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

…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…

…the use of chest compressions, as well as possibly ventilation and automatic external defibrillator (AED). Return of Spontaneous Circulation (ROSC) : Return of mechanical cardiac function…

…this sequence, before mechanical dysfunction ( i.e. left ventricular systolic or diastolic dysfunction) or electrical changes (ST T changes on ECG) become apparent. In contrast…

…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…

…an angle of 30–45 degrees , directed proximally along the course of the artery. 4. When pulsatile blood appears in the hub: lower the angle…

…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…

…Mechanical circulatory support, including extracorporeal membrane oxygenation (ECMO), may be required in this setting. Clinical presentation and symptoms The clinical presentation reflects the severity of…

…at least two left facing leads [7]. These stricter parameters correlate more closely with abnormal LV mechanical function and the potential benefit of resynchronization pacemaker…

…Antithrombotic therapy may reduce embolization of thrombotic or atheroembolic material, but pharmacological and mechanical strategies directed specifically at reperfusion injury have not generally demonstrated sufficient…

…revascularization, while avoiding unnecessary procedural complications and bleeding in those at lower risk or in whom the hazards of revascularization outweigh its potential benefit. A…

…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…

…shock most commonly reflects severe left ventricular (LV) dysfunction, accounting for approximately 80% of cases. Other causes include acute mechanical complications—particularly ventricular septal defect…

…Mechanical or pump failure complications , including heart failure and cardiogenic shock. Most out of hospital deaths occur early and are commonly related to ventricular fibrillation…

…treat (NNT) for the ACLS specific interventions is much higher or uncertain, meaning that the efficacy of these interventions is much lower or uncertain. Indeed…

…dysfunction, and hypercoagulability [1] [2] . Mechanical stasis in AF is most pronounced in the left atrial appendage (LAA). The LAA is a highly trabeculated, windsock…

…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…

…endotracheal intubation, mechanical chest compressions, targeted temperature management, etc.) and are much less effective in terms of the number needed to treat (NNT). The Number…

…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…

…earlier era. The needle is inserted close to the upper border of the rib, never at the lower border where the neurovascular bundle lies, and…

…preferably anteroposteriorly : one anteriorly over the praecordium to the left of the sternum, the other on the back between the left scapula and the spine…

… } 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…

…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…

…matrix constituents. The balance between synthesis and degradation influences plaque architecture and mechanical stability. Atherosclerotic lesions commonly arise at sites of disturbed flow, including branch…

…objective, particularly in patients with left ventricular dysfunction and/or MVD. Nevertheless, the optimal extent and timing of intervention depend on the clinical setting, haemodynamic…

…the full range of left ventricular ejection fraction and may result from systolic dysfunction, diastolic dysfunction, or both. The clinical consequences of extracellular volume expansion…

…ISR remains the most frequent cause of PCI failure, despite its substantially lower incidence with drug eluting stents (DES) than with bare metal stents (BMS…

Echocardiography Myocardial ischemia and infarction Definition and pathophysiology Left ventricular (LV) thrombus is an intracavitary clot attached to the LV endocardium, typically overlying an akinetic…

…monophosphate (cAMP) and calcium, as well as through the direct activation of voltage sensitive calcium channels. At lower doses, dobutamine stimulates beta2 and alpha receptors…

…small vessels, multivessel disease, bifurcation lesions, treatment of acute myocardial infarction Procedural and mechanical Stent underexpansion, incomplete wall apposition, residual inflow or outflow disease, edge…

…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…

…or cardiac surgical sympathetic denervation can be performed to mechanically reduce sympathetic output [4]. Evaluation of Treatment and Alternatives for Drug Failure The provided context…

…explain the marked differences in characteristics and outcomes across the data sources for out of hospital cardiac arrest (OHCA) and in hospital cardiac arrest (IHCA…

…spread of an electrical impulse is therefore directly coupled to a mechanical event; this is referred to as electromechanical coupling . The electrical conduction system of…

…resuscitated cardiac arrest, cardiac transplantation or mechanical circulatory support, nonfatal myocardial infarction, transient ischemic attack or stroke, and initiation of renal replacement therapy. The study…

…the ventricles. First degree AV block is rarely serious and may be left untreated in the vast majority of cases (exceptions are discussed later). Second…

…one study reporting a sensitivity of 75%. Thus, 25% of STEMI cases are missed by the EMS. Specificity : The specificity is relatively lower at 53%…

…only suicide attempts have lower survival outcomes. Nonetheless, prompt interventions can reverse cardiac arrest and survivors of traumatic cardiac arrest often exhibit favorable neurological outcomes…

…tunica adventitia , respectively. Figure 1. Layers of the left ventricular wall, pericardium and ventricular cavity. The endocardium The endocardium lines the atria, ventricles and the…

…myocardial mechanics, with emphasis on echocardiographic aspects. The bulk of the discussion concerns left ventricular function, which has been studied intensely over several decades. Left…

…confined to the left ventricle. ARVC causes ventricular tachycardia and sudden cardiac arrest; the disease is one of the most common causes of sudden cardiac…

…Hemodynamically, the gold standard definition of HFpEF relies on the demonstration of spontaneous or provokable elevated left ventricular (LV) filling pressures, defined invasively as a…

…hypertrophy, it may still be normal when compared to reference values. Figure 1. Types of left ventricular hypertrophy. Left ventricular volume is reduced in conc

…and echocardiographic assessment The importance of systolic function can be understood on an intuitive basis. Consider the fact that the left ventricle contracts and ejects…

…chronic value [4]. The grading must not be used mechanically. A patient with a plasma potassium of 6.2 mmol/L, new bradycardia and acute…

…aortic regurgitation gradually leads to impaired contractile function and the development of myocardial fibrosis. Contractile dysfunction further aggravates the regurgitation (the regurgitation volume increases). Mechanically…

…cells carry out the actual contraction but are also capable of transmitting the action potential, albeit at a much lower speed than the conduction cells…

…thickness. Strain imaging is also used routinely to visualize regional myocardial function and mechanics. Loading conditions and heart rate may affect left ventricular function. Transesophageal…

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