…requiring dialysis is uncommon except in the presence of substantial pre existing CKD, particularly when congestive heart failure or other causes of ischaemic AKI coexist…

…anterior infarction, advanced age, delayed or unsuccessful revascularization, and pre existing diabetes, previous myocardial infarction, or heart failure. Mechanical disruption must be considered whenever abrupt…

…involvement The anatomical territory, including anterior, inferoposterolateral or right ventricular involvement Pre existing abnormalities such as prior infarction, left bundle branch block, Wolff–Parkinson–White…

…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…

…including hypovolemia, hypoxia, cardiac tamponade, tension pneumothorax, preexisting acidosis, drug overdose, hypothermia, and hyperkalemia. Clinical Presentation and Symptoms The clinical manifestation of bradycardia depends on…

…No effect. AV system (AV node, His bundle, Purkinje system) Preexisting AV block, bundle branch block or fascicular block may become worse. Particularly, the degree…

…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…

…pre eclampsia or eclampsia. The blood pressure is often at least 180/120 mmHg, but no absolute threshold defines the condition. A rapid rise in…

…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…

…diabetes mellitus (both type 1 and type 2), obesity, smoking, obstructive sleep apnea and chronic obstructive pulmonary disease (COPD). Moreover, certain other tachyarrhythmias predispose to…

…Utstein guidelines (Table 1). The broad categories of causes are considered necessary due to the uncertainties prevailing in the pre hospital setting ( Perkins et al. )…

…rhythm ( Thorén et al ). The initial rhythm has immense significance for survival in cardiac arrest, regardless of all other circumstances. The initial rhythm is an…

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

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

…Bronchospasm (asthma) Other : Coma Central hypoventilation syndromes Neuromuscular diseases Anemia The natural course of asphyxia Should ventilation be entirely inhibited (as seen in acute airway…

…patients with valve prostheses or other cardiac devices (pacemaker, CRT, ICD). In addition to staphylococcus aureus , hemolytic streptococci and pneumococci cause acute endocarditis. Other microorganisms…

…the primary ECG finding is the ST segment depressions. In STE ACS, on the other hand, the ST segment depressions are secondary findings and the…

…among other reasons because it has the least renally dependent elimination. Agent Standard dose in atrial fibrillation Criteria for dose reduction according to FASS : : : Apixaban…

…0.5 mm V3R–V4R (right ventricle) ≥ 0.5 mm (≥ 1.0 mm in men < 30 years) Other thresholds Sinus bradycardia: < 50/min…

…Oliguria, dark urine or rapidly developing swelling. Pregnancy, gestational week and recent delivery. Pre eclampsia can present postpartum. Known hypertension and current antihypertensive treatment. Missed…

…account for attenuation and other technical factors. Relative perfusion assessment has an important limitation: it requires a normally perfused reference territory. In diffuse coronary disease…

…functional cardiac imaging technique used primarily to identify inducible myocardial ischaemia and to estimate prognosis in patients with suspected or established coronary artery disease (CAD)…

…pulmonary valve stenosis). Lateral ventricular infarction. Pre excitation. Switched arm electrodes (negative P and QRS T in lead I). Situs inversus. Left posterior fascicular block…

…pulmonary valve stenosis). Lateral ventricular infarction. Pre excitation. Switched arm electrodes (negative P and QRS T in lead I). Situs inversus. Left posterior fascicular block…

…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…

…condition is referred to as pre excitation (the ventricles are excited prematurely; refer to Figure 4, third panel). As illustrated in Figure 4 the initial…

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

…sputum purulence, the other cardinal symptoms and the severity of the illness. 7. Start NIV without undue delay in persistent hypercapnic respiratory acidosis, if invasive…

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

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

…particularly in patients with: Diabetes or other cardiometabolic risk factors Obesity Insulin resistance or metabolic syndrome Elevated triglycerides Low or apparently well controlled LDL C…

…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…

…NSTEMI and unstable angina. Management begins in parallel with the diagnostic work up. Obtain an interpretable 12 lead ECG within 10 minutes of first medical…

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

…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…

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

…contained in all apoB containing lipoproteins, including: LDL Intermediate density lipoprotein (IDL) Lipoprotein(a) [Lp(a)] Very low density lipoprotein (VLDL) Chylomicrons and other triglyceride…

…only one pathway of platelet activation, its antiplatelet effect is relatively limited compared with agents that inhibit other platelet pathways. The distinction between primary and…

…although some series report 10–20%. Other life threatening cardiopulmonary conditions account for approximately 5% of presentations in some populations. Despite this relatively low prevalence…

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

…with STEMI or other very high risk features. Noninferiority studies designed mainly around bleeding outcomes may not reliably exclude clinically important differences in ischemic events…

…coexists with left main coronary artery disease, diabetes mellitus, left ventricular dysfunction, peripheral vascular disease and other manifestations of diffuse atherosclerosis. Percutaneous coronary intervention (PCI)…

…of the aorta or arteries supplying the limbs. In adults over 40 years of age, atherosclerosis is the predominant cause. Other mechanisms include thrombosis, embolism…

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

…with a paper speed of 25 mm/s, which is standard in the US and many other countries, a 2:1 block will be difficult…

…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…

…ECG in acute coronary syndromes & chest pain patients An ECG must be performed on all patients seeking medical attention due to chest discomfort or 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…

…In PET (Positron Emission Tomography), radiotracers emit positrons. When a positron collides with an electron, they annihilate each other, producing two gamma photons emitted 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…

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

…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…

…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…

Procedurer What determines the outcome of a central venous catheter insertion is decided before the needle goes in: the choice of site, the use of…

…with poor circulation, above all the lower leg in a patient with peripheral arterial disease or diabetes — the wound may not heal. Over superficial nerves…

…That makes the test useful only if you have selected an objectively measurable finding in advance — usually ptosis or fatigable gaze palsy — that can be…

…hepatic function, a non pregnant adult of normal weight, and individual assessment. See the separate quick reference for dosing in impaired renal function. Respiratory tract…

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