated charcoal — in Sweden usually called medicinal charcoal — is the first line measure in decontamination…

…the bedside. The check against the patient's own identity immediately before transfusion is the single most important safety measure in the entire chain. In…

Endokrinologi & metabolism Lathundar An inpatient has a different insulin sensitivity from at home: less food, more stress, often corticosteroids, often impaired renal function. Prescribe basal…

CPR Sepsis induced cardiac arrest Sepsis is a life threatening condition characterized by systemic inflammatory response syndrome (SIRS), disseminated intravascular coagulation (DIC), and hypoperfusion manifesting…

…atrial contraction (premature atrial beat / complex) A premature atrial contraction is produced by an impulse discharged from an ectopic focus located anywhere in the atria…

…result from mechanisms that render chest compressions ineffective. For instance, a traumatic hemorrhage can deplete intravascular volume to such an extent that chest compressions fail…

…are elevated. Consequently, congestion may occur across the full range of left ventricular ejection fraction and may result from systolic dysfunction, diastolic dysfunction, or both…

…The haemodynamic disturbance results from impaired right ventricular contraction and reduced forward flow through the pulmonary circulation. Consequently, left ventricular filling falls and cardiac output…

…abrupt onset, although a brief warm up phase lasting approximately 5 to 10 seconds may precede the full tachycardia. It is characterized by short, rapid…

…regarded as a series of completely discrete diseases. Heart failure extends across the full range of LVEF, and echocardiographic measurement is subject to meaningful variability…

…systole showing apical ballooning akinesis with basal hyperkinesis in a characteristic takotsubo ventricle. Studies from the US and Japan has estimated that up to 2…

…approach generally applied to older patients. Frailty is characterized by reduced physiological reserve and increased vulnerability to adverse outcomes. It is dynamic and may improve…

…gap junctions, which are proteins that form channels between the cell membranes. Electrically charged ions can flow between cells through the gap junctions. It follows…

…of myocardium from one point to another. During the motion, all myocardium within a particular region displays the same velocity. The motion is characterized by…

…Comment : : : Reticulocytes 20–100 ×10⁹/L Distinguishes a production defect from haemolysis or bleeding Ferritin 15–300 µg/L (women 10–150) An acute phase…

…specific 99th percentile upper reference limit. It is classified as acute when serial measurements demonstrate a rise and/or fall. A stable elevation indicates chronic…

…documented rise and/or fall of cTn values. However, myocardial injury alone is an entity in itself and may arise from non ischaemic cardiac conditions…

…injury from infarction caused by acute ischaemia. Acute myocardial infarction Acute MI requires both: Acute myocardial injury , demonstrated by a rise and/or fall in…

…al. ). Figure 1 presents data from the Swedish Cardiac Arrest Registry, which has recorded causes of cardiac arrest with a separate category for cardiac etiologies…

…or measure at the toe instead. Marked pain that prevents the patient from tolerating compression. Preparation and equipment Equipment: a handheld Doppler probe 5–10…

…alert value < 3.9 mmol/L but at least 3.0 mmol/L Prompt action is needed to prevent a further fall Level 2…

…sets of blood cultures from separate peripheral punctures. Also culture from a central line if one is present 4 Take a full blood count with…

…tachypnoea, cold periphery Almost always Pulsus paradoxus above 10 mmHg A fall in systolic blood pressure during inspiration; one of the most useful signs Low…

…CYP2C9 variants) (1 point) E xcessive fall risk (1 point) S troke (1 point) HEMORR₂HAGES Score Risk category Incidence of major bleeding (per 100 patient…

…This distinction supports a risk based approach because cardiovascular benefit from blood pressure reduction may also occur in selected people whose pressure is elevated but…

…bicarbonate or blood gas, calcium, phosphate, glucose and a full blood count. 5. Take a urine dipstick and, where the cause is unclear or a…

CPR The course from sudden cardiac arrest (SCA) to death follows a pathophysiological process that affects the effectiveness of the interventions. Numerous studies demonstrate that…

Lungmedicin Akutsjukvård Lathundar Key messages Two things set the COPD exacerbation apart from many other causes of acute dyspnoea: oxygen must be titrated cautiously and…

…In heavy smokers, cardiovascular risk falls within five years of stopping but may remain elevated thereafter. The overall health benefit is greater still when reductions…

…Scars, hernia or visible abdominal wall collaterals (caput medusae) Puncture at least a few centimetres away from them Full bladder Have the patient void, or…

…The two pathways DBD DCD : : : Full name Donation after death by neurological criteria (total brain infarction) Donation after circulatory death Starting point A ventilated patient…

…from seizure onset Action : : 0 to 5 minutes ABCDE, start timing, glucose, monitoring, intravenous or intraosseous access, a targeted history At 5 minutes A full…

…mg/g—or both. The eGFR is generally estimated from serum creatinine using the Chronic Kidney Disease Epidemiology Collaboration (CKD EPI) equation, incorporating relevant demographic…

…the cardiac cycle. It is caused by an impulse discharged from an ectopic focus which may be located anywhere in the ventricles. The ectopic impulse…

…done without losing time. 7. Perform urgent CT of the brain and CT angiography from the aortic arch to the vertex. 8. Contact the thrombectomy…

…Every seven years HPV, with reflex cytology if HPV positive The interval is counted from the most recent sample analysed for HPV. Invitations are sent…

…5. At the same time, start treatment that eliminates potassium from the body. 6. Check the plasma potassium after about 1 hour and follow the…

…plasma and platelets. Observational data from trauma suggest a lower overall mortality after such protocols are introduced, although the effect on 24 hour mortality is…

…then rebreathes carbon dioxide from the mask Mask with a reservoir 10–15 L/min 60–90 % For acute severe hypoxaemia. Fill the bag before…

…runs away or the patient bleeds. In Sweden the treatment is usually managed from an anticoagulation clinic with dosing support, but whoever starts the drug…

…important therapeutic objectives. Evidence from randomized trials is often less applicable to very frail or multimorbid patients because these groups have historically been underrepresented. Consequently…

…likelihood of clinically significant EMI is generally low, particularly with bipolar electrocautery performed away from the device and with monopolar electrocautery below the umbilicus. Nevertheless…

…Indeed, the greatest opportunities for survival exist during the first few minutes from collapse. Table 1 shows the number needed to treat (NNT) for various…

…is most pronounced and extends towards the penumbra zone (the outermost and less ischemic area), which may receive oxygen from collateral vessels. In cardiac arrest…

…choose the more cautious course. Anticoagulation Assess the risk with CHA₂DS₂ VA (the sex category has been removed from the Swedish recommendation). Score Recommendation : : 0…

…the iliac crest is inaccessible, but biopsy must never be taken from the sternum — the needle may perforate into the mediastinum. The anterior superior iliac…

…the "can't intubate, can't oxygenate" situation there are no contraindications — a laryngeal mask is inserted even with a full stomach. Preparation and equipment…

…obstructive lesion Coronary embolism or thrombus Epicardial coronary vasospasm Coronary microvascular dysfunction Spontaneous coronary artery dissection (SCAD) Standard angiography may fail to demonstrate plaque disruption…

…atria begin to contract again. An unsynchronised shock that happens to fall in the T wave can precipitate ventricular fibrillation, and cardioversion of fibrillation of…

…recovery. A patient who stops at a low workload with a fall in blood pressure is a high risk patient even with normal ST segments…

…with the same risk as manifest hypertension. Non dipping: a nocturnal fall in pressure of < 10% of the daytime value; an independent risk marker…

…interpreted as specialist investigations. Both fail more often for practical than for medical reasons: the cuff is in the wrong place, the electrodes come off…

…autonomic reflexes that influence the haemodynamic result. Reflex tachycardia is the rule after a rapid fall in blood pressure. Drug Indications Dosing α1 β1 β2…