…Capillary refill is delayed, and venous filling may be reduced. Other possible findings include muscle stiffening and loss of deep tendon reflexes. Pulses are absent…

…endothelial dysfunction, smooth muscle cell dysfunction, and dysregulation of sympathetic innervation), coronary embolism, and spontaneous coronary artery dissection with or without intramural haematoma. Spontaneous coronary…

…or numbness of the foot and toes. Pain that is worse at night or when the limb is horizontal. Improvement when the leg is placed…

…muscle cells, leading to a white, platelet rich thrombus. Myocardial vulnerability, largely driven by coronary microvascular dysfunction, also contributes to the extension and severity of…

…smooth muscle, endothelial cells, macrophages, neurons and other tissues. This distribution helps explain why PA produces cardiovascular injury beyond its effects on blood pressure and…

…Definition and staging according to KDIGO Acute kidney injury is present when at least one of the following criteria is met [1]: A rise in…

…complex fibroatheroma. Smooth muscle cells (SMCs) migrate from the tunica media into the intima, driven by platelet derived growth factor (PDGF) and other cytokines. Within…

…accounting for approximately 80% of cases. Other causes include acute mechanical complications—particularly ventricular septal defect (VSD) and papillary muscle rupture with acute severe mitral…

…C based eGFR With an atypical muscle mass, or to confirm a creatinine based value The mean of creatinine and cystatin C The most reliable…

…myocardial injury , demonstrated by a rise and/or fall in cTn with at least one value above the 99th percentile URL; and Clinical evidence of…

…and bleeding complications than femoral access. In patients with acute coronary syndrome, randomized evidence has demonstrated lower rates of access site bleeding, surgical repair, and…

…particularly in iatrogenic aortic injury. Iatrogenic lesions commonly follow cardiac surgery, coronary angiography or other invasive procedures, and affected patients may be relatively painless compared…

…many cases, the renal injury probably represents acute tubular necrosis arising from the combined effects of contrast exposure and other ischaemic or nephrotoxic stresses. The…

…outcomes. The vast majority of infections with COVID 19 result in mild disease, with symptoms similar to seasonal flu (influenza) and other viral respiratory infections…

…ICU is the preferred level of care for the absolute majority. The CCU may be suitable for stable (hemodynamically and respiratory) and fully conscious patients…

…The test presupposes that the patient has spontaneous nystagmus at the time of examination and that the examiner is experienced with the head impulse test…

…is part of the treatment itself. Indications Salicylate poisoning with symptoms or a rising serum concentration. Alkalinisation increases renal elimination several fold and at the…

…Respiratory rate and oxygenation Evidence of systemic congestion or acute RV failure Syncope or altered clinical status Comorbid cardiopulmonary disease, active cancer, and other conditions…

…rate. Within the context of acute coronary syndromes, particularly ST elevation myocardial infarction (STEMI), ischemic injury can disrupt the conduction system at any level, producing…

…in hypertensive encephalopathy and should prompt consideration of stroke. Acute ischemic or intracerebral haemorrhage may coexist with severe hypertension. The decision to lower BP in…

…evidence of acute cardiomyocyte injury or necrosis. It is distinguished from acute myocardial infarction (AMI), in which myocardial ischaemia is accompanied by cardiomyocyte necrosis and…

…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…

…in other reports. It is more frequent in women and in patients presenting with NSTEMI than in those presenting with STEMI. Approximately one third of…

…liver injury is the commonest cause Isolated bilirubin Unconjugated, the others normal Gilbert's syndrome, haemolysis The R value = (ALT / upper limit of normal…

…the efficacy of diuretics and antihypertensives. Risk of acute kidney injury increases when combined with ACE inhibitors. Corticosteroids and other NSAIDs: Increased risk of gastrointestinal…

…and endothelial or myocardial injury. Antithrombotic therapy may reduce embolization of thrombotic or atheroembolic material, but pharmacological and mechanical strategies directed specifically at reperfusion injury…

…biomarkers because they are extremely sensitive and specific for myocardial injury. Elevated levels of cardiac troponins is firm evidence of myocardial necrosis (i.e infarction…

…Subclinical cerebral injury may contribute to vascular dementia, and thromboembolism may affect organs other than the brain. Patients with AF in the setting of ACS…

…and imaging technique. Coronary fistulae represent abnormal communications between a coronary artery and a cardiac chamber or vessel. Other congenital anomalies include anomalous origin of…

…no absolute threshold defines the condition. A rapid rise in blood pressure can cause serious organ damage even at lower levels, particularly in pregnancy [1…

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

…segment depression is a common and early electrocardiographic sign of acute pericarditis, reflecting pericardial involvement overlying the atria [4, 5]. Other Differential Diagnoses ST segment…

…transmural ischemia. On the other hand, leads V1–V3 (occasionally V4) may detect the injury currents and present them as ST segment depressions. These depressions…

…injury currents are not strong enough to be detected on leads with opposite angle of observation. Other vectors may interfere with the injury currents, and…

…or at least four drinks for women or five for men on one occasion. Pharmacokinetics and pathophysiology Approximately 95% of ingested ethanol undergoes hepatic metabolism…

…inflammation and other systemic influences. The severity of myocardial injury is determined not only by the epicardial obstruction but also by the vulnerability of the…

…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…

…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…

…closer monitoring — the patient cannot feel pressure injury Peripheral neuropathy of other cause As above Severe pain Titrate the pressure up gradually Rheumatoid arthritis with…

…Concussion, temporal bone injury, dissection, aminoglycoside toxicity, antiepileptic drugs, alcohol or sedatives Trauma and medication directed workup This corresponds to the principles of TiTrATE, in…

…high shear conditions. Disruption of an atherosclerotic plaque or injury associated with PCI exposes thrombogenic material, promoting platelet activation, aggregation, and fibrin formation. Within a…

…transmural ischemia. On the other hand, leads V1–V3 (occasionally V4) may detect the injury currents and present them as ST segment depressions. These depressions…

…skin tension lines and make it long enough — as a rule of thumb, along the whole length of the abscess or at least half its…

…if there is suspicion of cervical spine injury, in which scenario head tilt chin lift should only be used if other methods fail to open…

…function and drug concentration Gentamicin and other aminoglycosides A single dose initially. If treatment is continued, dosing is guided by drug concentration measurement. At a…

…or unsecured airway in a patient with a reduced level of consciousness Gastric lavage Corrosive injury or suspected oesophageal perforation Gastric lavage Petroleum products Gastric…

…longer a joint remains dislocated, the harder the reduction becomes and the greater the risk of chondral and neurovascular injury. Aim for reduction within a…

…are components of the myocardial contractile apparatus and are expressed predominantly in cardiac muscle. Troponin I is highly specific for myocardial injury. Interpretation of troponin…

…The extent of myocardial injury is strongly influenced by total ischaemic time. This interval includes: The time from symptom onset to recognition and seeking medical…

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

…are no means of determining what phase the patient is in. The three phases following a sudden cardiac arrest were described by Weisfeldt and Becker …

…cause of permanent loss of function is a tendon injury that was sutured over without being found. Indications A traumatic wound that gapes and cannot…

…injury. Influence of Muscle Mass and Diet: Serum creatinine levels, a key component of the MDRD equation, can be affected by factors such as muscle…

…ventilation. Inadequate ventilation with a rising pCO₂ and respiratory acidosis, or a markedly increased work of breathing with impending exhaustion. Threatened airway obstruction: inhalation injury…

…the anterior axillary line. Thoracostomy This method is generally deemed safer than using a needle due to reduced risk of injury. Thoracostomy should be performed…

…eye injury is to measure and document the visual acuity before anything else is done. The second most important is to look for signs of…

…about 30 minutes of continuous convulsive activity, t2, the risk of permanent neuronal injury increases. Treatment must therefore start at 5 minutes and be escalated…

…A patient with a plasma potassium of 6.2 mmol/L, new bradycardia and acute kidney injury may be at greater immediate risk than a…

…a large bore cannula in a suitable vein). Standby access in a patient at risk of rapid deterioration. Intraosseous access: Cardiac arrest where venous access…

…injury. The syndrome is therefore both a clinical risk factor cluster and a marker of broader metabolic dysfunction. Associated abnormalities may include increased apoB and…