…lupus erythematosus and rheumatoid arthritis, are important risk enhancing conditions and are more prevalent in women. Chronic kidney disease and several other comorbidities also contribute…

…used for type 1 myocardial infarction are fulfilled. The temporal relationship to stent implantation should always be specified. Coronary arterial thrombi are predominantly platelet rich…

…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…

…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…

…Contraindications Absolute: Cellulitis, a skin wound or other infection over the injection site. Bacteraemia or suspected septic bursitis or arthritis. A joint prosthesis in 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 QT…

Cardiology Endocrinology & metabolism Definition and pathophysiology Secondary hypertension is elevated blood pressure attributable to a specific, identifiable underlying cause. It should be considered in every…

…Lathundar ECG Criteria for ST Elevation Myocardial Infarction (STEMI) The diagnosis of STEMI relies on specific electrocardiographic thresholds for ST segment elevation measured at the…

…Despite their proven morbidity and mortality benefits, their use is limited by specific adverse effects. Most of these adverse events are related to the suppression…

…release of cardiac troponin, but troponin elevation is not specific for myocardial infarction. Other conditions may produce cardiomyocyte injury and elevated troponin, so biomarker interpretation…

…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…

…reserve (FFR) is an invasive, lesion specific physiological index used to estimate the functional significance of an epicardial coronary stenosis. It is defined during maximal…

…responds to further cholinesterase inhibition. The test has a sensitivity of around 60 % and is not specific: motor neurone disease, myopathies and Lambert–Eaton syndrome…

…preferably anteroposteriorly : one anteriorly over the praecordium to the left of the sternum, the other on the back between the left scapula and the spine…

…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…

…Documented atherosclerotic cardiovascular disease (ASCVD) Diabetes mellitus in circumstances where diabetes specific risk assessment or risk categorization is applicable Moderate or severe chronic kidney disease…

…heart failure, atrial fibrillation, and other arrhythmias or conduction abnormalities. CKD also worsens the prognosis of established CVD. Mechanisms linking CKD to cardiovascular disease The…

…sodium pump. Digoxin binds reversibly to a specific high affinity site on the extracytoplasmic face of the alpha subunit of the Na+ K+ ATPase. This…

…Natriuretic peptide concentrations reflect haemodynamic stress, but their release is not specific to left ventricular systolic dysfunction. Levels may also rise with: Left ventricular diastolic…

…injury. Myocardial injury Myocardial injury is defined by at least one cardiac troponin (cTn) concentration above the assay specific 99th percentile upper reference limit (URL)…

…dyslipidaemia, obesity, smoking and other conventional risk factors, together with diabetes specific vascular and metabolic abnormalities. Diabetes is associated with inflammation, thrombosis and accelerated atherosclerosis…

…the interventions available in BLS, the number needed to treat (NNT) for the ACLS specific interventions is much higher or uncertain, meaning that the efficacy…

…with acute myocardial infarction, unstable angina, severe aortic stenosis, decompensated heart failure, and uncontrolled arrhythmias. Pharmacologic stress agents have specific contraindications: Adenosine, Dipyridamole, Regadenoson : Should…

…and subject preparations. We will also discuss the relevance of withholding specific cardioactive medications during exercise testing (exercise ECG). Indications for exercise stress test Indications…

…examination, other examinations (which are not included in the standard examination), may be warranted. For most pathological conditions, there are specific guidelines (see links below)…

…it might be wise to observe the patient for 24 hours (including ECG monitoring). In all other situations, the underlying condition should be targeted and…

…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…

…aorta can be regarded as a cylinder, and the same assumption can be made for the other valves. The area is calculated by measuring the…

…vomiting is less specific than fresh haematemesis and can also be seen when the bleeding is slow or has stopped. The first steps Step Content …

…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…

…rate. Within the context of acute coronary syndromes, particularly ST elevation myocardial infarction (STEMI), ischemic injury can disrupt the conduction system at any level, producing…

…expected diagnostic or therapeutic benefit against the patient’s specific procedural risks. Vascular access and access site complications Radial and femoral access Radial access is…

…of the physiological significance of selected stenoses using fractional flow reserve (FFR) and instantaneous wave free ratio (iFR). Other invasive techniques can quantify coronary flow…

…status Renal dysfunction and other important comorbidities Frailty Liver cirrhosis Cognitive function and life expectancy, especially in older adults Previous sternotomy or CABG Patient preferences…

…Other guideline formulations similarly define resistant hypertension as blood pressure above goal despite three or more antihypertensive drugs from different classes at maximally tolerated doses…

…systole. Transesophageal echocardiography and surgical pathology demonstrate that over 90% of thrombi in non valvular AF originate within this specific anatomical cul de sac [19] …

…ECG changes and symptoms. Troponins and other biomarkers of myocardial necrosis (infarction) Myocardium can endure 20 to 30 minutes of complete ischemia. After this period…

…of the nine parameters listed above. Many of the diagnoses mentioned below are discussed in detail in other chapters, to which links are provided throughout…

…of arrhythmias) is presented in this chapter, followed by in depth discussions of specific arrhythmias in subsequent chapters. Cardiac arrhythmias can be subdivided into the…

…ECG and clinical examination, blood tests and other radiological examinations are most often required, in particular computed tomography (DT) and/or magnetic resonance imaging (MRI…

…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…

…familiar to every electrophysiologist, is that LVEF is both insensitive and non specific for SCD. Most people who die suddenly never had an ejection fraction…

…a decrease in Vmax. Consequently, shifts in the pacemaker site within the sinus node and sinus exit block may occur. In humans, adenosine initially slows…

…herpes zoster pain are other considerations when assessing chest pain [2]. Autoimmune/Malignancy: A history suggesting an autoimmune disorder or known malignancy may suggest specific…

…associated with extensive premature and progressive ASCVD; CAD and aortic stenosis may occur before the age of 20 years, with death often occurring before age…

…syndrome are fairly specific to the disorder, provided that the clinical characteristics are in line with the disorder. There are however other disorders that may…

…potentially indicating microvascular dysfunction or other pathologies. The software allows for detailed regional analysis of myocardial perfusion, highlighting specific segments of the left ventricle that…

…electrolyte imbalances are clinically negligible (from an electrophysiological standpoint), whereas others may be life threatening. The most common and clinically most relevant electrolyte imbalances concern…

…and patients with advanced renal failure, marked heart failure or circulatory shock require a specific protocol and early specialist involvement. DKA and HHS are dynamic…

…clinical risk factors rather than by the AF pattern. Important predictors include previous stroke or transient ischaemic attack (TIA), mitral stenosis, hypertrophic cardiomyopathy, diabetes mellitus…

…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…

…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…

…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…

…recent cervical spine surgery, atlantoaxial instability, severe rheumatoid arthritis of the neck. Symptomatic carotid stenosis, recent stroke or TIA in the vertebrobasilar territory. Retinal detachment…

…asthma, rhinitis, or urticaria triggered by: Acetylsalicylic acid (aspirin). Other non steroidal anti inflammatory drugs (NSAIDs). Other contraindications: Hemophilia. Thrombocytopenia. Active gastric or duodenal ulcers…

…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…

…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…

…operative assessment, or evaluation of other atherosclerotic disease. Routine population screening is not recommended because the prevalence of severe asymptomatic stenosis is low, screening has…

…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…