…Etiologies of hypoxic cardiac arrest : Trauma and injuries : Direct trauma can cause airway injuries, resulting in obstruction. Central nervous system (CNS) injuries might cause apnea…

…serum concentration. Alkalinisation increases renal elimination several fold and at the same time reduces the passage of salicylate into the central nervous system. Contact your…

…part via NMDA receptors. With prolonged alcohol exposure the nervous system adapts through reduced GABA mediated inhibition and increased glutamatergic activity. When the alcohol level…

…plasmapheresis or other extracorporeal therapy (requires a large bore dialysis catheter, not an ordinary triple lumen catheter). Measurement of central venous pressure and central venous…

…and other relevant information for the drug Ticagrelor . Table 1 Summary Indications Ticagrelor, in combination with acetylsalicylic acid (ASA), is indicated for the prevention of…

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

…A single central feature is enough to proceed with urgent investigation , and a normal CT of the brain does not exclude an infarction in the…

…pulmonary vascular obstruction is accompanied by limited cardiopulmonary reserve or other adverse comorbidity. The classification of acute PE comprises four clinically useful groups: High risk…

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

…90 mmHg, respectively, despite: Appropriate lifestyle measures; A renin–angiotensin system blocker; A calcium channel blocker; and A thiazide or thiazide like diuretic, with all…

…brainstem infarction, intoxication, Wernicke's encephalopathy, other central disease Neurological examination, gait and truncal stability, often MRI Episodic triggered vestibular syndrome Brief attacks, usually lasting…

…pain or a rapid deterioration in general condition may be the only signs of infection. Corticosteroids and other immunosuppressive treatments can blunt the febrile response…

…preferably anteroposteriorly : one anteriorly over the praecordium to the left of the sternum, the other on the back between the left scapula and the spine…

…= (CO × SVR) + Central Venous Pressure (CVP) This equation illustrates that MAP is determined by the volume of blood the heart pumps and the resistance…

…atrial fibrillation, and other arrhythmias or conduction abnormalities. CKD also worsens the prognosis of established CVD. Mechanisms linking CKD to cardiovascular disease The association is…

…lifelong exposure to high LDL C is central to the disease burden. In untreated HeFH, CAD commonly develops during the third or fourth decade in…

…maximally tolerated statin therapy, with or without other lipid lowering treatment. The durability of the response is central to its clinical use. After the initial…

…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…

…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…

…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…

…bradycardia in the absence of a pacemaker. Hypersensitivity to adenosine. Administration Normal route : Peripheral intravenous (IV). Alternative route : Central venous administration of adenosine is suitable…

…risk of inducing osmotic demyelination syndrome (ODS). It is therefore recommended to raise serum sodium by a maximum 8 mEq/L in the first 24…

…PiCCO, central venous catheter). The hemodynamic effects persist for 7–10 days after the end of infusion. Refer to Table 2 for a comparison between…

…dependent on the initial rhythm (first recorded rhythm). The initial rhythm is a marker of several crucial events and factors: Cause of cardiac arrest : Shockable…

…excellent, with the vast majority of patients recovering completely after restoration of sinus rhythm (or any other rhythm with normal ventricular rate and activation). Recovery…

…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…

…poisoning, withdrawal or several factors Inattention is central. A simple check is to ask the patient to recite the months of the year backwards. A…

…and venous filling may be reduced. Other possible findings include muscle stiffening and loss of deep tendon reflexes. Pulses are absent distal to the obstruction…

…produced during its first passage through the circulation. Due to this rapid clearance, adenosine must be administered as a rapid intravenous bolus. Unlike many other…

…Chronic: more than 90 days. The central clinical danger is progressive aortic wall disruption, rupture and compromise of branch vessels. Type A disease may cause…

…proportion of painless or silent STEMIs is greater in patients with diabetes mellitus and increases with age. STEMI may present as sudden onset breathlessness. Other…

…the ultrasound beam to sweep back and forth within a defined sector. The transducer registers reflections originating from the central ultrasound beam (main beam). However…

…detected during management of another condition, or identified only by implanted or wearable devices as subclinical AF. Some patients have frequent symptomatic episodes, whereas others…

…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…

…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…

…Familial and genetic screening in cardiovascular medicine is the systematic assessment of relatives and other individuals who may carry an inherited predisposition to cardiovascular disease…

…189 mg/dL, 10 year risk of a first hard ASCVD event—fatal or nonfatal myocardial infarction or stroke—should be estimated. The risk categories…

…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…

…begins in parallel with the diagnostic work up. Obtain an interpretable 12 lead ECG within 10 minutes of first medical contact, attach continuous rhythm monitoring…

…NSAIDs). Other contraindications: Hemophilia. Thrombocytopenia. Active gastric or duodenal ulcers. Liver cirrhosis. Severe heart failure. Doses 100 mg/day during the third trimester of pregnancy…

…C and other apoB containing lipoproteins within the arterial wall. This initiates inflammatory reactions that promote plaque formation and progression. As the burden of retained…

…aggregation. Because aspirin affects only one pathway of platelet activation, its antiplatelet effect is relatively limited compared with agents that inhibit other platelet pathways. The…

…discovered during targeted duplex ultrasound (DUS), pre operative assessment, or evaluation of other atherosclerotic disease. Routine population screening is not recommended because the prevalence of…

…an effort to clarify the issues. Is high cholesterol levels a true cause of coronary artery disease? First of all, don't confuse various lipids…

…from selected populations, frequently with low or intermediate ischemic risk and under representation of patients with STEMI or other very high risk features. Noninferiority studies…

…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…

…left ventricular dysfunction, peripheral vascular disease and other manifestations of diffuse atherosclerosis. Percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are revascularization procedures…

…Other mechanisms include thrombosis, embolism, vasculitis, fibromuscular dysplasia, arterial entrapment, cystic adventitial disease and trauma. Atherosclerotic PAD is a manifestation of systemic arterial disease rather…

…and limb threatening complications. Among patients with established peripheral artery disease, those who stop smoking have approximately twice the five year survival of those who…

…beats per minute. Note that with a paper speed of 25 mm/s, which is standard in the US and many other countries, a 2…

…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…

…myocardial ischemia. Other symptoms include dyspnea, pain radiating to the left arm/shoulder/throat, palpitations, back pain and selected cases of upper abdominal pain. An…

…1). This is possible by using two different sets of piezoelectric crystals; one set for sending ultrasound and the other for analyzing reflected sound waves…

…tomographic images of the left ventricle. In PET (Positron Emission Tomography), radiotracers emit positrons. When a positron collides with an electron, they annihilate each other…

…in STE ACS/STEMI. Note that a patient with STEMI may present during any of the phases illustrated in this figure, which is why it…

…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…

…at the end of expiration, with the tape horizontal and without compressing the skin. Ratios and other measurements Measurement Calculation Threshold : : : Waist–hip ratio Waist…

…the bleeding risk of the procedure and by renal function. In markedly reduced renal function (dabigatran at eGFR <30 mL/min, the other DOACs at…

…involvement. Work up of unexplained iron, B12 or folate deficiency when blood tests are insufficient. Contraindications Severe coagulopathy or ongoing anticoagulation — correct this first . Thrombocytopenia…

…margin must be included in the freeze. Contraindications Absolute: Suspected melanoma or any other pigmented lesion of uncertain diagnosis. A lesion in which histology is…