Myocardial ischemia and infarction Definition and Clinical Significance In stent restenosis (ISR) is recurrent narrowing within a previously implanted coronary stent. It represents a form…

Akutsjukvård Psykiatri Lathundar Delirium in older adults: quick reference A quick reference for ward and on call physicians: recognise hypoactive delirium, stabilise the patient, work…

…compendium (FASS) before administration — concentrations and formulations differ between units, and most serious dosing errors arise at the dilution step, not in the choice of…

…the preparation Avoid in renal failure, heart failure, a history of peptic ulcer, and old age Titrate according to the effect and the respiratory rate…

…Reported relative effects include: Approximately 11% reduction in cardiovascular events in a meta analysis of primary prevention trials involving individuals with an estimated 10 year…

…agonists (GLP 1 RAs) and evolving into multi receptor agonists, has unleashed a new paradigm in cardiometabolic medicine. These therapies are revolutionizing public health strategies…

Echocardiography Ultrasound artifacts The following artifacts are common in ultrasound imaging: The ultrasound image displays non existing structures. The ultrasound image does not display existing…

…of cardiac arrest patients—can induce such pupillary responses. In a comprehensive study by Javaudin et al., involving more than 11,000 cardiac arrest cases…

…Romhilt Este's score system Points Any of the following: R or S in any limb lead ≥20 mm S V1 or S V2 ≥30…

…infarction (STEMI) and non ST segment elevation myocardial infarction (Non STEMI, NSTEMI) in detail. Although myocardial ischemia may affect every aspect of the ECG – from…

…A patient who has become calm, quiet in the chest and stopped struggling may be about to stop breathing. Diminishing wheeze means improvement only if…

…At a creatinine clearance <20 mL/min, consider an alternative treatment In aminoglycoside treatment of obese patients, an adjusted body weight is used: adjusted weight…

…down by three adults. Procedure Batteries and magnets A button battery in the nose or the ear canal is an emergency, not a finding that…

…small adjustments impossible. Procedure Intravenous titration in acute severe pain Practical points during titration: Give the injection slowly over at least a minute; a rapid…

…results in augmentation of early afterdpolarization amplitude (typically seen with large T wave amplitude), and QT prolongation. Ventricular flutter Monomorphic VT at a rate ~300…

…cardiovascular death, and progression of atherosclerotic disease in patients with established coronary or other atherosclerotic vascular disease. Antiplatelet therapy is a central component because platelet…

…increased sympathetic drive may promote AF. In DHF, ventricular rate may decrease as dyspnoea improves and sympathetic activation subsides, making it difficult to determine whether…

…or reversible causes. The first step in treating sinus bradycardia is to discontinue any medications that may be contributing to the slow rate. Acute treatment…

Cardiology Clinical medicine Definition and Clinical Context Blood pressure management in older adults must account for chronological age, biological age, frailty, multimorbidity, cognitive status, functional…

…become progressively more complex. Older adults, often defined in cardiovascular practice as those older than 75 years, are not a homogeneous population: biological age, frailty…

…prevalence of asymptomatic atherosclerotic cardiovascular disease (ASCVD) than the general population. The evidence for premature atherosclerosis is particularly strong in RA and SLE. Ankylosing spondylitis…

…higher prevalence of cardiovascular complications and death than men. Despite the effectiveness of preventive interventions in both sexes, women are less likely to receive statins…

…reported rates are generally 5–10%, although some series report 10–20%. Other life threatening cardiopulmonary conditions account for approximately 5% of presentations in some…

…weight gain, peripheral edema, early satiety, abdominal distension and, in some patients, bendopnea. Congestion may also aggravate functional mitral regurgitation, ventricular dilatation, myocardial wall stress…

…Definition and pharmacological basis Ezetimibe is a non statin lipid lowering agent that inhibits the Niemann–Pick C1 like 1 (NPC1L1) transporter in the intestine…

Cardiology Genetic and miscellaneous conditions Definition and scope Familial and genetic screening in cardiovascular medicine is the systematic assessment of relatives and other individuals who…

…trained athletes in the absence of symptoms. C: Sinus bradycardia should persist with the onset of physical activity. D: Sinus bradycardia with heart rates between…

…atrial appendage, although competing mechanisms such as large artery atherosclerosis and small vessel disease may also contribute to stroke in patients with AF. Stroke risk…

…results in augmentation of early afterdpolarization amplitude (typically seen with large T wave amplitude), and QT prolongation. Ventricular flutter Monomorphic VT at a rate ~300…

…systole. Transesophageal echocardiography and surgical pathology demonstrate that over 90% of thrombi in non valvular AF originate within this specific anatomical cul de sac [19] …

…Confirm cardiac arrest In case of a collapse (out of hospital or in hospital) the first task is to determine if a cardiac arrest has…

…rate of 0.1°C/min during the cooling process. Malignant hyperthermia Malignant hyperthermia may manifest under two primary circumstances: Due to a genetic mutation in…

…In such instances, favorable neurological outcomes are possible even with prolonged periods of no blood flow, due to the reduced metabolic rate that accompanies declining…

…due to aspiration risks and inconclusive evidence. However, in cases of iron, lithium, or potassium intoxication where lavage might prove beneficial, the procedure should be…

ECG Myocardial ischemia and infarction Use of ECG in acute coronary syndromes & chest pain patients An ECG must be performed on all patients seeking medical…

…the term perimyocarditis . Hemodynamic effects of pericardial effusion and cardiac tamponade Intrapericardial pressure increases as fluid accumulates in the pericardial space. Intrapericardial pressure may reach…

…the elderly also tend to have more atherosclerosis (both in frequency and severity) which may compensate for the inability to reach their maximal heart rate…

…with cardiogenic shock, researchers compared the effectiveness of milrinone and dobutamine . The primary composite outcome included in hospital mortality, resuscitated cardiac arrest, cardiac transplantation or…

…or notch in the descending limb of the R wave and/or notch in the descending limb of the S wave In case of complete…

…down adenosine. These actions result in increased extracellular adenosine concentrations, causing vasodilation. Dobutamine Dobutamine is a chronotropic and inotropic agent. It increases heart rate, myocardial…

…upsloping ST segment. The depression in the J 60 point is usually <1 mm and it resolves rapidly once the exercise is stopped. Some experts…

ECG Myocardial ischemia and infarction ST segment elevation in acute myocardial ischemia ST segment elevations with straight (horizontal, upsloping, or downsloping) or convex ST segment…

ECG Myocardial ischemia and infarction T wave changes in acute myocardial infarction & ischemia A thorough discussion regarding the physiology of the T wavewas previously provided…

…pronounced improvement in the chain of survival is the dramatic increase in rates of bystander CPR ( Figure 2 ). Bystander CPR was provided in approximately 30…

…been discussed previously in this article. Briefly, accelerated ventricular rhythm (also called idioventricular rhythm) is a benign ventricular rhythm with a heart rate of 60…

…As mentioned before, the subendocardium of the left ventricle has the poorest prerequisites in case of ischemia. The infarction process starts in the subendocardium from…

CPR Bedside echocardiography in cardiac arrest In the context of cardiac arrest, focused echocardiography entails a swift evaluation of ventricular contractions and the status of…

…Anemia: Hemoglobin <13 g/dL in men or <12 g/dL in women (3 points) Severe Renal Disease: Estimated glomerular filtration rate (eGFR) <30 mL…

…Their clinical importance arises from the causal role of low density lipoprotein cholesterol (LDL C) and other apoB containing lipoproteins in atherosclerotic cardiovascular disease (ASCVD)…

…Consequently, the decision to prescribe colchicine requires attention to the balance between reduction in ischaemic events and possible infectious or other non cardiovascular adverse outcomes…

…improve angina and quality of life, but randomized trials have not demonstrated reductions in mortality or myocardial infarction rates. Clinical presentation and symptoms The clinical…

…including non calcified plaques that are not directly visualized by calcium scoring. In contrast, coronary CT angiography (CCTA) can characterize both calcified and non calcified…

…denotes treatment with aspirin plus a P2Y12 receptor inhibitor. In the setting of acute coronary syndrome (ACS), DAPT is used to reduce recurrent myocardial infarction…