…associations include: Idiopathic or viral pericarditis Malignant pericardial disease Tuberculosis Purulent or bacterial pericarditis Trauma Cardiac surgery and other iatrogenic cardiovascular procedures Acute aortic disease…

…condition is classified as cardiac tamponade. The classical signs of cardiac tamponade are hypotension, muffled heart sounds and jugular venous distention. Other frequent symptoms are…

…Focal chest pain or unilaterally reduced breath sounds Consider pneumothorax New arrhythmia or ischaemic ECG changes Concomitant cardiac disease Oxygen targets Patient Initial target saturation…

…made the procedure considerably safer than the blind subxiphoid technique still described in older textbooks. Indications Cardiac tamponade — the only absolute indication, and always urgent…

…Nocturnal Death Syndrome (SUNDS) [4] . The clinical presentation is notoriously heterogeneous, ranging from lifelong asymptomatic ECG anomalies to electrical storm and sudden cardiac arrest (SCA…

…shift. To analyze reflections from the myocardium, the ultrasound machine filters out all other reflected sound waves, such that only those representing myocardium are recorded…

…analyze myocardial motion, the ultrasound system must filter out all sound waves reflected by other structures, notably sound waves reflected by blood. This is achieved…

…often not true in other circumstances (e.g. pulmonary embolism, trauma, respiratory causes, drug overdoses, etc.). Among victims in whom the cardiac arrest was caused…

…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…

…by insufficient ventilation, leading to hypoxia. Etiologies of hypoxic cardiac arrest : Trauma and injuries : Direct trauma can cause airway injuries, resulting in obstruction. Central nervous…

…the maternal cardiac arrest. Within the context of pregnancy, hypovolemia and other etiologies of hypotension remain the predominant causes of cardiac arrest. Should cardiac arrest…

…showed no recent disease in coronary arteries or in heart muscle. In other words, the heart today is anatomically the same as it was yesterday…

…of ischemia (but the sensitivity is low). U wave changes always accompany other ischemic ST T changes. They may occur in both NSTEMI and STEMI…

…ECG and clinical examination, blood tests and other radiological examinations are most often required, in particular computed tomography (DT) and/or magnetic resonance imaging (MRI…

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

…although radiofrequency procedures, nerve stimulators, and other electronic equipment may also interfere with device function. The clinical consequences depend on the device, the patient's…

…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…

…Grading of hyponatremia. Hypernatremia Hypernatremia does not cause cardiac arrest. Calcium imbalance Hypercalcemia Definition : P/S Ca 2+ 2.6 mmol/L In approximately 90…

…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…

…other tachyarrhythmias with discernible QRS complexes. Shockable rhythm : Tachyarrhythmias that can be treated with defibrillation (ventricular fibrillation) or cardioversion (ventricular tachycardia). Non shockable rhythm : Cardiac…

…unexplained weakness, or a combination of these symptoms. The diagnosis requires elevated levels of cardiac troponins. In addition to elevated troponins, the patient must display…

CPR Predicting sudden cardiac arrest The purpose of discovering and measuring risk factors is to obtain estimates of risk, tailor management according to the risk…

…aorta can be regarded as a cylinder, and the same assumption can be made for the other valves. The area is calculated by measuring the…

…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…

…activated. Displacement of the tracheal tube. Cardiac arrest without adequate blood flow or ineffective compressions. While ETCO 2 is optimally measured in tracheal tubes, it…

…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…

CPR Neurons are exceptionally vulnerable to hypoxia and anoxia ( Casas et al ). In cardiac arrest without chest compressions (i.e. if cerebral perfusion ceases), irreversible…

…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…

…or extrapolation from other fields (e.g. sepsis research) or physiological reasoning. Cardiac arrest care is advanced and should preferably only be conducted in specialized…

…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…

Cardiology Key points Levosimendan alleviates heart failure symptoms, increases cardiac output, and lowers pulmonary artery pressure without increasing myocardial oxygen consumption. The inotropic effect of…

Critical care Myocardial ischemia and infarction Definition and Pathophysiology Cardiogenic shock is a state of inadequate tissue and end organ perfusion caused by cardiac insufficiency…

…Myocardial ischemia and infarction Definition and Pathophysiology Stress echocardiography is a functional cardiac imaging technique used primarily to identify inducible myocardial ischaemia and to estimate…

…Atrial Fibrillation and Atrial Thromboembolism Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and a profound driver of global cardiovascular morbidity and mortality…

…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…

…such as amyloidosis or sarcoidosis Other cardiac procedures Chemotherapeutic agents Catheter ablation Critical illness Defibrillator shocks Strenuous exercise Cardiac contusion The diagnosis should therefore distinguish…

[calc_map] Mean arterial pressure (MAP) represents the average pressure within the arteries throughout a single cardiac cycle, encompassing both systole and diastole. It is…

…is generally related to an atherothrombotic event, whereas Types 2–5 MI have other mechanisms of myocardial ischaemia and necrosis. Unstable angina (UA) represents myocardial…

…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…

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

…suggesting acute coronary occlusion. Most patients with this working diagnosis subsequently develop myocardial necrosis and cardiac troponin elevation, although not every patient with an initial…

…infarction (AMI), in which myocardial ischaemia is accompanied by cardiomyocyte necrosis and cardiac troponin release meeting the criteria of the universal definition of MI. Clinically…

…may lead to myocardial infarction, ventricular tachycardia, ventricular fibrillation, or sudden cardiac death. Spasm may involve the epicardial coronary arteries, the coronary microvasculature, or both…

…have complete LMCA occlusion, likely because most such occlusions result in prehospital cardiac arrest and death. As in other acute coronary events, the thrombotic process…

…and physical examination. It is also reasonable to analyze cardiac troponins if there is any probability of myocardial ischemia as the underlying cause. Holter ECG…

…propelled by breakthroughs in engineering, software development, and progress in our understanding of the pathophysiology of cardiac disease. Ultrasound systems have become cheaper, more portable…

…atrial impulses are conducted to the ventricles. The atria and the ventricles are electrically dissociated from each other. This condition is referred to as atrioventricular…

…Infection, hypovolaemia, cardiac dysfunction, haemodynamic instability, anaemia and other nephrotoxic exposures may contribute to tubular injury, making attribution to contrast alone difficult. In patients with…

…patients with valve prostheses or other cardiac devices (pacemaker, CRT, ICD). In addition to staphylococcus aureus , hemolytic streptococci and pneumococci cause acute endocarditis. Other microorganisms…

…a pulse that can be felt. The other predictable error is forgetting that pacing hurts a great deal in a conscious patient. Indications Immediate (transcutaneous)…

…reduced cardiac output, haemodynamic collapse, and death. The clinical consequences are particularly important when pulmonary vascular obstruction is accompanied by limited cardiopulmonary reserve or other…

…Adenosine is an endogenous nucleoside present throughout the body that interacts with G protein coupled A1 receptors located on the extracellular surface of cardiac cells…

…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…

…peripheral artery disease (PAD), and other manifestations of systemic atherosclerosis. The principal clinical concern is cerebral embolism or haemodynamic compromise leading to transient ischaemic attack…

…43 Contrast agent reaction 0.37 Haemodynamic complications 0.26 Cardiac chamber perforation 0.03 Other complications 0.28 Total major complications 1.70 In…

…syndrome (ACS), DAPT is used to reduce recurrent myocardial infarction, stent thrombosis and other ischemic events after coronary angiography, percutaneous coronary intervention (PCI), or medical…

…endothelial function, systemic inflammation, liver fat synthesis, adiposity, thrombosis and coagulation, cardiac function, satiety, appetite, the gut microbiome and metabolic expenditure. Food processing, additives and…