…abdominal surgery in a patient with known lung disease. Follow up of treatment effect and of disease progression. Assessment of pulmonary involvement in systemic disease…

…shaft or distal bifurcation involvement Disease in the left anterior descending and left circumflex arteries The number of additional diseased vessels Lesion morphology and technical…

…who survive long enough for clinical evaluation often have some residual antegrade flow, a dynamic thrombus, or collateral circulation that limits infarct size. In such…

…FVC Forced vital capacity FEV₁/FVC The ratio that defines obstruction PEF Peak expiratory flow — variability rather than the absolute value TLC Total lung capacity…

…airway produces no reliable symptoms in a patient with an impaired cough reflex, and the first feed then becomes a direct instillation into the lung…

…distinct and uncommon form of precapillary PH. It is defined haemodynamically by precapillary PH in the absence of CTEPH, lung disease, or another explanatory cause…

…in the supine position. This is possible due to the small distance between the heart and the ultrasound transducer, and because less air filled lung…

Procedurer What determines the outcome of a central venous catheter insertion is decided before the needle goes in: the choice of site, the use of…

…3 IV Pneumonia, in chronic lung disease amoxicillin 750 mg × 3 PO 5–7 days or benzylpenicillin 3 g × 4 IV Pneumonia, suspected atypical pathogen…

…systemic vascular resistance, and left ventricular dP/dt. Oral doses sufficient to control arrhythmias do not depress left ventricular ejection fraction (LVEF), even in patients…

…In the presence of a flow limiting coronary stenosis, supply cannot increase adequately. Ischaemia begins in the subendocardium, which contributes substantially to systolic wall thickening…

…to moderate exacerbation of asthma symptoms. Adenosine should be used with caution in patients with obstructive lung disease or asthma. Irregular wide complex tachycardia (absolute…

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…

…episodes Iatrogenic events (e.g., during central venous catheter insertion) Underlying lung pathologies In cases of benign pneumothorax, positive pressure ventilation can precipitate a tension…

…myocardial infarction. Rupture of the free ventricular wall. Neoplasms (particularly breast and lung cancer). Inflammatory conditions, such as rheumatoid arthritis, systemic lupus erythematosus, scleroderma, and…

…bradycardia in the emergency setting. Parameter Assessment A Airway Voice Breath sounds B Breathing Respiratory rate (12–20 / min) Chest wall movements Chest percussion Lung…

…coronary blood flow by relaxing vascular smooth muscle. They are contraindicated in patients with bronchospastic lung disease, or a history of significant reactive airway disease…

…to visualize clearly with trans thoracic echocardiography. Causes of right ventricular hypertrophy Lung disease (with increased pulmonary vascular resistance), congenital heart disease (transposition of the…

…spontaneous depolarization) in the sinoatrial node is increased during physical activity, stress, and nervousness. This is due to altered tone in the autonomic nervous system…

…poisoning — oxygen worsens the lung injury. Discuss with your national or regional poison control centre. An open flame or smoking in the room: a fire…

…and where no liver, lung or vessel lies in the path of the needle. Access Puncture site Direction Comment : : : : Subxiphoid 1–2 cm below and…

…Scan in the position in which the patient is to be punctured. Identify the diaphragm, the liver or spleen, the lung and the fluid level…

…adjusted D dimer in patients over 50: the threshold becomes age × 10 micrograms/L (FEU). Check which unit and which reference system your own laboratory…

…bleeding complications. The CHA₂DS₂ VA score is a clinical tool designed to assess stroke risk in patients with non valvular atrial fibrillation (AF). It is…

…nodal refractoriness. Its electrophysiologic effects on the His Purkinje system and ventricular muscle are minimal, except in cases of toxic concentrations. In most patients, the…

…cardiovascular interventions. Dressler syndrome now occurs in fewer than 1% of AMI cases and is seen predominantly after larger infarctions and/or delayed reperfusion. Its…

…in some instances, persist for extended durations. As for any long standing tachycardia, there is a risk of developing tachycardia induced cardiomyopathy. In pediatric populations…

…interval. The primary hazard lies in long QTc intervals because they induce a very unstable polymorphic ventricular tachycardia referred to as torsade de pointes . Abnormally…

ECG Please refer to the previous chapter: LQTS (Long QT Syndrome)

CPR Neurons are exceptionally vulnerable to hypoxia and anoxia ( Casas et al ). In cardiac arrest without chest compressions (i.e. if cerebral perfusion ceases), irreversible…

…drugs that may prolong the QT interval, and cause torsade de pointes (TdP) and long QT syndrome (LQTS) is presented below. With regards to drugs…

[calc_123lqts] Long QT Syndrome (LQTS) is an inherited cardiac channelopathy characterized by prolonged ventricular repolarization, which predisposes individuals to malignant ventricular arrhythmias, notably torsade…

Procedurer The donation process begins long before any retrieval: it begins when someone in the intensive care unit identifies a possible donor and the deceased…

Echocardiography Pericardial diseases: effusion and tamponade A long series of conditions can affect the pericardium (pericardium). The most common of these are acute pericarditis (perimyocarditis…

5 Year Risk of Life Threatening Ventricular Arrhythmias [calc_123lqts] Long QT Syndrome (LQTS) is an inherited cardiac channelopathy characterized by prolonged ventricular repolarization, which…

…without delay, in any of the following: A systolic blood pressure < 90 mmHg caused by the arrhythmia. Ongoing myocardial ischaemia with chest pain and…

Arrhythmias and arrhythmology Drugs and electrolyte imbalance ECG Definition and Pathophysiology Acquired long QT syndrome (LQTS) is characterised by an abnormal prolongation of the QT…

…ventilation of the lungs during cardiopulmonary resuscitation (CPR) differ substantially from normal circumstances. The purpose of CPR is to create large variations in intrathoracic pressure…

…how long to interrupt treatment before a procedure, and how to reverse in bleeding. Doses in atrial fibrillation Drug Standard dose Reduced dose and criterion…

…usually 10 mL in adults. Do not use saline — the salt can crystallise and block the valve. The material determines how long the catheter may…

…infarction (MI) encompasses long term interventions intended to reduce recurrent infarction, ischaemic stroke, cardiovascular death, and progression of atherosclerotic disease in patients with established coronary…

…a sequential systolic difference of 10 mmHg between the arms. Orthostatic hypotension: a fall of ≥20 mmHg in SBP and/or ≥10 mmHg in DBP…

…the symptoms began, whether they are continuous or episodic, how long an attack lasts, and whether anything actually triggers it [1,2]. The single most…

…an advanced version of the original SYNTAX Score, designed to improve the prediction of long term outcomes after revascularization. It incorporates both anatomical (from the…

…Long QT syndrome was identified several decades ago by Jervell et al . Brugada syndrome was identified in the early 1990s and early repolarization was identified…

…is a prodrug activated predominantly in the liver by very long chain acyl CoA synthetase 1. This activating enzyme is not expressed in skeletal muscle…

…It is frequently clinically silent, which promotes both patient and clinician inertia and contributes to inadequate long term control. The treatment objective is individualized blood…

…strongest established predictors of ischaemic stroke and systemic embolism are previous stroke or TIA and mitral stenosis. In patients with AF and previous ischaemic stroke…

…wave. Because of the long duration of the plateau phase most contractile cells are in this phase at the same time (more or less). Moreover…

…multifactorial clinical entity typically associated with drug induced long QT syndrome (DI LQTS) [1]. The condition arises in the setting of both modifiable and nonmodifiable…

…increases. This results in increased left ventricular load, while simultaneously affecting systemic perfusion. Aortic stenosis is a serious condition with poor long term outcomes. Patients…

…end tidal carbon dioxide, ETCO2) Capnography refers to the measurement of end tidal carbon dioxide (ETCO 2 ) in the respiratory system. ETCO 2 is the…

…long time and be detected randomly when investigating other conditions. More dramatic onset of symptoms can be seen in arrhythmogenic tumors of the myocardium; in…

…percentage change in left ventricular diameter during systole. It is measured in parasternal long axis view (PLAX) using M mode. The end systolic and end…

…venous pressure, pulmonary capillary wedge pressure and systemic vascular resistance increases. Harmful neurohormonal pathways are activated, similar to those seen in heart failure. A thorough…

…Two dimensional echocardiogram. This view is called parasternal long axis view (PLAX). Structures that are closest to the transducer are placed at the top of…

Klinisk kemi & laboratoriemedicin Akutsjukvård Lathundar Basic principle Interpret the blood gas in the same order every time. Skipping a step is a common reason why…

…axis, where a long half life produces more marked suppression. Stress dosing in known adrenal insufficiency A patient with primary adrenal insufficiency (Addison's disease)…

…coronary and renal perfusion, particularly in patients with long standing hypertension and a rightward shifted autoregulation [1,3]. The term hypertensive urgency is best avoided…

…few days. Principles Insulin component Function Who needs it : : : Basal insulin (intermediate or long acting) Covers fasting glucose production Everyone with type 1 diabetes, always…