…and procedural complexity. Overall incidence and major complications Complications during diagnostic coronary angiography occur in approximately 2% of patients. Serious events such as stroke and…

…centers. Post cardiac arrest syndrome (PCAS) Post cardiac arrest syndrome (PCAS) emerges after ROSC or initiation of ECMO. The syndrome was first described by Negovsky …

…perivalvular (adjacent to the valves), etc. Cardiac tumors cause nonspecific symptoms that depend on the size of the tumor, localization, hemodynamic effects and possible impact…

…from out of hospital cardiac arrest should not routinely undergo immediate angiography. A selective or delayed approach is recommended in this setting unless other findings…

…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…

…Other microorganisms, generally, cause subacute endocarditis. Endocarditis can affect native (own) valves and valve prostheses. As always, foreign materials pose a high risk of infection…

…AF may be pre existing, newly detected for the first time, or newly developed during management of an acute illness. The clinical relationship between AF…

…Despite the effectiveness of preventive interventions in both sexes, women are less likely to receive statins, aspirin or referral to cardiac rehabilitation and are less…

…of vascular autoregulation during a rapid or severe rise in BP. This may produce acute injury in the brain, retina, heart, aorta, kidneys, or other…

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

…arteries (MINOCA). Ventricular fibrillation and sudden cardiac death are important potential complications. Approximately one third of patients may have severe fixed coronary obstruction. Such patients…

…cardiac abnormalities, HF and sudden cardiac death. The relationship between glycaemia and cardiovascular disease is complex. Glycaemic control is important for prevention of microvascular complications…

…underlying structural cardiac explanation Early onset hypertension or cerebrovascular accident at a young age in the patient or family Hypertensive first degree relatives of patients…

…and other emergency instruments. Personnel conducting the test must be formally trained to assess cardiovascular response, symptoms, and ECG changes. Although the risk of cardiac…

…meaning that the efficacy of these interventions is much lower or uncertain. Indeed, the greatest opportunities for survival exist during the first few minutes from…

…sensitive and specific for myocardial injury. Elevated levels of cardiac troponins is firm evidence of myocardial necrosis (i.e infarction). This is explained by the…

…that of other forms of acute tubular necrosis, although the complication remains associated with post procedural morbidity and mortality. Pathophysiology The precise mechanism of contrast…

…Management of Bradycardia (Bradyarrhythmia). Initial rhythm and the course of arrhythmias during cardiac arrest The initial rhythm in cardiac arrest is defined as the first…

…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…

CPR Cardiac arrest during pregnancy and childbirth All healthcare units capable of managing pregnant women in cardiac arrest should engage in specialized clinical training to…

…care. Since the majority of all sudden cardiac arrests occur outside hospitals, the chain of care includes laymen, emergency dispatchers, ambulance, first responders (police, fire…

…ischemia. Inverted U waves are even more typical of ischemia (but the sensitivity is low). U wave changes always accompany other ischemic ST T changes…

…g. malignancy, amyloidosis). In case of suspicion of pericardial disease, in the first place, an echocardiographic examination is done. With echocardiography, good conditions are obtained…

…of myocardial ischemia result in cardiac arrest. In order for an infarction or ischemic episode to result in ventricular arrhythmia, it must coincide with other…

…causes of pericardial effusion. Important clinical associations include: Idiopathic or viral pericarditis Malignant pericardial disease Tuberculosis Purulent or bacterial pericarditis Trauma Cardiac surgery and other…

…intrinsic rhythm may develop prolonged pauses. Pacing dependent patients therefore require protection against inhibition during the period of anticipated EMI. The perioperative strategy should also…

…30–120 seconds of cardiac arrest and light reactivity is lost when cerebral blood flow ceases. In other words, during prolonged cardiac arrest without effective…

…cardiac arrest and are potentially reversible etiologies when promptly and appropriately addressed. Both venous and arterial blood gases can be utilized for the analysis of…

…On the other hand, sinus bradycardia developing during physical exercise is considered abnormal, because heart rate must increase during exercise. Mechanisms of cardiac arrhythmias The…

…slow, irregular breaths with a frequency of 1 to 4 breaths per minute. Agonal breathing is frequently seen during the first minute after cardiac arrest…

…et al and Marijon et al , long term prevention of cardiac arrest at the population level is very difficult. Future efforts may be more successful…

…blood travels during the flow period. VTI can be used for various volume calculations, such as calculation of stroke volume. Stroke volume (SV), cardiac output…

…team (CAT) and intensive care units and other units caring for resuscitated patients. Figure 1. The chain of survival in out of hospital cardiac arrest…

…cardiac arrest have ventricular fibrillation prior to the cardiac arrest. Most of these have atherosclerotic heart disease (coronary artery disease) as the underlying cause. Other…

…the majority of sudden cardiac deaths occur in patients with preserved LVEF, for whom no practical risk prediction tool currently exists. At the other end…

…ECMO) initiation ( Soar et al ). ETCO 2 trends can vary during CPR depending on various factors such as the cause of cardiac arrest, compression efficacy…

…ventricular filling). This may even lead to compression of the ventricles during diastole; cardiac tamponade occurs if excess pericardial fluid causes hemodynamic effects. Electrical alternans…

…However, due to varying strengths, limitations and clinical applications of these modalities, the definitions of cardiac planes, ventricular segments, and coronary arterial territories evolved differently…

…Survival in cardiac arrest is highly dependent on the initial rhythm (first recorded rhythm). The initial rhythm is a marker of several crucial events and…

…when other therapeutic options cannot be pursued. Patients receiving digoxin may present with symptoms of digitalis toxicity, which manifests across multiple organ systems. Non cardiac…

…ECG signs and development of infarction Like all other cells in the human body, cardiac myocytes use ATP (adenosine triphosphate) as the primary energy source…

…assessment of relatives and other individuals who may carry an inherited predisposition to cardiovascular disease. It combines a structured family history, clinical evaluation, cardiac investigations…

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

…Lathundar Key messages Two things set the COPD exacerbation apart from many other causes of acute dyspnoea: oxygen must be titrated cautiously and the blood…

…hypertrophy, LV dysfunction, or other pathology that could affect the safety or interpretation of the examination. Evaluation and Physical Examination Before stress echocardiography, clinical assessment…

…risk factor [2] . This change reflects robust evidence that female sex alone, in the absence of other comorbidities, does not significantly increase stroke risk. Conversely…

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

…cardiac biomarkers, imaging, angiography, and, occasionally, pathological examination. Pathologically, infarction represents myocardial cell death caused by prolonged ischaemia. The first cellular abnormalities of ischaemia include…

…between cardiac function and vascular resistance. Advantages of measuring MAP over systolic blood pressure While systolic blood pressure (SBP) indicates the maximum pressure during heart…

…of the coronary arteries or coronary microcirculation. These abnormalities can produce a transient and reversible mismatch between myocardial oxygen demand and blood supply, generally during…

…Myocardial injury leads to release of cardiac troponin, but troponin elevation is not specific for myocardial infarction. Other conditions may produce cardiomyocyte injury and elevated…

…and a cardiac chamber or vessel. Other congenital anomalies include anomalous origin of a coronary artery from the pulmonary artery and anomalous origin of one…

…inflammation and other systemic influences. The severity of myocardial injury is determined not only by the epicardial obstruction but also by the vulnerability of the…

…microvascular disease and vasospasm may coexist with atherosclerosis or may be the dominant cause of ischaemia. Other mechanisms capable of obstructing coronary arteries include embolism…

…The first and most critical genetic locus identified was SCN5A , the gene encoding the alpha subunit of the cardiac voltage gated sodium channel (Nav1.5…

…result in prehospital cardiac arrest and death. As in other acute coronary events, the thrombotic process is dynamic, with varying degrees of occlusion that may…

…T½ 3 h. 50% renal elimination. • Typically the first choice of drug. • Effective in sinus bradycardia or AV node block. • Dose <0.5 mg may…

…increases the quality of the examination, and allows for standardized comparisons of serial examinations. If pathology is discovered during the standard examination, other examinations (which…

…of 20–40 it is most likely a ventricular escape rhythm. Ventricular escape rhythms are unreliable, such that they may cease and thus cause cardiac…

…tricuspid inflow The echocardiographic counterpart of pulsus paradoxus Contraindications In overt tamponade with shock there are no absolute contraindications other than the conditions in which…