…than an anomalous right coronary artery. Anomalous origin of a coronary artery from the pulmonary artery can result in reduced coronary oxygen content, coronary steal…

…Type 2 myocardial infarction (MI) is defined as an ischaemic myocardial injury occurring in the context of a mismatch between myocardial oxygen supply and demand…

…Moreover, for optimal management in the context of sepsis induced cardiac arrest, consider the following recommendations: Administer 100% oxygen at the maximum flow rate . Hypoxia…

…dialysis catheter, not an ordinary triple lumen catheter). Measurement of central venous pressure and central venous oxygen saturation. Repeated blood sampling during intensive care. Exhausted…

…fluid ounces of wine containing approximately 12% alcohol, or 1.5 fluid ounces of 40% distilled spirits. Habitual heavy consumption is defined in the source…

…The Fourth Universal Definition classifies MI into five distinct subtypes based on pathophysiology and clinical context: Type 1 MI: Caused by atherothrombotic coronary artery disease…

…History taking in patients with chest pain (chest discomfort) HISTORY PARAMETER QUESTIONS COMMENTS Risk factors for the 5 serious etiologies Family history (focus on ischemic…

…finding that reflects brainstem (midbrain) function. In the context of cardiac arrest and the post resuscitation period, assessment of the PLR has long been considered…

…neonatologist, and anesthesiologist is essential. Figure 1 . When a pregnant woman is supine, the uterus can exert significant compression on both the inferior vena cava…

…1–6 L/min 24–44 % Comfortable; the patient can eat and talk. Flows above 6 L/min dry the mucosa without delivering more oxygen…

…measuring oxygen supply is easy). Thus, the theory regarding supply/demand balance has always been conceptual and lacks scientific evidence. As suggested by Heusch, [1…

…in acute airway obstructions), a rapid decline in blood oxygen saturation ensues. Within 1 2 minutes, oxygen saturation falls to approximately 60%, leading to unconsciousness…

…actively considered [1]. Do the following early: 1. Assess airway, work of breathing, level of consciousness and circulation. 2. Give controlled oxygen with a target…

…increases cardiac output, and lowers pulmonary artery pressure without increasing myocardial oxygen consumption. The inotropic effect of levosimendan is not affected by the concurrent use…

…SVR = 80 × (MAP − CVP) / CO PVR = 80 × (mean PA − PCWP) / CO Oxygen delivery (DO₂) = CO × (1.34 × Hb × SaO₂ + 0.003 × PaO₂)…

…determines the outcome. Transfusion restores circulating volume, oxygen transport and haemostatic capacity, but it cannot compensate for an uncontrolled source of bleeding. Minimise the time…

…and reduces myocardial oxygen consumption. Time to onset of action: 5 minutes. Effects Lowers blood pressure, reduces heart rate, myocardial oxygen consumption and myocardial contractility…

…Perioperative hypertension. Mechanism of action Beta 1 adrenergic blocker. Effects Lowers blood pressure, reduces heart rate, myocardial oxygen consumption and myocardial contractility. Less pronounced blood…

…and/or the coronary microcirculation. These abnormalities may produce a transient mismatch between myocardial oxygen demand and coronary blood supply, resulting in myocardial hypoperfusion or…

…a state of inadequate tissue and end organ perfusion caused by cardiac insufficiency. Sustained hypoperfusion reduces oxygen and nutrient delivery and, when severe or prolonged…

…or pharmacological stress. The physiological basis is an imbalance between myocardial oxygen demand and coronary blood supply. Stress increases myocardial oxygen requirements, principally through increased…

…article will deal with the physiology of exercise and emphasis will be placed on myocardial oxygen consumption and the development of myocardial ischemia during exercise…

…Image acquisition and evaluation Stress Imaging : Initially performed using exercise or pharmacologic agents to elevate myocardial oxygen demand (or simulate increased demand using vasodilatory agents)…

…1]. The first few minutes 1. Sit the patient up and minimise physical exertion. 2. Attach continuous pulse oximetry and an ECG. 3. Give oxygen…

…medication, fluid balance, renal function, electrolytes and supplemental oxygen [1]. Distinguish between: Acidaemia and alkalaemia , which describe the current pH of the blood. Acidosis and…

…Atelectasis and postoperative hypoxaemia. Hypoxaemic failure where high flow nasal oxygen is insufficient and the carbon dioxide is normal. Bilevel NIV: Acute exacerbation of COPD…

…and increased mortality [3,4]. Do this first 1. Assess vital signs and level of consciousness immediately. 2. Check oxygen saturation and capillary glucose. 3…

…reflexes, vomiting with a risk of aspiration. Inadequate oxygenation despite maximal oxygen or non invasive ventilation. Inadequate ventilation with a rising pCO₂ and respiratory acidosis…

…a reasonable target ScvO₂ 70–80 % A low value suggests inadequate oxygen delivery Capillary refill < 3 s Equivalent to lactate guided resuscitation in septic…

…enhanced elimination. For many poisonings, well delivered supportive treatment matters more than the antidote [1,2]. Telephone your national or regional poison control centre , which…

…same time has a lactate above 2 mmol/L. This combination carries a high mortality [1,2]. Give antibiotics immediately and aim for administration within…

…1 Initial diagnosis of STEMI ECG Management Recommendation Level of evidence A 12 lead ECG should be interpreted immediately (within 10 minutes) at first medical…

…diagnostic interpretation reserved for appropriately selected patients. Pathophysiological basis Exercise progressively increases myocardial oxygen demand through increases in heart rate, myocardial contractility and blood pressure…

…MINOCA accounts for approximately 1–14% of ACS presentations in different series and approximately 5–10% of patients presenting with myocardial infarction in other reports…

…results from an imbalance between myocardial oxygen supply and demand. The universal classification distinguishes infarction according to its mechanism: Type 1 myocardial infarction: acute atherosclerotic…

…control. Proposed mechanisms include: Reduction in glomerular hypertension and hyperfiltration Decreased tubular energy demand and oxygen consumption Natriuresis and diuresis Reduction in plasma volume, preload…

…Mechanism or setting Type 1 Acute atherothrombotic MI, usually related to plaque rupture or erosion Type 2 MI caused by oxygen supply–demand imbalance unrelated…

…output is insufficient. Aortic regurgitation may cause myocardial ischemia because cardiac output diminishes in parallel with increasing myocardial load (and hence oxygen demand). The most…

…is managed following the cardiopulmonary resuscitation (CPR) algorithm, incorporating an intravenous administration of 1 mg epinephrine. Predominant causes of anaphylactic cardiac arrest include food allergies…

…Stephen et al.). Figure 1 illustrates the decline in cardiopulmonary function and consciousness with decreasing body temperature. There appears to be a linear relationship between…

…One metabolic equivalent (1 MET) is defined as the amount of oxygen consumed while sitting at rest and is equal to 3.5 ml O2…

…die. Figure 1. Myocardial cells require a continuous oxygen supply in order to maintain normal metabolism. If oxygen supply is less than oxygen demand, ischemia…

…myocardial oxygen supply matches demand (Duncker et al). Reference values for coronary blood flow Normal coronary blood flow at rest: 0.6 to 1.3…

…integral aspect of virtually every echocardiographic examination. Wall motion is assessed in each segment of the left ventricle (Figure 1; refer to Segments of the…

…is most pronounced and extends towards the penumbra zone (the outermost and less ischemic area), which may receive oxygen from collateral vessels. In cardiac arrest…

…fundamental pathophysiological substrate for acute coronary syndromes (ACS), including ST Elevation Myocardial Infarction (STEMI) [1] . Historically viewed as a simple plumbing problem characterized by the…

…coronary artery. Arterial blood supply of the conduction system Figure 1 presents the components of the conduction system and the arterial blood supply. The first…

…they described these phases, which require different treatment strategies to maximize survival (Table 1). Phase Period Optimal treatment Electrical phase 0 to 4 minutes Defibrillation…

…membrane potentials in the ischemic area. Myocardial cells are capable of normalizing their membrane potentials immediately as oxygen becomes available. Recall that ST segment elevations…

…and Localization of Infarction & Ischemia). Figure 1 shows a detailed view of the coronary arteries. Figure 1. The right ventricle is supplied by the right…

…to alteplase and is simpler to administer, since the whole dose is given as a bolus [1,2]. In a meta analysis of three phase…

…Skin symptoms may be absent, and circulatory shock does not have to be present for the condition to be serious [1]. Intramuscular adrenaline (epinephrine) is…

…be secured. Preparation and equipment Edrophonium 10 mg/mL, 1 mL (named patient product — order well in advance). Atropine 0.5 mg for premedication, plus…

…continuous recording; automated or manual blood pressure measurement. Resuscitation trolley with defibrillator, oxygen, suction and emergency drugs in the room. Staff with current CPR competence;…

…minutes the absorption can be reduced by around half. Liquid preparations: in practice within about 1 hour. Tablets and solid preparations: up to about 2…

…the correct size, a sharps bin. For vaccination: adrenaline 1 mg/mL, an antihistamine, oxygen, and the ability to lay the patient down. Injection Needle…

…and inotropic effects (Figure 1). What follows is a quick reference for their use in the emergency department, the intensive care or coronary care unit…

…2022 the z score with a lower limit of normal at z = −1.64 (the fifth percentile) has been recommended in preference to fixed…

…imaging, the blood count or contact with the patient's own clinic delay empirical antibiotics [1]. A practical target: give the first dose of broad…

…is given. Oxygen with a mask and a bag available. The opioid drawn up in a 1 mL syringe at a known concentration, clearly labelled…