…activation. PMVT is frequently associated with acute myocardial ischemia, electrolyte derangements, or underlying channelopathies (e.g., Torsades de Pointes in Long QT Syndrome) [1] . Underlying…

…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…

…patients may rely on continuous biventricular pacing for haemodynamic stability. In patients with resynchronization devices, maintaining CRT during surgery is recommended to provide better haemodynamic…

…35 and a PaCO₂ above 6.0 kPa despite optimal medical treatment with bronchodilators, steroids and controlled oxygen. Acute on chronic hypercapnic failure in obesity…

…term prediction using smart devices and emerging technologies ( Marijon et al ). The stochastic nature (randomness) of sudden cardiac arrest is in some aspects similar to…

…do not guess. Measure the blood pressure in both arms when fitting the device. Use the arm with the higher pressure, or the non dominant…

…Echocardiography is generally performed in order to evaluate ventricular function, since it may affect the choice of device therapy and also suggest whether other interventions…

…tachyarrhythmias, uncontrolled heart failure, and concomitant valvular heart disease. In patients with ANOCA/INOCA, symptoms may persist despite non obstructive coronary anatomy. Such patients require…

…lead to misclassification. Blood pressure should be measured with a validated and calibrated device using a consistent method for the individual patient. The recommended procedure…

…The etiology of HFrEF is broadly dichotomized into ischemic and non ischemic causes, a distinction that fundamentally alters diagnostic work up and device therapy eligibility…

…TIA) or stroke. The risk associated with asymptomatic disease depends substantially on stenosis severity and plaque characteristics. In the general population, the prevalence of asymptomatic…

…death, and among those who did, only a minority had a reduced value — the majority of sudden cardiac deaths occur in patients with preserved LVEF…

…intend to present an ECG with early repolarization (which is associated with 5 times as great a risk of ventricular fibrillation and sudden cardiac death)…

Continous medical discussion: the ECG blog Myocardial ischemia and infarction Myocardial ischemia The definition of ischemia may appear trivial but it is actually a very…

Continous medical discussion: the ECG blog ECG The best ECG book is not the one making it simple In the thrilling and ever evolving field…

…evident in the ascending part of the ST segment. A male patient (Figure 1) presented at age 36 years with an ECG showing deep and…

…China and Italy (1–5). Two recent studies published in JAMA Cardiology are summarized below. Shi et al present data on 416 patients hospitalized with…

…Study, which demonstrated that high blood pressure and high cholesterol levels, among other risk factors, were strongly associated with coronary artery disease and myocardial infarction…

…and assess cardiovascular risk. 4 Furthermore, ectopic fat accumulation, such as intermuscular adipose tissue (IMAT), is independently associated with coronary microvascular dysfunction and major adverse…

…half of all individuals with heart failure ( Packer et al ) and 30% of people with diabetes ( Cavallari et al ). Organizational challenges in cardiac arrest Optimal…

…NSTEMI and unstable angina. Management begins in parallel with the diagnostic work up. Obtain an interpretable 12 lead ECG within 10 minutes of first medical…

…High BMI is associated with several health conditions: Type 2 diabetes Hypertension Coronary artery disease Heart failure Dyslipidemia (including high LDL, total cholesterol and triglycerides)…

…therapy Management Recommendation Level of evidence Reperfusion is indicated in all patients with symptoms of ischaemia of <12 h duration and persistent ST segment elevations…

…inadequate emotional support is associated with recurrent cardiac events. One possible mechanism is poorer adherence to prescribed treatment. Rehabilitation programmes that incorporate psychosocial care and…

…the dose of prasugrel; extending DAPT beyond 12 months in carefully selected patients with high ischemic risk and low bleeding risk. These strategies are intended…

…for emergency medicine (and prehospital medicine). This is high quality medical education simply. Life in the Fast Lane Australian site with one of the most…

…substantially in patients with acute coronary syndromes. Importantly, the ECG findings dictate the management of acute coronary syndromes. Hence, an ECG must be performed and…

…The condition is associated with falls, aspiration, pressure sores, loss of function, longer length of stay, institutional care, readmission, cognitive decline and increased mortality [3…

…in older textbooks. Indications Cardiac tamponade — the only absolute indication, and always urgent. A large pericardial effusion with symptoms despite medical treatment. Diagnostic drainage in…

…is often used in combination with meprobamate for the treatment of sleep disorders. <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Aceprometazine+AND+(%22QT…

…patient with acute graft occlusion may report an abrupt reduction in walking distance before claudication, accompanied by moderate pain or paresthesia, while sensory and motor…

…responses, arrhythmias and prognosis, with diagnostic interpretation reserved for appropriately selected patients. Pathophysiological basis Exercise progressively increases myocardial oxygen demand through increases in heart rate…

…especially in older adults Previous sternotomy or CABG Patient preferences and expectations Frailty and liver cirrhosis are associated with increased postoperative mortality and should influence…

…or delayed approach is recommended in this setting unless other findings justify urgent intervention. Risk scores Several risk scores integrate clinical, ECG, and biomarker variables…

…relief of angina in some patients and a greater likelihood of repeat PCI. Multivessel disease in ACS is associated with an adverse prognosis. In STEMI…

…is the first line diagnostic test in suspected acute coronary syndrome. It should be obtained immediately at first medical contact and interpreted within a target…

…permit vascular remodelling and renal impairment to develop, leaving persistent hypertension despite correction of the initiating disorder. Earlier diagnosis is associated with a greater likelihood…

…is an acute myocardial infarction associated with a working diagnosis of persistent ST segment elevation or an accepted equivalent in the setting of ischaemic symptoms…

…nearly empty). In patients with an initial shockable rhythm, compressions and ventilation can extend the duration of the shockable rhythm by several minutes, allowing for…

…out of hospital cardiac arrest in 130'000 cases ( Rawshani et al ). Cardiac etiology Cardiac arrests caused by cardiovascular conditions and events are highly stochastic…

…catheter interventions, and medical therapies. Adults with congenital heart disease are mostly managed in GUCH clinics (Grown Up Congenital Heart disease). Prevalence of congenital heart…

…more frequently associated with coronary microvascular dysfunction, though epicardial coronary artery disease frequently coexists as a bystander or secondary contributor [8] . Pathophysiology and mechanisms The…

…design their courses in accordance with official guidelines (ERC, AHA, ACC). The chain of survival EARLY RECOGNITION OF CARDIAC ARREST If no medical professional is…

…severity. Tricuspid stenosis is visually characterized by thickened leaflets, with reduced motion and potentially fused commisures. Continuous Doppler is used to assess the stenosis. Doppler…

…stroke quick reference. Stopping the drug and forgetting to restart it after the procedure. Document the restart date in the medical record. Sources ESC Guidelines…

…diagnosis and the donor care The time from withdrawal of treatment to circulatory arrest Indications An intensive care patient with severe brain injury in whom…

…due to sinus pause or post VPC pause) results in augmentation of early afterdpolarization amplitude (typically seen with large T wave amplitude), and QT prolongation…

…of aneurysms are not calcified and therefore cannot be identified reliably by radiography. Assessment should include consideration of associated vascular disease. In patients with AAA…

…medical emergency. Evaluation and Physical Examination The evaluation of chronic cough in a patient taking an ACE inhibitor should begin with a comprehensive history and…

…changes), renal function, and potassium should be evaluated within 1 to 2 weeks after initiation of ACE inhibitors, especially in patients with preexisting azotemia, hypotension…

…in direct comparative studies, and combinations are frequently required. The central therapeutic aim is symptom control rather than modification of long term cardiovascular outcomes. With…

…or other major adverse cardiovascular events. Complete revascularization is therefore considered an important therapeutic objective, particularly in patients with left ventricular dysfunction and/or MVD…

…and much earlier, more severe clinical disease. HeFH affects approximately 1 in 250–300 people and is the most common inherited metabolic disorder associated with…

…Those with possible ACS, a non diagnostic ECG, and normal initial troponin may be observed in a chest pain unit or another non intensive care…

…reduction in mortality or myocardial infarction with routine CTO PCI compared with medical therapy. Clinical presentation and symptoms A CTO may be asymptomatic and identified…

…generate false positive results and unnecessary downstream procedures. In patients with a high probability, testing may add little diagnostic value and invasive coronary angiography may…

…Presentation and Symptoms In up to one half of STEMI cases, a precipitating factor such as vigorous physical exercise, emotional stress, or a medical or…

…factor is identifiable in up to one half of cases. Reported precipitants include vigorous physical activity, emotional stress, and an intercurrent medical or surgical illness…

…and obtaining medical authorization. Fibrinolysis reduces mortality in patients with STEMI, with the greatest benefit when administered early. The largest absolute benefit is observed in…

…dependent and its diagnostic performance is influenced by image quality and local expertise. Clinical Presentation and Indications Stress echocardiography is used in patients with suspected…