…be established. Nasopharyngeal airways may cause complications in patients with skull fractures (risk of intracranial malposition of the tube) or coagulopathy (risk of bleeding). An…

…Procedural and mechanical Stent underexpansion, incomplete wall apposition, residual inflow or outflow disease, edge dissection, overlapping stents, crush technique, stent fracture or collapse Lesion specific…

…to recite the months of the year backwards. A normal result does not exclude delirium, however, and an abnormal result is not specific to delirium…

…can be present [5]. Distinguishing Features: Pleuritic pain suggests pulmonary infarction, and a history of pain exacerbation with inspiration, along with a pleural friction rub…

…features of Brugada syndrome are fairly specific to the disorder, provided that the clinical characteristics are in line with the disorder. There are however other…

…X linked or other non autosomal dominant mechanisms. Complex or multifactorial genetic architecture. The inheritance pattern affects the appropriate scope and duration of family surveillance…

…definition of MI. Type 1 MI is generally related to an atherothrombotic event, whereas Types 2–5 MI have other mechanisms of myocardial ischaemia and…

…injury leads to release of cardiac troponin, but troponin elevation is not specific for myocardial infarction. Other conditions may produce cardiomyocyte injury and elevated troponin…

…mass and lesion haziness raise suspicion of thrombus, although haziness is not specific. Intravascular imaging can identify plaque disruption, thrombus and other structural features that…

…risk of stroke; Increased risk of end stage renal disease; Increased mortality; and A higher probability of secondary hypertension. Patients may also have comorbid features…

…prediction tool currently exists. At the other end, roughly two thirds of ICDs implanted for reduced LVEF never deliver an appropriate shock, so the false…

…or fracture of the leads. External causes are less common and include electrolyte disorders, metabolic disorders, hypoxemia, antiarrhythmic drugs, or electromagnetic disturbance caused by other…

…resolution does not consistently permit identification of foamy macrophages. The occurrence of neoatherosclerosis helps explain why ISR and other stent related events may arise well…

…must be differentiated from hyperacute T waves seen in the very early phase of myocardial ischemia. Hyperacute T waves are broad based, high and symmetric…

…Clinical features Occlusion of the left main coronary artery (LMCA) abruptly interrupts blood flow to both the left anterior descending (LAD) and left circumflex (LCx…

…and spotty calcification. However, the concept has important limitations. Although thin capped fibroatheromas may have imaging characteristics associated with rupture, fewer than 5% of such…

…impulse reaches the atrioventricular node when there are two pathways, one being refractory and the other capable of conducting the impulse, re entry may arise…

…This is because the strong and oppositely directed forces tend to cancel each other out. However, the ECG may show features characteristic of biventricular hypertrophy…

[calc_aorta] Sinus of Valsalva (SOV) and Aortic Root Assessment The sinus of Valsalva diameter (SOVd) is a critical measurement in evaluating aortic root morphology…

…The etiology, clinical characteristics and ECG features of pericarditis will be discussed here. From a clinical point of view, clinicians must be able to separate…

…Other causes of ventricular dilation ( e.g ischemic cardiomyopathy) must be excluded before establishing a diagnosis of DCM. Patient characteristics, clinical features, family history and…

…favorable prognosis, as compared with other forms of ventricular tachycardia. Mechanisms of ventricular tachycardia Ventricular tachycardia (VT) may emerge due to increased/abnormal automaticity, re…

…over 40 years of age, atherosclerosis is the predominant cause. Other mechanisms include thrombosis, embolism, vasculitis, fibromuscular dysplasia, arterial entrapment, cystic adventitial disease and trauma…

…foam cells and macrophages; a thin fibrous cap; positive remodelling; neovascularization; intraplaque haemorrhage; adventitial inflammation; spotty calcification. Nevertheless, the presence of these features does not…

…extent of circulatory compromise. Features associated with an unfavourable short term prognosis include: Tachycardia Low systolic blood pressure Respiratory insufficiency, manifested by tachypnoea and/or…

…electrically dissociated from each other. This condition is referred to as atrioventricular (AV) dissociation. Importantly, for the ventricles to have any electrical (and thus pumping)…

…hypoxemia and ischemia all aggravate the risk of developing ventricular fibrillation, in any situation. ECG features of ventricular fibrillation The ECG shows irregular waves with…

…Other coronary anomalies Anomalous coronary origin and course can impair coronary perfusion, particularly during vigorous exercise. In AAOCA, high risk anatomical features include an interarterial…

…from selected populations, frequently with low or intermediate ischemic risk and under representation of patients with STEMI or other very high risk features. Noninferiority studies…

…early phases of ischemia). To conclude, concave ST segment elevation is atypical of ischemia, but they do not rule out ischemia. Other features of ischemic…

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

…Call anaesthetics and intensive care early with life threatening features or an inadequate response. First line treatment is oxygen in hypoxaemia, repeated doses of an…

…1, formerly termed glucocorticoid remediable aldosteronism, and other familial forms associated with adrenal adenoma or bilateral adrenal hyperplasia. A family history is therefore important, particularly…

…overlapping features frequently lead to confusion between LBBB and acute STEMI. In fact, studies have shown that LBBB is the most common cause of false…

…and there is always variation between the leads. Some leads may display all waves, whereas others might only display one of the waves. Regardless of…

…whereas others have features overlapping with HFpEF, including abnormalities of LV relaxation and filling. Hypertension and diabetes can contribute to the development of heart failure…

…dominant manifestation of CAD. As LV dysfunction and HF become more prominent, angina may diminish or disappear. Others have no recognized history of angina or…

…the reduction becomes and the greater the risk of chondral and neurovascular injury. Aim for reduction within a few hours. Contraindications A fracture dislocation requiring…

…as an open fracture. The anatomy of the nail apparatus The terminology is hard to follow without a picture, and several of the steps below…

…dislocation. Immobilisation of a ligament injury, a tendon injury, or after suturing over a joint. Pain relief and stabilisation for transfer in a suspected fracture…

…cannula in a large vein gives many times the flow of a fine needle, and collapsed veins mean that the fine needle is in addition…

…stricture or a known diverticulum Relative Recent nasal or pharyngeal surgery Signs that should raise the suspicion of a base of skull fracture: periorbital bruising…

…uncontrolled source of bleeding. Minimise the time to surgery, endoscopy, an obstetric procedure or angiographic intervention. Summon anaesthesia, the operating specialty, the blood bank and…

…The contralateral side of the septum already cauterised — bilateral cautery carries a risk of perforation Anterior packing: Suspected base of skull fracture or a significant…

…depression, or untreated severe respiratory failure without the possibility of monitoring. Paralytic ileus and suspected obstructive ileus (an opioid can be given for the pain…

…Suspected base of skull fracture or marked coagulopathy argues against the nasal route; the oral route may then be considered. Preparation and equipment A 12…

…pressure measured, or be palpated. Indications A sensation of something in the eye, watering, photophobia and redness after working with a grinder, a drill, a…

…catheter is not easier to pass. With a difficult passage it is the shape of the tip and the technique that matter, not the calibre…

…the vulnerability caused by marked local differences in repolarization. This article is part of the comprehensive chapter: How to read and interpret the normal ECG

…the surface ECG. Intracardiac electrodes – with the placement of electrodes against the sinoatrial node – are necessary to diagnose first and third degree sinoatrial block. However…

…interpretation Physiology and ECG features of the P wave, PR interval and PR segment The P wave ECG interpretation usually starts with assessment of the…

…malignant than anomalous origin of the right coronary artery. High risk anatomical features include: An interarterial course between the aorta and pulmonary artery A slit…

…of preeclampsia with severe features during the subsequent two weeks. Cerebral circulatory autoregulation is also disturbed. This helps explain the neurological manifestations of preeclampsia and…

…approximately 1–2% without reperfusion to about 0.2% in the reperfusion era. Clinical presentation and symptoms A new episode of hypotension, recurrent chest pain…

…ST segment elevation and positive T waves. The ST segment elevation rarely exceeds 5 mm. Figure 4 illustrates the distinguishing features of RBBB and LBBB…

…supine position and after 3 minutes of standing to determine if orthostatic hypotension is present. High risk features on history include: New onset of chest…

…signs and a focused examination directed toward both alternative diagnoses and high risk features of acute coronary syndrome. The physical examination should include: Assessment of…

…This manifests with three features on the ECG and the combination of these features are unique to pre excitation: ECG features of pre excitation Short…

…Presentation and Initial Clinical Context Chest pain or discomfort is the most common symptom initiating evaluation for ACS. Features that increase the likelihood of ACS…

…on the vascular territory involved and may include systemic arterial embolic manifestations. The source material does not provide a detailed catalogue of specific embolic syndromes…