…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…

…blood pressure of 20 mm Hg systolic or 10 mm Hg diastolic leads to a doubling of the risk of stroke and acute myocardial infarction…

…cessation lowers the risk of peripheral artery disease, myocardial infarction, premature death, recurrent infarction and limb threatening complications. Among patients with established peripheral artery disease…

…sex and blood pressure, affected patients have more frequent stroke, nonfatal myocardial infarction and atrial fibrillation, as well as greater cardiovascular mortality. Metabolic syndrome and…

…established ASCVD, its potential reduction in non fatal myocardial infarction and ischaemic stroke must be weighed against clinically important gastrointestinal and intracranial bleeding. Evidence in…

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

…a real giant. During his lecture professor Yusuf said that he was not too impressed with current guidelines. He said that guidelines tend to be…

…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…

…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…

…be studied in detail. Figure 2. The electrocardiographic natural course in STEMI (ST elevation myocardial infarction). Pitfalls Acute transmural ischemia located in the basal portio

…AV block Mobitz type 2, newly discovered complete heart block without current symptoms, alternating bundle branch block in acute anterior infarction, and before drugs or…

…systemic cardiovascular risk. The presence of a carotid bruit is associated with approximately double the risk of myocardial infarction and cardiovascular death. Management must therefore…

…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…

Myocardial ischemia and infarction ECG Posterior (posterolateral) acute myocardial infarction (STEMI) The heart is rotated 30° to the left in the thorax. This positions the…

…stress testing has been the diagnostic evaluation of coronary artery disease. However, current guidelines (ESC, AHA, ACC) discourage the use of exercise stress testing for…

ECG Myocardial ischemia and infarction ST segment depression due to acute myocardial ischemia ST segment depressions caused by ischemia are characterized by a horizontal or…

…recommended ECG criteria (e.g. criteria for acute myocardial infarction) have been derived and validated using the 12 lead ECG. The 12 lead ECG displays…

…and supplemental oxygen [1]. Distinguish between: Acidaemia and alkalaemia , which describe the current pH of the blood. Acidosis and alkalosis , which describe processes that lower…

…compression. Infection in the skin overlying the puncture site. Previous pelvic irradiation on the intended side (yields fibrotic, unrepresentative marrow — choose the other side). A…

…is disputed and practice differs between units. Poisoning with other weak acids where the poison control centre recommends it, for example certain phenoxy acid herbicides…

…as a rapid intravenous bolus. Unlike many other intravenous medications where rapid boluses risk hemodynamic instability or transiently toxic concentrations, adenosine requires a rapidly delivered…

Myocardial ischemia and infarction Definition and Pathophysiology Left main coronary artery disease (LMCAD) refers to atherosclerotic narrowing of the left main coronary artery, which supplies…

…ECG interpretation is a sophisticated art, even in the current era of artificial intelligence (AI). ECG interpretation requires a comprehensive understanding of cardiovascular pathophysiology and…

…inward sodium current ($I {Na}$) and are identified in 20% to 30% of probands [7] . Historically, expanded genetic panels implicated over 20 other genes…

…and therapeutic considerations, with recommendations aligned with current guidelines from both the American Heart Association (AHA) and American College of Cardiology (ACC), as well as…

…failure, coronary artery disease, acute coronary syndromes and stroke ( Steyerberg et al ). Achieving this has been significantly more difficult for the prediction of cardiac arrest…

…Piezoelectric crystals have unique electromechanical properties. When an electric current is applied to a piezoelectric crystal, it starts to vibrate and these vibrations generate sound…

…Definition and staging according to KDIGO Acute kidney injury is present when at least one of the following criteria is met [1]: A rise in…

…among others, can raise the blood pressure. Serotonin syndrome can also cause autonomic instability and hypertension [4]. Step 2: look systematically for acute organ damage…

…for whom no practical risk prediction tool currently exists. At the other end, roughly two thirds of ICDs implanted for reduced LVEF never deliver an…

…differences in the myocardium. Current guidelines, however, still recommend the use of the J point for assessing acute ischemia ( Third Universal Definition of Myocardial Infarction…

…Pathological R waves also indicate previous myocardial infarction Current European (ESC) guidelines suggest that R waves may also be used to diagnose previous myocardial infarction…

…mostly due to acute myocardial ischemia or myocardial infarction, and in these cases, the likelihood of ROSC is higher as compared to other etiologies and…

…exhibit ST segment elevations, but the condition should be managed as STEMI (ST Elevation Myocardial Infarction) in terms of treatment and interventions. As discussed previously…

…not by the values on admission alone. Diagnosis Current diagnostic criteria According to the international consensus report of 2024, the diagnosis of DKA requires three…

…persistently mildly reduced systolic function. This dynamic nature makes prior imaging particularly important when interpreting a current LVEF of 41–49%. Diagnostic phenotype Criterion HFmrEF…

…encounter a new medium, some sound waves will be reflected while others will transfer the mechanical (pressure) energy to the new medium, which may also…

…dispersion in the refractoriness. This means that some myocardial regions will be refractory while others will be excitable at the same time. As previously discussed…

…Figure 1. Pathological R wave progression is indicative of previous myocardial infarction. U wave changes New U waves (in absence of bradycardia) may indicate ischemia…

…Dosage: Prior Myocardial Infarction Ticagrelor 60 mg twice daily is the recommended dose for extended treatment for patients who had a heart attack at least…

…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…

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

…dangerous differential diagnoses [1,2]. STEMI and other ECG patterns suggesting acute coronary occlusion are time dependent conditions. The decision on immediate reperfusion is based…

…makes positioning impossible. Severe angina, heart failure or recent myocardial infarction. Red flags — investigate further instead Finding Suggests : : Nystagmus that is purely vertical, downbeating or…

…Dosage Acute myocardial infarction: Initial loading dose: 300–500 mg as soon as possible after symptom onset. Prophylaxis against cardiovascular complications (after acute myocardial infarction…

…interventions intended to reduce recurrent infarction, ischaemic stroke, cardiovascular death, and progression of atherosclerotic disease in patients with established coronary or other atherosclerotic vascular disease…

…burden of retained atherogenic particles accumulates over time, the probability of an acute atherosclerotic cardiovascular event increases. Non HDL Cholesterol Non HDL C is calculated…

…by an acute coronary process. Myocardial injury leads to release of cardiac troponin, but troponin elevation is not specific for myocardial infarction. Other conditions may…

…with homozygous FH typically die from acute myocardial infarction at 20 to 30 years of age. People with familial hypercholesterolemia have no other metabolic aberration…

…In the setting of acute coronary syndrome (ACS), DAPT is used to reduce recurrent myocardial infarction, stent thrombosis and other ischemic events after coronary angiography…

…stroke and the possibility of thrombolytic treatment. Cardiac and pulmonary complications Acute hypertension may precipitate myocardial ischemia or infarction, acute heart failure, or pulmonary oedema…

…myocardial infarction and stroke Likelihood of repeat revascularization Symptom burden and treatment goals Diabetes, left ventricular function and other comorbidities Surgical risk and contraindications to…

…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…

…flutter. Similar to atrial fibrillation, atrial flutter can be classified into the following types: Acute atrial flutter (includes newly diagnosed cases). Paroxysmal atrial flutter. Chronic…

…case the ECG or other examinations suggest left ventricular hypertrophy (LVH), one should suspect concomitant right ventricular hypertrophy (RVH) if the following ECG criteria are…

…for interpretation of ischemia. All available ECG criteria for acute myocardial infarction and ischemia are based on conventional 12 lead ECG. Established ECG criteria do…

…two different sets of piezoelectric crystals; one set for sending ultrasound and the other for analyzing reflected sound waves. The cardinal difference between continuous wave…

…radiotracers emit positrons. When a positron collides with an electron, they annihilate each other, producing two gamma photons emitted in opposite directions. PET scanners detect…

…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…

…and without compressing the skin. Ratios and other measurements Measurement Calculation Threshold : : : Waist–hip ratio Waist / hip Men 0.90, women 0.85 = abdominal…