…100 cases had full recovery. More recent studies has reported mortality rates reaching 4%. ECG in takotsubo cardiomyopathy (broken heart syndrome) 80% of patients have…

…ECG changes were stable over a period of 30 years. The ST segment depressions were accentuated during exercise. The patient developed atrial fibrillation at 55…

…GY. A novel user friendly score (HAS BLED) to assess 1 year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey…

…all cases had no myocardial disease or acute coronary syndrome. Indeed, the majority of the victims were healthy and tragically killed by a sudden and…

…provided it is tolerated. Patients with functional loss but preserved independence require a more detailed geriatric assessment. Where functional impairment is accompanied by inability to…

…fibrinolysis (Wilner et al.). Their findings revealed that a substantial number of these patients had complete coronary artery occlusions, and outcomes improved when they were…

…dose for extended treatment for patients who had a heart attack at least a year ago and are at high risk of a new event…

…undergo CABG due to better long term outcomes. Intermediate scores (23–32) require careful consideration by a heart team. Predict Outcomes : The score has been…

…effusions may produce a large pericardial collection with initially limited symptoms because the pericardium has had time to adapt. Hypotension and muffled heart sounds are…

…observed in patients with elevated TnT levels who had underlying cardiovascular disease, of which 69.4% died. Guo et al also report a significant association…

…those who did, only a minority had a reduced value — the majority of sudden cardiac deaths occur in patients with preserved LVEF, for whom no…

…remains consequential, and historically 2–6% of patients discharged with presumed non ischaemic chest pain were subsequently found to have had an infarction. Pathophysiological Considerations…

…with the patient fasting or having had a light breakfast according to local practice. Let the patient rest lying down or sitting for at least…

…Extracorporeal Membrane Oxygenation) , a type of ECLS, operates by drawing venous blood from the patient to an oxygenator (gas exchanger), where it undergoes oxygenation and…

…complications. Seizures in a patient with preeclampsia indicate eclampsia. Postpartum disease is clinically important. Hypertension is most frequent in women who had antenatal hypertensive disorders…

…reflex for predicting a poor neurological outcome was 68.8%. This implies that approximately one third of the patients who ultimately had a favorable neurological…

…Patients with greater ST elevation in aVR had higher crude in hospital and 6 month mortality (up to 18% at 6 months for 1 mm…

…dose of another statin. Approximately 45% of participants had type 2 diabetes. Over a median follow up of 40.6 months, the time averaged LDL…

…in patients with acute coronary syndromes (ACS) and is also a common tachyarrhythmia requiring treatment in decompensated heart failure (DHF). In the critically ill patient…

…the clinician must set a lower goal regarding workload (e.g. reaching 70% of maximal pulse instead of 85%). Many patients appreciate the exercise test…

Akutsjukvård Lathundar Basic principle Manage the patient, not the list of poisons. Stabilisation according to ABCDE, the plasma glucose, a blood gas and an ECG…

…patient The Wells criteria for pulmonary embolism: Criterion Points : : Clinical signs of deep vein thrombosis 3 Pulmonary embolism is the most likely diagnosis 3 Heart…

…the stable patient Drug Situation Comment : : : Beta blocker (metoprolol) First choice in most cases The IV dose is titrated slowly. Caution in acute heart failure…

…cell transplantation and patients treated with CAR T cells or other advanced immunotherapies may require separate local protocols. Definition Criterion Practical definition : : Fever A single…

…commonest error in paracentesis is not performing it. Every patient admitted with ascites should undergo a diagnostic paracentesis , because spontaneous bacterial peritonitis often lacks abdominal…

…that pacing hurts a great deal in a conscious patient. Indications Immediate (transcutaneous) pacing in bradycardia with haemodynamic compromise — hypotension, shock, impaired consciousness, heart failure…

…management The most dangerous asthma attack is the silent one. A patient who has become calm, quiet in the chest and stopped struggling may be…

…is limited. In a patient with moderate symptoms the physician must judge the likelihood that the symptoms really are caused by the hyponatraemia. With severe…

…a longer stay, although the results are influenced by the fact that the sickest patients are more often intubated [4]. Intubation is reasonable in: a…

…against the patient's own identity immediately before transfusion is the single most important safety measure in the entire chain. In massive haemorrhage a second…

…saw, protective sheeting Hot water gives faster setting and more heat production — a risk of burns Document the distal neurovascular status before casting : sensation, motor…

…Delirium is common but often missed. On medical and geriatric wards a substantial proportion of older patients are affected, and the incidence is particularly high…

…patients during airway management , and both are predictable. Indications Inability to protect the airway: reduced level of consciousness, loss of pharyngeal reflexes, vomiting with a…

…is a standardized assessment in which a patient performs progressively increasing external work, usually on a treadmill, while symptoms, a 12 lead ECG, heart rate…

…concept Myocardial infarction with non obstructive coronary arteries (MINOCA) describes a clinical presentation in which the patient has symptoms suggestive of acute coronary syndrome (ACS)…

…same time, exacerbation is a clinical syndromic diagnosis, not a sufficient explanation for all acute dyspnoea in a patient with COPD. Pneumonia, heart failure, pulmonary…

…course and precipitating circumstances , and then selecting a targeted examination. The patient's description of the quality of the dizziness — rotatory vertigo, unsteadiness or faintness …

…place, the electrodes come off, the patient has not kept a diary. The set up and the instructions decide whether the investigation will be usable…

…A short course (no more than 7 days) may be given to selected patients with an eGFR of 30 40 mL/min for lower urinary…

…is done wrongly: the patient pinches the nasal bone instead of the soft part, and lets go after two minutes. Management is a ladder — compression…

…heart rate response, arrhythmias and recovery. A patient who stops at a low workload with a fall in blood pressure is a high risk patient…

…measure in decontamination, and gastric lavage is today a rare procedure reserved for very serious poisonings in which the patient reaches hospital early. The benefit…

Procedurer For many patients a gynaecological examination is associated with a sense of exposure, and technically correct performance is only half the task. The examination…

…insertion. 3. Stretch the skin with the thumb and index finger, or compress the muscle in a slim patient. 4. Insert the needle perpendicularly , quickly…

…antibiotics that saves the patient — the puncture must never delay it. Indications Suspected meningitis or encephalitis. Suspected subarachnoid haemorrhage with a normal or non diagnostic…

…Procedure 1. Inspect both nasal passages and choose the more patent one. Ask the patient about a previous nasal fracture or unilateral nasal obstruction. 2…

…irrespective of the saturation (see below). Oxygen does not relieve breathlessness in a patient who is not hypoxaemic. Breathlessness without hypoxaemia is not an indication…

…dislocations. There is a hollow beneath the acromion, the arm is held in slight abduction and external rotation, and the patient resists internal rotation. Check…

…as needed and place the patient in the recovery position when this is practicable. Give oxygen if hypoxaemic. Use a bag and mask if ventilation…

…cause — warm the patient instead. Refractory shock in which the bradycardia and reduced contractility of hypothermia are not tolerated. A decision to withhold further life…

…3. Reduce to 5 mg (two tablets) on days 1 and 2 in patients over 75, with a weight below 60 kg, heart failure, hepatic…

…combined with a dihydropyridine CCB is appropriate for many patients. Long acting nitrates or ranolazine may be added when symptoms persist or when heart rate…

…V2 to V3 Greater than or equal to 1.5 mm All patients Other leads Greater than or equal to 1 mm These criteria for…

…be initiated concurrently. In patients with a confirmed indication for treatment but blood pressure in the range of 120–139/70–89 mmHg, concomitant indications…

…represent a more favorable profile, as the upper limit of the "healthy" range can still harbor significant metabolic risk. 3 For patients with a BMI…

…probability is the clinician’s estimate of the probability that the patient has anatomically obstructive CAD before the result of a new test is known…

…with the patient’s clinical context and the results of all relevant investigations. Haemodynamic definition At rest, PH is defined invasively by a mean pulmonary…

…hypertension is elevated blood pressure attributable to a specific, identifiable underlying cause. It should be considered in every patient with newly diagnosed or referred hypertension…

…obstruction of an epicardial coronary artery. A vulnerable atherosclerotic plaque and thrombogenic blood interact to initiate and extend thrombosis. Plaque vulnerability is influenced by inflammation…

…trained medical or paramedic support capable of acquiring and transmitting a 12 lead ECG and obtaining medical authorization. Fibrinolysis reduces mortality in patients with STEMI…