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

…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…

…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…

Arrhythmias and arrhythmology Emergency medicine Pharmacology & dosing Definition and Pathophysiology Bradycardia encompasses a spectrum of rhythm disturbances characterized by an inappropriately slow heart rate. Within…

…is generally related to an atherothrombotic event, whereas Types 2–5 MI have other mechanisms of myocardial ischaemia and necrosis. Unstable angina (UA) represents myocardial…

…agree with those viewpoints. Going through some guidelines the other day I realized that they are indeed becoming thicker and thicker. Guidelines issued by AHA…

…myocardial infarction. In SVG PCI, slow flow or no reflow rates may reach 15%–20%, substantially exceeding those seen with native vessel PCI. Mechanisms The…

…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…

…does not display ST segment elevations during posterior (posterolateral) transmural ischemia. On the other hand, leads V1–V3 (occasionally V4) may detect the injury currents…

…when recording during chest pain is not consistent with myocardial ischemia. In other words, chest pain caused by ischemia will always result in ischemic ST…

…cessation of cerebral blood flow. Agonal breathing : Deep, slow, irregular breaths with a frequency of 1 to 4 breaths per minute. Agonal breathing is frequently…

…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…

…high risk of infection. Approximately 20% of all endocarditis affect people with valve prostheses and among other cases 18% show significant valvular disease. Table 1…

…intravenous beta blocker Digoxin In heart failure or hypotension, or as an add on Slow onset. Dose reduction in renal failure and in old age…

…intestinal transit. Coffee ground vomiting is less specific than fresh haematemesis and can also be seen when the bleeding is slow or has stopped. The…

…tissue prolapse, thrombus, or other acute complications; investigation of restenosis and stent thrombosis. Intravascular imaging may also clarify the mechanism of an acute coronary syndrome…

…slow ventricular rate (beta blockers being the mainstay of this therapy). Rate control does not affect the rhythm per se . Rhythm control, on the other…

…different types of dilated cardiomyopathy. Other causes of ventricular dilation ( e.g ischemic cardiomyopathy) must be excluded before establishing a diagnosis of DCM. Patient characteristics…

…fascicular block, the myocardium without fascicular supply will depend on impulses spreading from other parts of the ventricle (where the fascicle is intact). Figure 1…

…order to evaluate ventricular function, since it may affect the choice of device therapy and also suggest whether other interventions (e.g. heart failure management…

…However, it is often difficult to differentiate pericarditis and myocarditis, and they tend to accompany each other. Therefore, the term perimyocarditis is often used in…

…to measuring ventricular dimensions, trabeculae and papillary muscles are considered part of the left ventricular cavity. Other dimensions– including atrial dimensions, mitral annulus, aortic annulus…

…medical system (EMS), as well as the hospital cardiac arrest team (CAT) and intensive care units and other units caring for resuscitated patients. Figure 1…

…entirely outside of the ventricular conduction system, and thus the ventricular depolarization is slow (yielding a wide QRS complex). Because the ventricular depolarization is abnormal…

…patient is drowsy, difficult to rouse, hypervigilant, or has reduced orientation to the surroundings Other cognitive disturbance Disorientation, memory impairment, disorganised thinking, language disturbance or…

…the pressure, but emergency department studies show that raised values often persist after the visit and predict future hypertension and cardiovascular risk [3]. Questions that…

…also utilized for ventricular rate control in atrial fibrillation, particularly when other therapeutic options cannot be pursued. Patients receiving digoxin may present with symptoms of…

…wave, it is still referred to as a QRS complex . In other words, if ventricular depolarization only generates a Q wave and an R wave…

…and hence it originates in the atria. In other words: tachycardias with narrow QRS complexes originate in the atria. the term supraventricular tachycardia is often…

…abnormal. For example, sinus bradycardia (a slow rhythm directed by the sinoatrial node) is a common finding in athletes and during sleep; in these scenarios…

…lead ECG does not display ST segment elevations during posterolateral transmural ischemia. On the other hand, leads V1–V3 (occasionally V4) may detect the injury…

…impulse cannot travel directly from atrial myocardium to ventricular myocardium because the two are electrically isolated from each other by the fibrous rings ( anulus fibrosus)…

…of ischemia (but the sensitivity is low). U wave changes always accompany other ischemic ST T changes. They may occur in both NSTEMI and STEMI…

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

…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…

…C) is the principal therapeutic target in lipid management because LDL and other apolipoprotein B containing lipoproteins play a causal role in atherosclerotic cardiovascular disease…

…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…

…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…

…drugs . The diagnosis rests on the history, a positive Dix–Hallpike test and the absence of other neurological findings. The treatment is a repositioning manoeuvre…

…Interactions Pharmacodynamic interactions Anticoagulants, thrombolytics, or other platelet aggregation inhibitors: Salicylates inhibit platelet function and enhance the effect of anticoagulants, increasing bleeding risk. Monitor coagulation…

…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…

…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…

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

…faintness, and other symptoms may occur without chest pain and should be considered anginal equivalents. The emergency evaluation of non traumatic chest discomfort is structured…

…Study, which demonstrated that high blood pressure and high cholesterol levels, among other risk factors, were strongly associated with coronary artery disease and myocardial infarction…

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

…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…

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

…with avoidance of second hand smoke and, where possible, other inhaled nicotine products. In cardiovascular medicine, the objective is not merely to reduce cigarette consumption…

…most cardiac conditions may be associated with atrial flutter. As compared with several other supraventricular tachyarrhythmias, atrial flutter does not occur among otherwise healthy individuals…

…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…

…1 A ). Concave ST segment elevations, on the other hand, are much less likely to be caused by ischemia ( Figure 1 B ). This is noted…

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

…rivaroxaban and edoxaban. Check every 6 months 15 30 Dabigatran contraindicated. The other DOACs are possible according to FASS, but the documentation is insufficient; check…

…Previous pelvic irradiation on the intended side (yields fibrotic, unrepresentative marrow — choose the other side). A patient who cannot lie still — plan for sedation rather…

…incompatible infusions. Haemodialysis, plasmapheresis or other extracorporeal therapy (requires a large bore dialysis catheter, not an ordinary triple lumen catheter). Measurement of central venous pressure…

…margin must be included in the freeze. Contraindications Absolute: Suspected melanoma or any other pigmented lesion of uncertain diagnosis. A lesion in which histology is…

…sick sinus syndrome or high grade AV block without pacemaker protection. Asthma and other marked obstructive airways disease — relative; the risk of bronchospasm is real…

…then 100 mg × 1 5–7 days Epiglottitis and other severe upper airway infection cefotaxime 1–2 g × 3 IV Depends on the diagnosis Always…