…may be due to hypovolaemia, shock, obstruction or advanced renal injury. Conversely, significant AKI may be non oliguric, particularly after nephrotoxins, sepsis or diuretic treatment…

…administer to patients with a history of asthma, rhinitis, or urticaria triggered by: Acetylsalicylic acid (aspirin). Other non steroidal anti inflammatory drugs (NSAIDs). Other contraindications…

…due to mechanisms other than myocardial ischaemia. Acute myocardial injury may arise from conditions such as sepsis, myocarditis, or takotsubo syndrome, while chronic myocardial injury…

…may be used to diagnose myocardial ischemia and infarction. Symptoms – Patients with acute myocardial infarction may present with typical ischemic chest pain, or with dyspnea…

…spine injury, in which scenario head tilt chin lift should only be used if other methods fail to open the airway. Figure 1. Methods to…

…transmural ischemia. On the other hand, leads V1–V3 (occasionally V4) may detect the injury currents and present them as ST segment depressions. These depressions…

…combined effects of contrast exposure and other ischaemic or nephrotoxic stresses. The kidney is particularly vulnerable to toxic injury because of its high blood flow…

…acute injury in the brain, retina, heart, aorta, kidneys, or other vascular beds. Malignant hypertension represents an extreme form in which acute microvascular injury occurs…

…or sarcoidosis Other cardiac procedures Chemotherapeutic agents Catheter ablation Critical illness Defibrillator shocks Strenuous exercise Cardiac contusion The diagnosis should therefore distinguish isolated myocardial injury…

…test and the absence of other neurological findings. The treatment is a repositioning manoeuvre. Indications Brief attacks of vertigo, seconds to a minute or so…

…and death. The clinical consequences are particularly important when pulmonary vascular obstruction is accompanied by limited cardiopulmonary reserve or other adverse comorbidity. The classification of…

…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…

…fail to demonstrate plaque disruption, intraluminal thrombus, or dissection. Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) can reveal lesions that are not apparent on…

…the lower limbs. Patients frequently have concomitant coronary, cerebrovascular or other peripheral arterial disease, and management should therefore address the entire arterial circulation. PAD is…

…lesion or process. Although Type 1 MI and acute coronary syndromes are commonly related to atherothrombotic events, myocardial ischaemia may also result from other mechanisms…

…intravenous drugs. Such treatment has not been shown to improve the prognosis and can cause hypotension, acute kidney injury, myocardial ischaemia or cerebral hypoperfusion. Pain…

…the suspicion to bone, pregnancy or malignancy. A markedly raised GGT with the other tests normal is most often enzyme induction by alcohol or drugs…

…as carrier solution according to local protocol. Potassium chloride for infusion. Urine dipstick with a pH scale, or urine pH measurement on a blood gas…

…Types 2–5 MI have other mechanisms of myocardial ischaemia and necrosis. Unstable angina (UA) represents myocardial ischaemia without demonstrable acute cardiomyocyte injury or necrosis…

…limb salvage. Evaluation and physical examination ALI requires immediate clinical assessment by a vascular specialist or urgent transfer to a facility with vascular expertise. The…

…of life, contribute to heart failure, and increase the risk of stroke and other thromboembolic events. Subclinical cerebral injury may contribute to vascular dementia, and…

…is essential to reconfirm the rhythm in two leads if possible to distinguish true bradyarrhythmic or asystolic arrest from other tachyarrhythmic events. On the surface…

…There are no absolute contraindications to coronary angiography in the general sense; the decision depends on balancing the expected diagnostic or therapeutic benefit against the…

…detailed symptom to anatomy correlation. Pain may be absent, particularly in iatrogenic aortic injury. Iatrogenic lesions commonly follow cardiac surgery, coronary angiography or other invasive…

…immediate stenting or other procedural intervention. The clinical importance of the finding is related to the extent of myocardium at risk. Occlusion or impaired perfusion…

…transmural ischemia. On the other hand, leads V1–V3 (occasionally V4) may detect the injury currents and present them as ST segment depressions. These depressions…

…macrophages, neurons and other tissues. This distribution helps explain why PA produces cardiovascular injury beyond its effects on blood pressure and potassium balance. The principal…

…and fibrin and enlarging the occlusive thrombus. The severity of myocardial injury depends on the size of the supplied territory, completeness and duration of occlusion…

…Thrombotic susceptibility is likewise affected by inflammation and other systemic influences. The severity of myocardial injury is determined not only by the epicardial obstruction but…

…or convex ST segment strongly suggest acute transmural ischemia ( Figure 1 A ). Concave ST segment elevations, on the other hand, are much less likely to…

…or to confirm a creatinine based value The mean of creatinine and cystatin C The most reliable in routine clinical practice Cockcroft–Gault Still used…

…women or five for men on one occasion. Pharmacokinetics and pathophysiology Approximately 95% of ingested ethanol undergoes hepatic metabolism. Alcohol dehydrogenase converts ethanol to acetaldehyde…

…The vast majority of infections with COVID 19 result in mild disease, with symptoms similar to seasonal flu (influenza) and other viral respiratory infections. However…

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

…any age) V2 to V3 Greater than or equal to 1.5 mm All patients Other leads Greater than or equal to 1 mm These…

…helps explain why ISR and other stent related events may arise well after the initial intervention. Mechanical mechanisms Mechanical abnormalities may initiate or perpetuate ISR…

…injury involves the overlapping of vulnerable plaque and thrombogenic blood, which are critical determinants for infarction occurrence and extension. Plaque rupture or erosion leads to…

…length Large thrombotic burdens increase procedural risk because thrombus can fragment, embolize to other coronary branches or vascular beds, propagate through gaps between stent struts…

…often conflicting. Many recommendations are therefore based on observational data, expert opinion, or extrapolation from other fields (e.g. sepsis research) or physiological reasoning. Cardiac…

…debris, modern vascular biology has redefined atherosclerosis as a dynamic, immune mediated fibroproliferative response to endothelial injury [2] . The process initiates with endothelial dysfunction, a…

…compartments Orthopaedic surgeon Close to large vessels, in the groin or on the neck Bleeding, vascular injury, pseudoaneurysm Surgeon, ultrasound first Other situations that argue…

…medication or an exposure Concussion, temporal bone injury, dissection, aminoglycoside toxicity, antiepileptic drugs, alcohol or sedatives Trauma and medication directed workup This corresponds to the…

…A normal creatinine can conceal markedly reduced renal function. Acute kidney injury changes clearance from day to day. Reassess the dose daily and follow creatinine…

…closer monitoring — the patient cannot feel pressure injury Peripheral neuropathy of other cause As above Severe pain Titrate the pressure up gradually Rheumatoid arthritis with…

…Indications Hypoxaemia: a saturation below the target range, or a PaO2 below 8 kPa on an arterial blood gas. Acute critical illness during initial stabilisation —…

…where gastric emptying is delayed — may justify charcoal later, in some cases up to 6 hours or more. Discuss this with the poison control centre…

…or unchanged in ischemia. R wave amplitude Acute transmural ischemia may transiently increase the amplitude of the R waves. This is believed to be due…

…and the decision on intubation early. Initial assessment Confirm that the presentation fits an exacerbation A COPD exacerbation is an acute or subacute worsening of…

…reported in patients taking ticagrelor. This is related to ticagrelor inhibiting the P2Y12 receptor on healthy donor platelets in the test. Information about concurrent ticagrelor…

…dominant transmission, in which an affected heterozygous individual has a 50% risk of transmitting the relevant variant to each child. However, other inheritance patterns, de…

…combined dyslipidaemia, non HDL C is particularly relevant because it captures triglyceride rich lipoproteins in addition to LDL and other apoB containing particles. Cardiovascular risk…

…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…

…a non PCI hospital to wire crossing As quickly as possible, primary PCI if the total expected time is 120 minutes or less If PCI…

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

…to particle size and composition. As a result, apoB and cholesterol measures may be discordant. A patient may have: Relatively high apoB despite normal or…

…inflammatory drugs Corticosteroid therapy Other antiplatelet or antithrombotic drugs Selective serotonin reuptake inhibitors Patient selection Aspirin should not be prescribed routinely to individuals without established…

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

…may have resulted in increased mortality due to stopping statins. There are three main questions discussed in media, blogs and on social plattforms: Is high…

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

…left ventricular function and other comorbidities Surgical risk and contraindications to prolonged dual antiplatelet therapy Patient preferences, local expertise and operator or institutional experience Assessment…