…energy requirements and mitigation of reperfusion injury are complementary objectives of initial STEMI management. The principal acute complications fall into two broad categories: Electrical complications…

…ECG interpretation requires a comprehensive understanding of cardiovascular pathophysiology and electrocardiology. Unfortunately, numerous books and online resources fall into the trap of oversimplification. Physicians, nurses…

…heart disease, other medical conditions (pulmonary embolism, bleeding, stroke, etc.) as well as cases where the cause does not fall into the other categories. Trauma…

…an opioid can be given for the pain, but the effect on the bowel must be taken into account). Known allergy to the preparation — rare…

…acute myocardial injury must be coupled with clinical evidence of acute myocardial ischaemia. The Fourth Universal Definition classifies MI into five distinct subtypes based on…

…sarcoidosis Other cardiac procedures Chemotherapeutic agents Catheter ablation Critical illness Defibrillator shocks Strenuous exercise Cardiac contusion The diagnosis should therefore distinguish isolated myocardial injury from…

…clinical presentation of VT, with a deep dive into the underlying etiologies ranging from benign idiopathic variants to complex scar related and genetic substrates. Furthermore…

…and ST Elevation Myocardial Infarction (STEMI). Historically, guidelines bifurcated ACS into STEMI and NSTE ACS pathways. However, the 2023 European Society of Cardiology (ESC) and…

…single most important tool when intubation fails, since it restores oxygenation without requiring a view down into the larynx. The difficult airway rarely kills because…

…as ejection fraction may provide easily obtained parameters, but fail to provide important insights into left ventricular mechanics. Regional differences in contractile function are of…

…gravity and slow movement; those that fail usually do so because the patient tenses up with pain, or because the operator pulls harder rather than…

…or arrhythmia. 4. Shift potassium into the cells with insulin and glucose. Add high dose salbutamol in marked hyperkalaemia if there is no contraindication. 5…

…with a high BMI, and that the deltoid injection is placed too high — which causes the shoulder injury known as SIRVA. Both are avoided with…

…why, or the patient at risk of carbon dioxide retention is given 15 litres on a reservoir mask and drifts off into a respiratory acidosis…

…a glass injury: consider radiography, since glass is usually visible on plain films. Irrigation fluid: a copious volume of drinking quality tap water or sodium…

…of acute coronary syndrome (ACS), biochemical evidence of myocardial injury with corroborating evidence of infarction caused by ischaemia, and no obstructive stenosis in a major…

…mechanism. Sequential activation implies that the atria are activated first and they fill the ventricles with adequate volumes of blood before ventricular contraction commences. To…

…Injection of contrast media into the ventricle will instead reveal that the apical portion of the left ventricle is dilated (hence the term apical ballooning…

…Previous pelvic irradiation on the intended side (yields fibrotic, unrepresentative marrow — choose the other side). A patient who cannot lie still — plan for sedation rather…

…However, full recovery of contractility may take hours to days. It is generally stated that myocardium resists 20 minutes of severe hypoxia before cell death…

…in twenty falls outside them . Order twelve tests in a healthy person and the probability is around 46 % that at least one will fall outside…

…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…

…myocardial infarction Acute myocardial infarction requires: Acute myocardial injury, demonstrated by a rise and/or fall in cardiac troponin with at least one value above…

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

…alcohol, a missed meal, physical activity and any other precipitating factor. Thresholds The thresholds below are used above all in diabetes. The severity of the…

…a full blood count with a differential, CRP, creatinine, electrolytes, liver function tests, glucose and lactate. Add a blood gas, coagulation tests and other investigations…

…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…

…with elevation of their diastolic pressures. Right sided filling becomes increasingly dependent on the fall in intrathoracic pressure during inspiration. The inspiratory increase in right…

Njurmedicin Lathundar Acute management on call Acute kidney injury, AKI, is a syndrome of rapidly deteriorating renal function. Management is governed not by the creatinine…

…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…

…the signal disappears, deflate slowly (2 mmHg/s) and note the pressure at which the signal returns. Repeat on the other arm. 2. Ankle pressure…

…1. Assess airway, breathing and circulation. 2. Assess the neurological symptoms and at the same time exclude other acute causes, for example hypoglycaemia, poisoning, stroke…

…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…

…Types 2–5 MI have other mechanisms of myocardial ischaemia and necrosis. Unstable angina (UA) represents myocardial ischaemia without demonstrable acute cardiomyocyte injury or necrosis…

…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…

…exercise capacity, an abnormal blood pressure response or ventricular arrhythmias. A fall in systolic blood pressure, particularly when accompanied by evidence of ischaemia, may indicate…

…in which the patient reaches hospital early. The benefit of both methods falls steeply with the time since ingestion, and both can harm the patient…

Cardiology Pharmacology & dosing Definition and pathophysiology Congestion is a central expression of the heart failure syndrome and reflects excessive retention of sodium and water, with…

…dangerous differential diagnoses [1,2]. STEMI and other ECG patterns suggesting acute coronary occlusion are time dependent conditions. The decision on immediate reperfusion is based…

…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…

…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…

…and the incidence is particularly high after hip fracture, major surgery and intensive care [1,2]. The condition is associated with falls, aspiration, pressure sores…

…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…

…convulsive activity, t2, the risk of permanent neuronal injury increases. Treatment must therefore start at 5 minutes and be escalated without unnecessary pauses [1]. The…

…kidney function declines and as albuminuria increases. When eGFR falls below approximately 60–75 mL/min/1.73 m², the probability of coronary artery disease…

…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…

…through the pulmonary circulation. Consequently, left ventricular filling falls and cardiac output may become markedly depressed. Right sided filling pressures—including central venous, right atrial…

…with avoidance of second hand smoke and, where possible, other inhaled nicotine products. In cardiovascular medicine, the objective is not merely to reduce cigarette consumption…

…High altitude sickness Aspiration Chronic obstructive pulmonary disease (COPD) Bronchospasm (asthma) Other : Coma Central hypoventilation syndromes Neuromuscular diseases Anemia The natural course of asphyxia Should…

…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…

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

…Non hyperemic pressure ratios (instantaneous wave free ratio [iFR], resting full cycle ratio [RFR], and related resting indices) simplified the procedure by removing the need…

…is prolonged after a premature beat). This yields more time to fill the ventricles with blood (increased ventricular filling). Persons with premature beats might perceive…

…increased after a premature ventricular complex). This yields more time to fill the ventricles with blood (increased ventricular filling). The person with premature beats might…

…This is also a normal finding. Abnormal (pathological) causes of sinus bradycardia In all other situations, sinus bradycardia should be regarded as a pathological finding…

…compressions ineffective. For instance, a traumatic hemorrhage can deplete intravascular volume to such an extent that chest compressions fail to generate stroke volumes. Consequently, addressing…

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

…attack Acute severe attack Life threatening attack : : : : Speech Full sentences Cannot complete a sentence in one breath Single words or unable to speak Position and…