…In one trial of patients with previous myocardial infarction, the Mediterranean intervention involved greater consumption of fruits, vegetables, legumes, bread and an alpha linolenic acid…

…airway is paramount to evaluate for impending respiratory compromise. Diagnostics The diagnosis of ACE inhibitor induced cough is primarily clinical and relies on the temporal…

…al ). Randomized clinical trials are lacking. Figure 1 . Left panel : The association between compression depth and survival to hospital discharge ( Stiell et al ). Right panel…

…Life Support (ECLS) encompasses several extracorporeal systems designed to assist in cases of cardiac or respiratory failure by means of an extracorporeal pump and oxygenator…

…all in diabetes. The severity of the symptoms and the patient's need for help matter more than a single measured value [2]. Level Plasma…

…with temporary mechanical circulatory support (MCS) considered as a bridge. Clinical Presentation and Symptoms Symptoms of STEMI The usual symptom is severe, prolonged ischemic discomfort…

…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…

…may remain stable for prolonged periods, but chronic coronary disease can progress or destabilize abruptly, leading to an acute coronary syndrome (ACS). Clinical manifestations may…

…100 Normal values for ejection fraction (EF) Studies in healthy individuals suggest that the mean ejection fraction is 63% to 69%. European and American guidelines…

…therefore have both an acidosis and an alkalosis at the same time despite a normal pH. The lungs compensate for a primary metabolic disturbance within…

…noradrenaline) and cautious fluid administration. Large fluid volumes worsen an already strained right ventricle. Clinical probability in the stable patient The Wells criteria for pulmonary…

…for pacing AV block I PR interval ≥0.22 s Rarely AV block II, type 1 (Wencheback block) PR interval is gradually prolonged until one…

…pro thrombogenic and pro thrombolytic factors varies from one minute to another, which may cause variations in the size of the thrombus. This means that…

…it might be wise to observe the patient for 24 hours (including ECG monitoring). In all other situations, the underlying condition should be targeted and…

…Refer to Figure 1 for an example. The premature ventricular impulse replaces a sinus beat and induces a delay to the next sinus beat (the…

…cautiously [1,3]. Euglycaemic DKA Euglycaemic DKA means ketosis and metabolic acidosis despite a normal or only moderately raised glucose, often below 13.9 mmol…

…exercise tests should not be maximal, which means that the clinician must set a lower goal regarding workload (e.g. reaching 70% of maximal pulse…

…allow for the calculation of all clinically relevant hemodynamic parameters, with few exceptions. Prior to the Doppler era, hemodynamic assessments were performed by means of…

…Do not wait for the blood gas result before starting treatment. Clinical assessment History that affects the level of risk Ask briefly and to the…

…one of the most impressive ECG libraries available. A must for anyone interested in ECG interpretation. Also includes vast amounts of clinically relevant discussions and…

…which means that it should be flat and on the same level as the baseline (recall that the baseline is the level of the PR…

…impaired ventricular function, does not allow for adequate filling of the ventricles, which results in reduced stroke volume and reduced cardiac output. Most patients experience…

…minute = 0.1634 Watts). Protocols for clinical exercise testing generally include an initial warm up period (at a low workload), followed by a successive …

…Chest pain is one of the most nuanced symptoms in clinical practice and it is fundamental to be able to differentiate benign from serious etiologies…

…Criteria for pathological R waves: R wave ≥0,04 s in V1 V2 and R/S ratio ≥1 with concordant positive T wave in absence…

…muscle fibers results in longitudinal, radial and circumferential shortening (contraction). Traditional methods for investigating left ventricular function — e.g ejection fraction (EF), fractional sorting (FS…

…Drugs for type 2 diabetes in inpatients Agent The acutely ill inpatient : : Metformin Stop in acute kidney injury, hypoxia, shock, before contrast studies and before…

…guidelines and several Swedish clinical knowledge support documents have tightened the threshold to 24 hours for patients with risk factors; cardioversion between 24 and 48…

CPR Time is the most critical factor for survival in cardiac arrest. Life saving interventions must be initiated momentarily to maximize the probability of survival…

…critical importance as they must be able to directly pinpoint where the coronary artery occlusion is located. The term culprit – which means "the guilty one…

…anticoagulation clinic with dosing support, but whoever starts the drug is responsible for the first week. Indications A mechanical valve prosthesis — warfarin is mandatory, and…

…pattern is referred to as de Winter's ECG . Figure 3 provides all clinically relevant differential diagnoses, and their ECG appearance, to ischemic ECG changes…

…severity of the bleeding clinically Signs of major or ongoing bleeding are: hypotension or a postural drop tachycardia a cold periphery and delayed capillary refill…

…for example in pregnancy, acute glomerular disease or scleroderma renal crisis [1,2]. A hypertensive emergency means a markedly raised blood pressure together with ongoing…

…which means that one healthy value in twenty falls outside them . Order twelve tests in a healthy person and the probability is around 46 % that…

…umbrella term for conditions that either affect the automaticity of the sinoatrial node or block the impulse from reaching the atria. Disturbed automaticity and blocked…

…Note: activated charcoal is ineffective against alcohols, lithium, and heavy metals. Enhance elimination Induce diuresis through urine alkalinization, contingent upon renal elimination of the toxicant…

…of cardiovascular disease. It has been the number one killer in Western and high income countries for more than half a century, causing approximately 20…

…17 mm/m2 Aortic arch 22 36 mm Descending aorta 20 30 mm ​Indexing means that the value is adjusted for body surface area (BSA)…

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

…reserved for very serious poisonings in which the patient reaches hospital early. The benefit of both methods falls steeply with the time since ingestion, and…

…and a target value that must never be exceeded, during the first 72 hours for as long as the patient remains unconscious. The evidence Trial…

…2 should not be the sole determinant for terminating CPR or initiating ECMO ( Paiva et al ). If both ETCO 2 and other indicators suggest ROSC…

…pattern and syndrome: from ECG criteria to management Although the early repolarization pattern has been recognized for almost 50 years, it is still one of…

…recommendations for athletes emphasize on measures to detect hypertrophic cardiomyopathy. Hypertrophic cardiomyopathy is the most common cause of sudden cardiac death among athletes, and one…

…since it may affect the choice of device therapy and also suggest whether other interventions (e.g. heart failure management, evaluation for coronary artery disease…

…Always search carefully for the P wave as it may be very discrete and only cause an irregularity of the contour of the T wave…

…π × radius 2 , where radius = diameter/2 ), and velocity is measured by means of Doppler (Figure 1). Figure 1. Calculating flow through a cylinder…

…6. Observe for 10 minutes and check the pharynx — blood running down into the pharynx means that the bleeding is not controlled. Petroleum jelly gauze…

…2. Clean and let it dry. Do not palpate the puncture site again with an unsterile hand. 3. Insert the needle in one movement, aspirating…

…oesophagus rather than into the trachea. Coughing, stridor or an inability to speak means malposition; withdraw and start again. 8. Remove the stylet once the…

…the nose clip and have the patient seal the lips tightly around the mouthpiece without the tongue blocking it. 3. Quiet breathing for a few…

…duration of cardiac arrest, quality of CPR, and a prognostic indicator for survival. In the nationwide Swedish Cardiopulmonary Resuscitation Registry, 30 days survival in OHCA…

…membranes of adjacent cells and enable the flow of ions between cells. This means that the action potential spreads from one cell to another via…

…seizures, and infections. However, the underlying evidence for many of the recommendations is based on few randomized trials and the evidence is often conflicting. Many…

…for reflected sound waves at 3.4 MHz. One can increase the frequency of the emitted sound when studying objects located near the transducer, and…

…to diastolic function. High compliance is desirable and means that the ventricle is capable of filling rapidly while operating at low end diastolic pressure. EDV …

…marked LVH with ST T changes — is an argument for imaging rather than a conventional exercise test. Preparation and equipment Cycle ergometer with a braked…

…included as criteria for myocardial infarction. This is explained by the fact that T wave inversions do occur after an ischemic episode, and these T…

…between 45° and 90°. The QRS duration will be slightly prolonged (the prolongation ranges between 0.01 to 0.04 seconds). ECG criteria for left…