…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…

…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…

…myocardial infarction is based on the following three components: Cardiac troponins – Elevation of cardiac troponins in peripheral blood is mandatory to establish a diagnosis of…

…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…

…can change before creatinine but is not a pure marker of filtration. Oliguria may be due to hypovolaemia, shock, obstruction or advanced renal injury. Conversely…

…acute PE severity , including clinical findings, RV dysfunction on imaging, and myocardial injury shown by laboratory testing. Comorbidity and aggravating conditions , which may worsen early…

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

…Risk of acute kidney injury increases when combined with ACE inhibitors. Corticosteroids and other NSAIDs: Increased risk of gastrointestinal bleeding when combined with acetylsalicylic acid…

…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…

…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…

…acute HMOD, although other guidance emphasizes that no single BP threshold is diagnostically sufficient: the presence of ongoing acute organ injury is decisive. The pathophysiology…

…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…

…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…

…and heart failure are among the conditions associated with myocardial injury. Relationship to chronic coronary syndromes Chronic coronary syndromes (CCS) describe stable period clinical presentations…

…on the treatment threshold and on whether haemodialysis should be considered. Rhabdomyolysis with marked elevation of CK and threatened kidney injury, as an adjunct to…

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

…uncommon, but their clinical spectrum ranges from transient arrhythmias and minor access site bleeding to myocardial infarction, stroke, coronary perforation, haemodynamic collapse, acute kidney injury…

…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…

…myocardial injury and troponin elevation but are non ischaemic mimics rather than MINOCA when identified as the final diagnosis. Reported prevalence varies according to the…

…be described by their effect on walking distance, daily activities, work and independence. Exercise testing can quantify both the time to initial claudication and the…

…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…

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

…from other mechanisms. Differential diagnoses and alternative causes of troponin release must therefore be considered throughout assessment. Coronary disease is most commonly related to atheromatous…

…four processes that defined the victim's outcome: Neurological injury Myocardial dysfunction Systemic response to reperfusion and ischemia Effects of the underlying cause of cardiac…

…The injury currents are not strong enough to be detected on leads with opposite angle of observation. Other vectors may interfere with the injury currents…

…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…

…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…

…biliary cholangitis, drugs Mixed Both raised Drug induced liver injury is the commonest cause Isolated bilirubin Unconjugated, the others normal Gilbert's syndrome, haemolysis The…

…possible to distinguish true bradyarrhythmic or asystolic arrest from other tachyarrhythmic events. On the surface electrocardiogram, sinus bradycardia may appear at rates of 40 to…

…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…

…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…

…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…

…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…

…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…

…measure the dosing recommendation is based on. The absolute GFR (mL/min) must be used for dosing, not the value normalised to body surface area —…

…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…

…in approximately 0.5–12% of angiographic series and up to 5–75% of CT series; other angiographic descriptions report rates of approximately 5–10%…

…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…

…problem is necessary for durable treatment. Intracoronary imaging is encouraged to define the mechanism rather than relying on angiography alone. Factors associated with restenosis The…

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

…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…

…Concussion, temporal bone injury, dissection, aminoglycoside toxicity, antiepileptic drugs, alcohol or sedatives Trauma and medication directed workup This corresponds to the principles of TiTrATE, in…

…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…

…of the pleural air and speeds resorption. Other conditions in which high flow oxygen is given irrespective of the saturation according to international guidelines are…

Procedurer Emptying the stomach has gone from routine to exception. Activated charcoal — in Sweden usually called medicinal charcoal — is the first line measure in decontamination…

…of the R waves. This is believed to be due to delayed (and thus electrically unopposed) depolarization in the ischemic area. Fragmented QRS complex The…

…Opioids, benzodiazepines and other sedating drugs. Thromboembolic risk, for example immobilisation, cancer and previous venous thromboembolism. A documented decision on the ceiling of care. Signs…

…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…

…during exercise; this manifests with ST segment depressions with upsloping ST segment during exercise but the person is asymptomatic). No changes on resting ECG. Benign…

…parallel with drug treatment and transport planning [1,5]. Symptom duration Under 12 hours: reperfusion is indicated in persisting STEMI. 12 to 48 hours: primary…

…with established coronary or other atherosclerotic vascular disease. Antiplatelet therapy is a central component because platelet activation and aggregation contribute importantly to arterial thrombus formation…

…containing lipoproteins, including: LDL Intermediate density lipoprotein (IDL) Lipoprotein(a) [Lp(a)] Very low density lipoprotein (VLDL) Chylomicrons and other triglyceride rich particles Thus, non…

…compared with agents that inhibit other platelet pathways. The distinction between primary and secondary prevention is fundamental: Primary prevention refers to individuals without established atherosclerotic…

…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…

…after complex interventions. The present chapter focuses principally on ACS, for which the evidence and recommendations differ from those applicable to elective PCI. Clinical presentation…

…and treatment goals Diabetes, left ventricular function and other comorbidities Surgical risk and contraindications to prolonged dual antiplatelet therapy Patient preferences, local expertise and operator…