…prognostic evaluation using two complementary domains: Indicators of acute PE severity , including clinical findings, RV dysfunction on imaging, and myocardial injury shown by laboratory testing…

…ECG finding is the ST segment depressions. In STE ACS, on the other hand, the ST segment depressions are secondary findings and the primary findings…

…perfusion differences. Perfusion assessment The assessment of myocardial regions in myocardial perfusion imaging (MPI) is based on principles similar to those used in echocardiography. The…

…Evidence such as increased left atrial size, left ventricular hypertrophy or abnormal LV filling supports the diagnosis Unlike HFpEF, objective evidence of structural or functional…

…the sinoatrial node) is a common finding in athletes and during sleep; in these scenarios, it should not be considered abnormal. On the other hand…

…infarction Definition and pathophysiology Myocardial infarction (MI) is a clinical diagnosis that integrates myocardial injury, evidence of acute myocardial ischaemia, electrocardiographic findings, cardiac biomarkers, imaging…

…inversion can occur without coronary artery disease. Proposed explanations in the source material include cardiac memory after abnormal ventricular activation, transient rate related conduction abnormalities…

…evaluated. The findings were as follows: The absence of a pupillary reflex demonstrated a sensitivity of 72.2% for predicting an unfavorable neurological outcome, indicating…

…This is also a normal finding. Abnormal (pathological) causes of sinus bradycardia In all other situations, sinus bradycardia should be regarded as a pathological finding…

…V6. Refer to Figure 1 . Abnormal R wave progression implies that the gradual increase from V1 to V5 is absent. It may be broken, as…

…formerly termed Prinzmetal or variant angina, is myocardial ischaemia caused by transient abnormal vasoconstriction of one or more coronary arteries. Epicardial spasm produces a reversible…

…the rhythm per se . Rhythm control, on the other hand, attempts to restore sinus rhythm by use of antiarrhythmic drugs. Randomized controlled trials have not…

…the liver are the prothrombin time (INR) , the albumin and the bilirubin — and they become abnormal late. A cirrhotic liver can have entirely normal transaminases…

…Moderate or severe chronic kidney disease (CKD) Hypertension mediated organ damage (HMOD) Probable or definite familial hypercholesterolaemia Other markedly abnormal single risk factors or genetic…

…Components of the ATRIA Score The ATRIA score assigns points based on five clinical factors: Anemia: Hemoglobin <13 g/dL in men or <12 g…

…Coronary fistulae represent abnormal communications between a coronary artery and a cardiac chamber or vessel. Other congenital anomalies include anomalous origin of a coronary artery…

…of the sinoatrial (SA) node. This enhanced atrial activity is most commonly attributable to abnormal automaticity or re entry mechanisms; triggered activity is a less…

…during ventricular contraction and relaxation. Pericardial effusion is the presence of an abnormal amount of fluid in the pericardial space. It can be caused by…

…a premature ventricular contraction. Classification of premature ventricular contractions When every other beat on the ECG is a premature ventricular complex (PVC), the rhythm is…

…alcohol, a missed meal, physical activity and any other precipitating factor. Thresholds The thresholds below are used above all in diabetes. The severity of the…

…m² Abnormal urinalysis or renal imaging Mild progression risk, increased by proteinuria 3a 45–60 mL/min/1.73 m² Cardiovascular disease or other organ…

…MINOCA accounts for approximately 1–14% of ACS presentations in different series and approximately 5–10% of patients presenting with myocardial infarction in other reports…

…need for a structured and guideline directed approach. This chapter focuses on practical diagnostic and therapeutic considerations, with recommendations aligned with current guidelines from both…

…Diagnostic criteria for acute myocardial infarction A diagnosis of myocardial infarction is based on the following three components: Cardiac troponins – Elevation of cardiac troponins in…

…all other situations, the underlying condition should be targeted and, if necessary, bradycardia should be treated (treatment alternatives are discussed in the article on sinus…

…yielding a wide QRS complex). Because the ventricular depolarization is abnormal, the repolarization will also be abnormal (read aboutsecondary ST T changes on ECG). Hence…

…is which change can explain the pH, and whether the other variable lies within the expected range of compensation. Sample type and baseline values An…

Akutsjukvård Psykiatri Lathundar Delirium in older adults: quick reference A quick reference for ward and on call physicians: recognise hypoactive delirium, stabilise the patient, work…

…depression). As mentioned above there are numerous other conditions that affect the ST T segment and it is fundamental to be able to differentiate these…

…negative if its terminal portion is below the baseline, regardless of whether its other parts are above the baseline. T wave inversions are frequently misunderstood…

…involve coronary or non coronary factors, and ischaemic thresholds vary substantially between individuals depending on the magnitude of the stressor, the presence of non cardiac…

…enlarge. Risk Stratification: Stroke and Bleeding Assessment The decision to initiate oral anticoagulation (OAC) hinges on a rigorous assessment of both thromboembolic and hemorrhagic risks…

…than the base rate should inhibit the pacemaker. P waves The appearance of the P wave depends on where the atrial lead is fixed. Typically…

…favorable prognosis, as compared with other forms of ventricular tachycardia. Mechanisms of ventricular tachycardia Ventricular tachycardia (VT) may emerge due to increased/abnormal automaticity, re…

…of the type of oral anticoagulant used. Studies have shown that it performs similarly or superiorly to other bleeding risk assessment tools, such as HEMORR2HAGES…

ECG Introduction to ECG interpretation The QRS complex (ventricular complex): normal and abnormal configurations and intervals A complete QRS complex consists of a Q , R…

…electrolyte imbalances are clinically negligible (from an electrophysiological standpoint), whereas others may be life threatening. The most common and clinically most relevant electrolyte imbalances concern…

…risk must be considered alongside thromboembolic risk. The HAS BLED score includes hypertension, abnormal renal or liver function, prior stroke, bleeding tendency or previous bleeding…

…Opioids, benzodiazepines and other sedating drugs. Thromboembolic risk, for example immobilisation, cancer and previous venous thromboembolism. A documented decision on the ceiling of care. Signs…

…on healthy donor platelets in the test. Information about concurrent ticagrelor treatment is required for interpreting platelet function tests for HIT. Other cosiderations Based on…

…conditions Definition and scope Familial and genetic screening in cardiovascular medicine is the systematic assessment of relatives and other individuals who may carry an inherited…

…C) is the principal therapeutic target in lipid management because LDL and other apolipoprotein B containing lipoproteins play a causal role in atherosclerotic cardiovascular disease…

…and infarction Myocardial ischemia: cellular changes, ECG signs and development of infarction Like all other cells in the human body, cardiac myocytes use ATP (adenosine…

…2]. STEMI and other ECG patterns suggesting acute coronary occlusion are time dependent conditions. The decision on immediate reperfusion is based on symptoms, the ECG…

…without drugs . The diagnosis rests on the history, a positive Dix–Hallpike test and the absence of other neurological findings. The treatment is a repositioning…

…Interactions Pharmacodynamic interactions Anticoagulants, thrombolytics, or other platelet aggregation inhibitors: Salicylates inhibit platelet function and enhance the effect of anticoagulants, increasing bleeding risk. Monitor coagulation…

…cardiovascular death, and progression of atherosclerotic disease in patients with established coronary or other atherosclerotic vascular disease. Antiplatelet therapy is a central component because platelet…

…containing lipoproteins, including: LDL Intermediate density lipoprotein (IDL) Lipoprotein(a) [Lp(a)] Very low density lipoprotein (VLDL) Chylomicrons and other triglyceride rich particles Thus, non…

…only one pathway of platelet activation, its antiplatelet effect is relatively limited compared with agents that inhibit other platelet pathways. The distinction between primary and…

…or evaluation of other atherosclerotic disease. Routine population screening is not recommended because the prevalence of severe asymptomatic stenosis is low, screening has not been…

…faintness, and other symptoms may occur without chest pain and should be considered anginal equivalents. The emergency evaluation of non traumatic chest discomfort is structured…

Cardiology Continous medical discussion: the ECG blog Coronary artery disease: On LDL cholesterol, dietary fat & statins You are probably aware that ischemic heart disease, also…

…infarction (NSTEMI), and unstable angina. The initial clinical distinction depends on symptoms, serial electrocardiography, and cardiac troponin findings. The default treatment after ACS, whether or…

…acute HMOD, although other guidance emphasizes that no single BP threshold is diagnostically sufficient: the presence of ongoing acute organ injury is decisive. The pathophysiology…

…Expected effects on death, myocardial infarction and stroke Likelihood of repeat revascularization Symptom burden and treatment goals Diabetes, left ventricular function and other comorbidities Surgical…

…or arteries supplying the limbs. In adults over 40 years of age, atherosclerosis is the predominant cause. Other mechanisms include thrombosis, embolism, vasculitis, fibromuscular dysplasia…

…HIV infection or other circumstances that may affect cessation or treatment monitoring. Single question screening can identify unhealthy drug use requiring counselling regarding cardiovascular effects…

…most cardiac conditions may be associated with atrial flutter. As compared with several other supraventricular tachyarrhythmias, atrial flutter does not occur among otherwise healthy individuals…

…cancel each other out. However, the ECG may show features characteristic of biventricular hypertrophy. Biventricular hypertrophy ECG In case the ECG or other examinations suggest…

…be performed on all patients seeking medical attention due to chest discomfort or other symptoms that may be caused by myocardial ischemia. Other symptoms include…