…As for any long standing tachycardia, there is a risk of developing tachycardia induced cardiomyopathy. In pediatric populations, a distinct form of atrial tachycardia may…

…prolongs survival. Myocardial stunning starts to normalize within minutes after the hypoxia is relieved. However, full recovery of contractility may take hours to days. It…

…the arms. Orthostatic hypotension: a fall of ≥20 mmHg in SBP and/or ≥10 mmHg in DBP at 1 or 3 minutes after standing, following…

…the underlying cause. KDIGO recommends prompt investigation of reversible causes, continuing staging, and treatment directed at both the cause and the severity [1]. Three questions…

…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 : …

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

…drug or nothing Preparation and equipment INR, full blood count, creatinine with eGFR and liver function tests before starting. A complete medication list including over…

…Suspected acute leukaemia, myelodysplastic syndrome or myeloproliferative neoplasm. Work up and staging of lymphoma and myeloma. Suspected bone marrow metastasis. Assessment of treatment response and…

…Figure 1). Myocardial fibers adjacent to the endocardium are longitudinally oriented (from base to apex) and yield a longitudinal shortening (Figure 1A), which means that…

…adverse effects such as hypotension, syncope, falls, and functional deterioration may have greater consequences in frail patients. Clinical Assessment Frailty and Functional Status Treatment decisions…

…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…

…life threatening clinical syndrome in which increased intrapericardial pressure compresses the heart and impairs ventricular filling. It generally results from accumulation of pericardial fluid, blood…

…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…

…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…

…spectrum ranges from symptom free presentation to persistent chest discomfort, cardiac arrest, electrical or haemodynamic instability, and cardiogenic shock. ACS is distinct from myocardial infarction…

…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…

…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…

…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…

…above 10 mmHg A fall in systolic blood pressure during inspiration; one of the most useful signs Low voltage on the ECG, electrical alternans Supportive…

…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…

…The transition from a quiescent plaque to a highly thrombogenic surface occurs via three primary mechanisms: Plaque Rupture: Accounting for 60 70% of ACS presentations…

…trials, the field has transitioned from a predominantly pharmacological strategy to one that heavily integrates early catheter ablation and sophisticated device therapy [1] [2] . This…

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…

…with haemodynamic compromise, whatever the current haemoglobin — haemoglobin falls late in acute haemorrhage and a normal value does not exclude significant blood loss. Massive haemorrhage…

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…

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…

…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…

…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…

…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…

…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…

…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…

…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…

…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…

…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…

…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…

…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…

…from the device and with monopolar electrocautery below the umbilicus. Nevertheless, perioperative planning should be individualized according to the patient, device, procedure, and anticipated electrical…

…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…

…a dose of 30 ml/kg. Should fluid resuscitation fail to maintain a mean arterial pressure (MAP) above 65 mmHg, consider the initiation of vasopressor…

…and they fill the ventricles with adequate volumes of blood before ventricular contraction commences. To coordinate these two tasks, the heart has an electrical conduction…

…are often mildly elevated. Hence, takotsubo cardiomyopathy cannot be differentiated from ST segment elevation myocardial infarction. Due to their clinical presentation, these patients are immediately…

…long has the fibrillation lasted, and does the patient need an anticoagulant? The unstable patient Immediate electrical cardioversion, without delay, in any of the following…

…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…

…one minute apart, taking the mean of the last two Orthostatic testing after 1 and 3 minutes of standing in older patients, patients with diabetes…

…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…