…days and resolution within about 1 week in the usual course. Severe AKI requiring dialysis is uncommon except in the presence of substantial pre existing…

…pre existing diabetes, previous myocardial infarction, or heart failure. Mechanical disruption must be considered whenever abrupt circulatory collapse occurs after STEMI. Rupture may involve the…

…ischaemia and whether infarction has occurred The extent and degree of myocardial involvement The anatomical territory, including anterior, inferoposterolateral or right ventricular involvement Pre existing…

…syndromes (ACS) and is also a common tachyarrhythmia requiring treatment in decompensated heart failure (DHF). In the critically ill patient, AF may be pre existing…

…failure. The pathophysiology of these events may stem from reversible causes, including hypovolemia, hypoxia, cardiac tamponade, tension pneumothorax, preexisting acidosis, drug overdose, hypothermia, and hyperkalemia…

…syndrome) and other conditions involving an accessory pathway. Paroxysmal atrial fibrillation in patients with severe symptoms, provided that first line therapies have failed and the…

…or other atherosclerotic disease; diabetes and other cardiovascular risk factors; smoking, hypertension, hypercholesterolaemia, and sedentary behaviour; family history, particularly in the broader assessment of peripheral…

…principle, not a universal target. Chronic hypertension shifts autoregulation in the brain and kidneys towards higher pressures. Too rapid a normalisation can therefore cause cerebral…

…intoxication, or other sympathomimetic exposure, including methamphetamine. Abrupt withdrawal of antihypertensive medication, particularly clonidine, can also precipitate a hypertensive crisis. Pregnancy Hypertensive emergencies in pre

…complexes due to bundle branch blocks or other conduction defects. However, in rare instances, it may be due to pre excited atrial fibrillation (i.e…

…Moreover, certain other tachyarrhythmias predispose to developing atrial fibrillation: atrial flutter, AVNRT and AVRT (pre excitation, WPW syndrome) being the most common. Atrial fibrillation with…

…ischemia, parasympathetic and sympathetic tone) while others take months or years to develop (e.g. myocardial remodeling in heart failure or after myocardial infarction). Ventricular…

…pre load (the ventricle is empty or nearly empty). In patients with an initial shockable rhythm, compressions and ventilation can extend the duration of the…

…Pre excitation, Wolff Parkinson White syndrome) and ectopic atrial tachycardia have traditionally been referred to as paroxysmal supraventricular tachycardias , because these tachyarrhythmias originate in the…

…provided that the clinical characteristics are in line with the disorder. There are however other disorders that may bring about similar ECG changes, and these…

CPR Hypoxia and asphyxiation Hypoxia refers to a reduced partial pressure of oxygen in the blood. Asphyxia is characterized by insufficient ventilation, leading to hypoxia…

…as to embolization in the systemic circulation. The complications can be fatal. Approximately 500 Swedes are affected annually by endocarditis and the median age of…

…on the other hand, the ST segment depressions are secondary findings and the primary findings are the ST segment elevations. As explained in the previous…

…valve prosthesis and in moderate to severe mitral stenosis, where warfarin applies. Apixaban is often preferred, among other reasons because it has the least renally…

…repolarisation: J point elevation ≥ 1 mm with notching or slurring in the inferolateral leads. See also the Calculators section for QTc formulas and risk scores.

…in several ways. Monoamine oxidase inhibitors can cause a hypertensive crisis through interactions, while venlafaxine and higher doses of bupropion, among others, can raise the…

…or high pre test likelihood of obstructive coronary artery disease, defined in the cited guidance as greater than 15% and up to 85%. The examination…

…It is particularly appropriate when: The pre test likelihood of obstructive CAD is moderate or high, generally greater than 15% and less than 85% Baseline…

…Pre excitation. Switched arm electrodes (negative P and QRS T in lead I). Situs inversus. Left posterior fascicular block is diagnosed when the axis is…

…Pre excitation. Switched arm electrodes (negative P and QRS T in lead I). Situs inversus. Left posterior fascicular block is diagnosed when the axis is…

…if other methods fail to open the airway. Figure 1. Methods to open the airway. No large study has compared oropharyngeal and nasopharyngeal airways in…

…indicates pre excitation (presence of an accessory pathway). This is associated with a delta wave. For further details on the PR interval and the PR…

…the sensitivity is low). U wave changes always accompany other ischemic ST T changes. They may occur in both NSTEMI and STEMI. QTc prolongation The…

…antibiotics on the basis of sputum purulence, the other cardinal symptoms and the severity of the illness. 7. Start NIV without undue delay in persistent…

…interpreting platelet function tests for HIT. Other cosiderations Based on a relationship observed in the PLATO study between the maintenance dose of ASA and the

Cardiology Genetic and miscellaneous conditions Definition and scope Familial and genetic screening in cardiovascular medicine is the systematic assessment of relatives and other individuals who…

…Non HDL C and apoB are secondary targets or risk refining measures, particularly in patients with: Diabetes or other cardiometabolic risk factors Obesity Insulin resistance…

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…

…Overview Acute coronary syndrome comprises STEMI, NSTEMI and unstable angina. Management begins in parallel with the diagnostic work up. Obtain an interpretable 12 lead ECG…

…on the spot, in three minutes, without drugs . The diagnosis rests on the history, a positive Dix–Hallpike test and the absence of other neurological…

…80 mg tablet once daily. Warnings and precautions Use Aspirin with caution in the following cases: Concurrent anticoagulant therapy (e.g., coumarin derivatives or heparin…

… reduce ischaemic stroke and cardiovascular mortality; prevent stent thrombosis after PCI; reduce recurrent atherothrombotic events in chronic coronary disease; preserve the benefit of coronary intervention…

…from the causal role of low density lipoprotein cholesterol (LDL C) and other apoB containing lipoproteins in atherosclerotic cardiovascular disease (ASCVD). Atherosclerosis develops through the…

…effect is relatively limited compared with agents that inhibit other platelet pathways. The distinction between primary and secondary prevention is fundamental: Primary prevention refers to…

…in the chest and may extend to the arms, shoulders, neck, jaw, upper back, abdomen, or epigastrium. Dyspnoea, nausea, vomiting, diaphoresis, fatigue, faintness, and other…

…since the 1960s. In 1948 the NHLBI initiated the Framingham Heart Study, which demonstrated that high blood pressure and high cholesterol levels, among other risk…

…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…

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

…Tibial and peroneal arteries, involved in approximately 40–50%. Distal disease is particularly common in older people and in patients with diabetes. The haemodynamic consequences…

…other inhaled nicotine products. In cardiovascular medicine, the objective is not merely to reduce cigarette consumption but to achieve complete abstinence from tobacco and ultimately…

…standard in the US and many other countries, a 2:1 block will be difficult to discern because the flutter wave may fuse with the…

…strong and oppositely directed forces tend to cancel each other out. However, the ECG may show features characteristic of biventricular hypertrophy. Biventricular hypertrophy ECG In…

…if the opportunity is given. An ECG without ischemic ST T changes when recording during chest pain is not consistent with myocardial ischemia. In other…

Echocardiography Continuous Wave Doppler In continuous wave Doppler (CW Doppler), ultrasound waves are continuously emitted from the transducer and the reflections of these waves are…

…and blurrier images. The absence of thallium uptake indicates non viable myocardium, while redistribution into initially hypoperfused regions suggests viability. What is myocardial redistribution? In…

…on the other hand, are much less likely to be caused by ischemia ( Figure 1 B ). This is noted in both North American and European…

…3. In third degree AV block, no atrial impulses are conducted to the ventricles. The atria and the ventricles are electrically dissociated from each other…

…index 15–19 kg/m² 17–22 kg/m² Ideal and dosing weight Drug dosing often requires a weight other than the actual body weight…

…50 Dose reduction as in the table above for rivaroxaban and edoxaban. Check every 6 months 15 30 Dabigatran contraindicated. The other DOACs are possible…

…well the puncture went. Indications Unexplained cytopenia in one or more cell lines. Suspected acute leukaemia, myelodysplastic syndrome or myeloproliferative neoplasm. Work up and staging…

…check the length in the set against the chosen side. An ultrasound machine with a high frequency linear probe, a sterile probe cover and sterile…

…inside the visible ice front , and this is why the margin must be included in the freeze. Contraindications Absolute: Suspected melanoma or any other pigmented…

…obstruction of the bowel or the urinary tract. Marked bradycardia, sick sinus syndrome or high grade AV block without pacemaker protection. Asthma and other marked…

…The exceptions are pregnancy and the period before a urological procedure. A positive urine dipstick in an older patient is difficult to interpret. Skin and…

…physical activity and any other precipitating factor. Thresholds The thresholds below are used above all in diabetes. The severity of the symptoms and the patient…