…pulmonary congestion, a new cardiac murmur, or jugular venous distension in the days after MI should prompt immediate consideration of a mechanical complication. Clinical deterioration…

…leads [7]. These stricter parameters correlate more closely with abnormal LV mechanical function and the potential benefit of resynchronization pacemaker therapy [7]. R Wave Peak…

…intracerebral haemorrhage, after cardiac arrest. Repeated blood gases, for example during mechanical ventilation or severe metabolic derangement. Major surgery with expected blood loss or large…

…Haemodynamic instability or cardiogenic shock Life threatening arrhythmias or cardiac arrest after presentation Mechanical complications of myocardial infarction Recurrent dynamic ECG changes suggestive of ischaemia…

…instability or cardiogenic shock recurrent or ongoing chest pain refractory to medical treatment life threatening arrhythmias or cardiac arrest mechanical complications of acute myocardial infarction…

…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…

…with other procedural complications, including distal embolization, coronary dissection, perforation, and abrupt closure. The clinical consequences depend heavily on the amount of viable myocardium supplied…

…Ongoing or newly recognized LV systolic dysfunction. A patient may also present because of complications of the underlying infarction or LV remodeling, including heart failure…

…Intervention BLS or ACLS NNT to save 1 person Reference Early detection of cardiac arrest BLS 11 Berdowski et al Bystander CPR BLS 15 Hasselqvist…

…e.g cardiac magnetic resonance imaging (MRI), cardiac computerized tomography (CT), ergospirometry (exercise stress testing), and cardiac catheterization. Principles of management of congenital heart disease…

…cardiogenic shock. Identification of life threatening arrhythmias. Assessment for high risk mechanical complications. Determination of symptom onset time and anticipated time to primary PCI. Patients…

Procedurer Almost all the complications of pleural aspiration arise from two errors: the needle is placed in the wrong site, and too much is drained…

…its major complications—including myocardial infarction, unstable angina and stroke—may occur abruptly and without preceding warning. Initiation and progression of the fatty streak The…

…does not determine the anticoagulation indication. Previous stroke or TIA. The presence of mitral stenosis, a mechanical heart valve or hypertrophic cardiomyopathy. Heart failure, hypertension…

…acute phase of STEMI. Death due to ventricular dysfunction, or mechanical complications, is much less common in the acute phase. The chain of care in…

…of several possibilities: Extension of the original infarction or reinfarction Acute native vessel thrombosis Stent thrombosis Mechanical complications of myocardial infarction Pericarditis Dynamic recurrence of…

…mechanical complications, and ischaemia related ventricular failure as potential causes of shock. Patients with moderate to severe chronic kidney disease have a higher burden of…

…will transfer the mechanical (pressure) energy to the new medium, which may also start to vibrate (Figure 1). Figure 1. The principle of how sound…

…interpreted as cardiac arrest and cardiopulmonary resuscitation should be initiated. Agonal breathing is interpreted as manifest cardiac arrest. Defibrillation : Use of non synchronized electric shock…

Cardiology The ischemic cascade The ischemic cascade describes the sequence of events during myocardial ischemia, beginning with perfusion abnormalities and ultimately leading to chest pain…

…agents Platelet transfusion has weak evidence; discuss with the on call coagulation service Always in parallel: mechanical control of bleeding, tranexamic acid where it is…

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

…EMG about 95 %). Contraindications Known hypersensitivity to edrophonium. Mechanical obstruction of the bowel or the urinary tract. Marked bradycardia, sick sinus syndrome or high grade…

…Warfarin has a narrow therapeutic index, a half life of several days and more than a hundred clinically relevant interactions. What determines whether the treatment…

…represents approximately 5–10% of cases. Intermediate high risk PE occurs in haemodynamically stable patients with both RV dysfunction on imaging and elevated cardiac biomarkers…

…to additional mechanical revascularization. Despite treatment with antianginal drugs and PCI or CABG, daily or weekly angina remains present in approximately 2%–24% of patients…

…Atrial Fibrillation and Atrial Thromboembolism Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and a profound driver of global cardiovascular morbidity and mortality…

…g skeleton, calcifications, mechanical heart valves) and reflect virtually all sound waves, leaving too few waves to explore the area behind the reflector. This results…

…defibrillation (when possible) are the strongest determinants of survival in cardiac arrest. All subsequent actions require trained professionals (e.g endotracheal intubation, mechanical chest compressions…

…ultrasound waves, they begin to vibrate and these mechanical vibrations are converted into electric current that is sent back to the ultrasound machine, where the…

…replacement can be performed with biological or mechanical prostheses. The former is preferred due to the lower risk of thrombosis and evidence demonstrating long term…

…the R wave The shock is delivered immediately Why Avoids the vulnerable phase of the T wave There is no R wave to synchronise to…

…heparin unless contraindicated Head of the bed 30–45° Stress ulcer prophylaxis During mechanical ventilation, in coagulopathy, or with a history of gastrointestinal bleeding Refeeding…

…and after cardiac arrest with persisting electrical activity. Overdrive pacing in bradycardia dependent torsades de pointes. Standby pacing — pads applied but the device not switched…

… } Interpretation of CHADS VASc score and decisions on anticoagulation Men Women Points Recommendation Evidence Recommendation Evidence 0 No treatment Low No treatment High 1 Oral…

…of left ventricular ejection fraction and may result from systolic dysfunction, diastolic dysfunction, or both. The clinical consequences of extracellular volume expansion include elevated cardiac…

…Incomplete lesion preparation Persistent stenosis within the treated segment Mechanical factors are particularly important because correction of the underlying problem is necessary for durable treatment…

…right atrial pressure. Levosimendan represents a distinct class of inodilator. It enhances myocardial contractility and induces peripheral vasodilation through cardiac myofilament calcium sensitisation. This process…

…ganglion block (SGB) or cardiac surgical sympathetic denervation can be performed to mechanically reduce sympathetic output [4]. Evaluation of Treatment and Alternatives for Drug Failure…

…al ). The incidence of treated cardiac arrests outside hospitals (OHCA) is about 70 cases per 100,000 person years in Europe ( EuReCA One, Benjamin et…

…the wide use of pacemakers and the trend towards increased use of cardiac devices in general, it is crucial to be familiar with these devices…

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

…block): definition, causes, diagnosis & management This article covers the fundamental principles of atrioventricular (AV) blocks, which are classified into three types: first degree, second degree…

…the T wave apex (the peak of the T wave), which represents an electrically vulnerable phase during the cardiac cycle (see R on T phenomenon…

…the epicardium is called myocardium . It contains cardiac muscle fibers, connective tissue and a very high density of capillaries. The muscle fibers are organized into…

…large body of science has demonstrated that these parameters are highly interdependent and rather complex. Indeed, myocardial mechanics constitute a whole research field. Cardiac function…

…ARVC causes ventricular tachycardia and sudden cardiac arrest; the disease is one of the most common causes of sudden cardiac arrest among adolescents and athletes…

…cardiac abnormalities and/or elevated natriuretic peptides (NPs) [1] [2] . The evolution of HF terminology has been driven by a deeper understanding of myocardial mechanics…

…of sudden cardiac death. Therefore, current screening recommendations for athletes emphasize on measures to detect hypertrophic cardiomyopathy. Hypertrophic cardiomyopathy is the most common cause of…

…to global cardiac function. Systole is a complicated process involving three distinct ventricular contractions, namely longitudinal, radial and circumferential contraction (refer to Myocardial Mechanics and…

…of rise. Often outpatient or brief inpatient follow up depending on the clinical picture Moderate 6.0 to 6.4 mmol/L ECG and cardiac…

…Chronic aortic regurgitation leads to dilatation and hypertrophy of the left ventricle. Cardiac remodeling Ventricular dilatation and hypertrophy lead to myocardial remodeling and neurohormonal changes…

…1 illustrates the relevant components of the conduction system, the heart and the classical ECG waveforms. Figure 1 . The cardiac cycle starts when cells in…

…provide important insights into left ventricular mechanics. Regional differences in contractile function are of utmost importance, particularly in the setting of (confirmed or suspected) myocardial…