…abscess, a markedly unwell patient with fever and systemic upset, suspected necrotising soft tissue infection, a child who cannot tolerate the procedure while awake. Suspected…

…Indirect criteria after circulatory arrest, following a five minute no touch period The circulation at retrieval Maintained up to retrieval Ceased; warm ischaemic time is…

Myocardial ischemia and infarction Procedurer Definition and Clinical Role Invasive coronary angiography (ICA) is a catheter based investigation that visualizes the coronary arterial tree after…

…4a MI: Represents a periprocedural myocardial infarction associated with percutaneous coronary intervention (PCI). Type 4b MI: Denotes myocardial infarction related to stent thrombosis following PCI…

…revascularization is common and may reflect procedural myocardial injury rather than a clinically significant infarction. Mechanisms of injury Procedural injury may result from acute compromise…

…of patients. Evaluation and clinical assessment Clinical factors influencing treatment selection The following characteristics favour CABG when clinically and anatomically appropriate: Diabetes mellitus, particularly with…

…first The induction of vomiting has no place in the modern treatment of poisoning. Charcoal also does not bind every poison. With the following substances…

…and prolonged ICU admissions. Pending the correct level of care, the following actions can be performed. CPR Initiate CPR in adherence to standard guidelines. However…

…the following: Symptoms of myocardial ischaemia. New ischaemic ECG changes. New pathological Q waves. Imaging evidence of new loss of viable myocardium or a new…

…The increasing prevalence of refractory angina reflects population ageing and improved survival among patients with CAD following advances in anti ischaemic treatment and coronary revascularization…

…lower sensitivity and specificity in women. This may be due to the following: Atherosclerosis is generally less severe in women. Women tend to have more…

…injuries to the mediastinum can cause tamponade. Post operative Complications : Post surgical complications following thoracic procedures can cause tamponade. Tamponade with swinging heart of the…

…segment elevation myocardial infarction (STEMI) and following complex PCI. Stent thrombosis remains multifactorial, reflecting interactions between patient related, lesion related, device related, and procedural factors…

…stent implantation is increased by: Small reference vessel size A small post procedural luminal diameter A high degree of residual stenosis Long lesion length Diabetes…

…the dose and measure more frequently Acute illness and infection The insulin requirement rises, often despite a reduced food intake Insulin pump The patient manages…

…Do the following early: 1. Assess airway, work of breathing, level of consciousness and circulation. 2. Give controlled oxygen with a target of 88 to…

…affecting cardiac function or hemodynamics. The following functions are attributed to the pericardium: The pericardium serves as a barrier to infections. The pericardium reduces friction…

…ECG changes. Significant pericardial effusion may bring about the following ECG changes.: Low voltage: large amounts of pericardial effusion will diminish the QRS amplitudes. Electrical…

…all pediatric patients. Sinus rhythm is defined by the following criteria: Regular rhythm with a ventricular rate within the age specific normal interval. P wave…

…multiorgan dysfunction. 10% die from recurrent arrhythmias. To monitor and evaluate the victim after ROSC, the following modalities and investigations are routinely used: Computed to

…At least one of the following provides the required evidence of ischaemia: Symptoms compatible with myocardial ischaemia New ischaemic ECG changes Development of pathological Q…

…Diagnostic criteria for acute myocardial infarction A diagnosis of myocardial infarction is based on the following three components: Cardiac troponins – Elevation of cardiac troponins in…

…For instance, a patient with stable CAD may present with clinical manifestations of myocardial ischaemia following an acute gastrointestinal bleed or a sustained tachyarrhythmia. Symptoms…

…indicated in patients with symptoms suggestive of acute myocardial infarction and at least one of the following criteria present: haemodynamic instability or cardiogenic shock recurrent…

…shoulders, and arms, sometimes following the trapezius ridge [2]. Distinguishing Features: Recognition may be aided by the pain not being relieved by rest or nitroglycerin…

…Other Differential Diagnoses ST segment elevations simulating acute ischemia or infarction may also occur in the following conditions [15]: Myocarditis Early repolarization patterns Left bundle…

…the entire QRS complex is comprised of one negative deflection. The following figure shows pathological Q waves in two patients with acute STEMI. Figure 2…

…is permeated by the mantra time is myocardium, which refers to the progressive loss of myocytes following the occlusion of a coronary artery. The size…

…of MI. Clinically, UA is defined by one or more of the following patterns: Angina at rest, usually prolonged for more than 20 minutes. New…

…80 mg tablet once daily. Warnings and precautions Use Aspirin with caution in the following cases: Concurrent anticoagulant therapy (e.g., coumarin derivatives or heparin…

…troponin T (cTNT). The following differences exist between troponin I and T: An increase in troponin I (cTnI) is only seen in myocardial injury. Hence…

…level, producing atrioventricular (AV) or intraventricular blocks. Isolated sinus bradycardia in the early hours following infarction may be associated with hemodynamic compromise. More broadly, bradyarrhythmic…

…exclude or verify the following potentially life threatening causes of chest pain: Ischemic heart disease : stable angina pectoris, unstable angina pectoris, acute myocardial infarction (AMI)…

…6 hours after an episode of ischemia/infarction, but no later than 24 hours. However, T wave inversions following reperfusion develop within 4 hours and…

Cardiology Indications for pharmacologic agents Pharmacologic stress tests are indicated in the following scenarios: Inability to exercise due to physical limitations. Contraindications to exercise, such…

…determining what phase the patient is in. The three phases following a sudden cardiac arrest were described by Weisfeldt and Becker (2002). Drawing on physiology…

…Intermittent bradycardia The following conditions may cause intermittent bradycardia: Extrasystoles (premature ventricular beats or premature atrial supraventricular beats) can cause transient AV blocks by affecting…

…ischemia, old myocardial infarction, long QT, and bundle branch block. Cardiac monitoring is indicated for patients with a high pretest probability of arrhythmia causing syncope…

…abnormal, and the following differential diagnoses are at hand: Sinus node dysfunction. Side effects of drugs (diltiazem, verapamil, beta blockers, digitalis). Hypoxia. Myocardial ischemia/infarction…

…with the following: Myocardial Infarction : LBBB can develop as a complication of myocardial infarction (MI) [5]. It is more frequently associated with anterior infarction than…

…myocardial infarction (STEMI) This applies to patients undergoing either primary or delayed percutaneous coronary intervention (PCI). Contraindications Prasugrel should not be used in the following…

…onset atrial fibrillation to sinus rhythm. Vernakalant is used in the following settings: Non surgery patients: atrial fibrillation ≤7 days duration. Post cardiac surgery: atrial…

…with chloride following passively down the resulting electrochemical gradient. By inhibiting SGLT2, these drugs produce coupled sodium and glucose loss in approximately a 1:1…

…catheter insertion) Underlying lung pathologies In cases of benign pneumothorax, positive pressure ventilation can precipitate a tension pneumothorax, leading to circulatory collapse. Diagnosis of a…

…Causes of sinoatrial (SA) block The following conditions cause sinoatrial block: Sinus node dysfunction (SND) Perimyocarditis Acute myocardial infarction (or ischemia) Drug side effects (procainamide…

…in the sinoatrial node or conduction defects (e.g. second degree AV block) as a result of ischemia/infarction. Sinus Node Dysfunction (SND) – Sinus node…

…in partial (incomplete) occlusion of the coronary artery. NSTE ACS results in one of the following diagnoses: Non ST Elevation Myocardial Infarction (NSTEMI, non STEMI) …

…latter term has been deprecated. The left bundle branch is subdivided into the following two fascicles: (1) the anterior (anterosuperior) fascicle , which delivers the electrical…

…in partial (incomplete) occlusion of the coronary artery. NSTE ACS results in one of the following diagnoses: Non ST Elevation Myocardial Infarction (NSTEMI, non STEMI) …

…Ebstein's anomaly is characterized by the following malformations: The septal and posterior leaflets of the tricuspid valve adhere to the ventricular myocardium (failure of…

…measure ST segment deviation. The following must be noted regarding the ST segment: The normal ST segment is flat and isoelectric. The transition from ST…

…These estimates should be viewed as approximations due to the following: Registry data indicate that survival is possible with longer periods of no flow ( Rawshani…

…effects for up to 2 weeks. The peak vasodilatory effect is observed between 2 4 days following the infusion. This delayed onset is attributable to…

…Hence, heart rate and blood pressure must also be noted. In summary, the following variables should be included in the survey: personal identification, age, sex…

…ACS), including ST Elevation Myocardial Infarction (STEMI) [1] . Historically viewed as a simple plumbing problem characterized by the gradual accumulation of inert cholesterol debris, modern…

…hypertrophy). The following rules will distinguish the two conditions in the vast majority of cases: Right ventricular hypertrophy shifts the electrical axis to the right…

…complex in leads I and II. The following rules apply: Normal axis : Net positive QRS complex in leads I and II. Right axis deviation : Net…

…complex in leads I and II. The following rules apply: Normal axis: Net positive QRS complex in leads I and II. Right axis deviation: Net…

…As always, foreign materials pose a high risk of infection. Approximately 20% of all endocarditis affect people with valve prostheses and among other cases 18…

Hematologi & onkologi Infektionssjukdomar Lathundar Key message Fever in a neutropenic patient is an emergency. Infection can progress rapidly, while the typical local signs of inflammation…