…wheezing, or coughing before cardiac arrest also speak for anaphylaxis (airway obstruction caused by a foreign body is an important differential). Treatment of anaphylaxis and…

…0.4 0.8 2.1 Table 1. Survival in out of hospital cardiac arrest due to external causes ( Kitamura et al). References DeBehnke DJ…

…solution (NaCl) if suspected of toxin exposure. Gastrointestinal lavage is infrequently employed due to aspiration risks and inconclusive evidence. However, in cases of iron, lithium…

…a large myocardial territory through the left anterior descending (LAD) and left circumflex (LCx) arteries (Figure 1). Acute obstruction can lead to rapid hemodynamic deterioration…

…classification comprises five groups: Group 1: Pulmonary arterial hypertension Group 2: PH due to left heart disease Group 3: PH due to chronic lung disease…

…nucleus that often exhibits cavities, which consist of hemorrhages in the tumor. Polypoid myxoma usually causes haemodynamic complications due to obstruction. Papillary myxomas are small…

…can change before creatinine but is not a pure marker of filtration. Oliguria may be due to hypovolaemia, shock, obstruction or advanced renal injury. Conversely…

…LVOT obstruction, age, and left ventricular function. The HCM Risk SCD score aims to identify individuals with a high risk of SCD and determine whether…

…patients with total and proximal occlusions may present without ST segment elevations (which they should exhibit) due to rich collateral circulation in the ischemic area…

…increased resistance in the aortic valve itself, due to the reduced area of the valvular orifice. Both aortic stenosis and hypertension result in increased ventricular…

…pressure may be due to low flow, low vascular tone or both, and the appropriate action differs fundamentally between these cases. Pressures in the heart…

…80 mg tablet once daily. Warnings and precautions Use Aspirin with caution in the following cases: Concurrent anticoagulant therapy (e.g., coumarin derivatives or heparin…

…biliary tract disease. There is no contraindication to analgesia in the acute abdomen . The notion that an opioid masks the diagnosis has been disproved — withholding…

…tachycardia induced cardiomyopathy. In pediatric populations, a distinct form of atrial tachycardia may occur due to embryological remnants within the atrial myocardium. These residual tissues…

…caution in patients with obstructive lung disease or asthma. Irregular wide complex tachycardia (absolute contraindication) . Irregular wide complex tachycardia is most often due to atrial…

…In such individuals, screening with ECG may reveal atrial fibrillation. Unfortunately, atrial fibrillation is too often discovered first at hospital admission due to its complications…

…within 48 hours – due to the risk of aggravating the infarction, as well as inducing ventricular arrhythmias. Unstable angina pectoris in the acute phase (before…

…Right ventricular dysfunction due to pressure/volume overload. Right ventricular infarction. Ebstein's anomaly (Figure 1). Carcinoid heart disease. Endocarditis (common in intravenous drug addicts…

…VT) may emerge due to increased/abnormal automaticity, re entry or triggered activity. All types of myocardial cells may be engaged in initiation and maintenance…

…arterial obstruction that has persisted for at least 30 days. CTOs are common among patients undergoing coronary angiography, with reported prevalence ranging from 18% to…

…acute RV failure. In acute PE, obstruction of pulmonary blood flow increases RV pressure load and may impair RV filling and forward output. The resulting…

…a disorder of coronary microvascular perfusion rather than persistent obstruction of the treated epicardial segment. The phenomenon occurs in approximately 2%–3% of PCI procedures…

…75 %; single fibre EMG about 95 %). Contraindications Known hypersensitivity to edrophonium. Mechanical obstruction of the bowel or the urinary tract. Marked bradycardia, sick sinus syndrome…

…upper airway obstruction where laryngoscopy will not succeed; plan for a surgical airway or awake fibreoptic intubation. A difficult airway is anticipated in a stable…

…Physical inability to perform the test safely. Relative: Condition Comment : : Left main stenosis Known — perform the test only on a clear indication and with full…

…but because the team keeps trying to intubate instead of changing the plan. The aim is always oxygenation, never intubation in itself — and every difficult…

…The ratio that defines obstruction PEF Peak expiratory flow — variability rather than the absolute value TLC Total lung capacity, which requires body plethysmography DLCO Diffusing…

…the patient to flex the head forward and swallow repeatedly , preferably with sips of water if swallowing is safe. Advance the tube in time with…

…deep tendon reflexes. Pulses are absent distal to the obstruction, although Doppler examination may detect residual arterial flow in less advanced disease. Clinical manifestations may…

…biomarker of coronary atherosclerotic burden rather than as a direct measure of luminal obstruction. Calcified plaque is generally less likely to rupture than non calcified…

…during the index ACS admission. In treatment naïve patients unlikely to achieve the LDL C goal with statin therapy alone, initiation of high intensity statin…

…troponin elevation following PCI or CABG may indicate procedural myocardial injury. Late gadolinium enhancement cardiac magnetic resonance imaging has demonstrated procedural injury in patients undergoing…

…worsen the obstruction. Furthermore, cardiomyocyte swelling, interstitial edema, and tissue inflammation promote extravascular compression, exacerbating myocardial injury. Clinical Presentation and Symptoms In up to one…

…of activity, unlike typical exertional angina. A precipitating factor is identifiable in up to one half of cases. Reported precipitants include vigorous physical activity, emotional…

…recent myocardial infarction. UA belongs to the broader spectrum of acute coronary syndromes, which may present with recent changes in symptoms or signs, with or…

…left side (Figure 1). Additional offloading of the vena cava can be accomplished using a wedge board (or any hard material) to tilt the body…

…failure early in life and a family history of heart failure, ventricular arrhythmias or sudden cardiac arrest is common. The following cardiomyopathies lead to dilation…

…This type of cardiomyopathy is characterized by pronounced hypertrophy of the myocardium. It may also lead to obstruction of the LVOT (Hypertrophic Obstructive Cardiomyopathy, HOCM)…

…Signs of a serious condition Finding Significance : : Inability to speak in full sentences Marked work of breathing Use of accessory respiratory muscles or paradoxical abdominal…

…against obstruction, the IPAP against hypercapnia SpO₂ 88–92% Hypoxaemic failure without hypercapnia CPAP or high flow nasal oxygen 5–10 cmH₂O According to oxygenation…

…as a consequence Medicinal charcoal Bowel obstruction, ileus or suspected perforation Gastric lavage An unprotected or unsecured airway in a patient with a reduced level…

…Coronary artery disease and obstructive stenosis Anatomically significant epicardial CAD is conventionally defined as stenosis of at least 70%, while a left main coronary stenosis…

…recommended to complement ICA, particularly for intermediate non left main coronary stenoses. Myocardial ischaemia may occur despite the absence of significant epicardial obstruction. In patients…

…cramping, numbness or fatigue. The symptomatic territory is usually distal to the arterial obstruction: Buttock, hip or thigh symptoms suggest aortoiliac disease. Calf symptoms are…

…septum, or mitral valve apparatus. These lesions can cause acute severe regurgitation, a left to right shunt, tamponade, or sudden loss of effective cardiac output…

…spasm produces a reversible functional occlusion and usually causes transmural ischaemia. The resulting abnormalities in left ventricular function may lead to myocardial infarction, ventricular tachycardia…

…without left ventricular hypertrophy. Among patients with NSTE ACS undergoing angiography, approximately 10% have no critical epicardial stenosis. In some of these patients, microvascular obstruction…

…Definition and clinical concept Myocardial infarction with non obstructive coronary arteries (MINOCA) describes a clinical presentation in which the patient has symptoms suggestive of acute…

…symptoms, and occupational exposure to dust, gas or fumes. Preoperative assessment before thoracic or upper abdominal surgery in a patient with known lung disease. Follow…

…or left ventricular hypertrophy. Hypertension, diabetes, and elevated NT proBNP are more frequent in this pattern. Endothelial dysfunction may contribute to both microvascular and epicardial…

…A D dimer must not be used to rule it out The age adjusted D dimer in patients over 50: the threshold becomes age × 10…

…50% in the chronic coronary syndrome pathway. Coronary CT angiography (CCTA) is generally preferred to exclude obstructive CAD. Intermediate or high probability: above 15% in…

…CAD following advances in anti ischaemic treatment and coronary revascularization. Consequently, more patients survive with severe, diffuse CAD that is no longer amenable to additional…

…failure and in obstructive airways disease Verapamil or diltiazem When a beta blocker is contraindicated, for example in asthma Contraindicated in impaired left ventricular function…

…left ventricular ejection fraction) to provide a more personalized risk assessment. Key Variables in SYNTAX Score II Anatomical SYNTAX Score : Derived from the original SYNTAX…

…and relieving anginal symptoms, while maintaining tolerability and adherence. Selection should be individualized according to blood pressure, heart rate, left ventricular function, comorbidities, concomitant medications…

…clinically silent. The underlying coronary disease may be obstructive or non obstructive. Atherosclerotic plaque accumulation in the epicardial arteries is a major pathological substrate, but…

…sectional images from x ray attenuation measurements obtained at multiple angles. Tissue attenuation is expressed relative to water in Hounsfield units. Bone is highly attenuating…

…not confined to the ECG. Ischaemia may also produce angina, impaired exercise capacity, an abnormal blood pressure response or ventricular arrhythmias. A fall in systolic…

…coronary syndrome (ACS), particularly when angiography shows no significant obstructive disease or when the culprit lesion is uncertain. In these settings, OCT or IVUS may…