…arrest. Patients aged 18 to 70, who received bystander CPR and initially presented with a ventricular arrhythmia without return of spontaneous circulation within 15 minutes…

…achieve ROSC in the emergency room (ER) are transferred to the intensive care unit (ICU), coronary care unit (CCU), or catheterization laboratory. A 12 lead…

…most patients to return to normal blood pressure (normotension). Combination therapy with multiple antihypertensives is often necessary to normalize blood pressure. Management of hypertension requires…

…and worsen the prognosis. The patient must go to cardiothoracic surgery. In profound shock, very limited decompression may be considered in consultation with a cardiothoracic…

…A rapid increase in preload (e.g by increasing venous return to the heart in supine position) leads to an immediate increase in ejection fraction…

…and depressive symptoms Facilitate return to work and appropriate recreational or sporting activity Limit recurrent myocardial infarction, cardiovascular morbidity, and mortality The modern concept of…

…questions that patients tend to ask nowadays and therefore I will make an effort to clarify the issues. Is high cholesterol levels a true cause…

…venous return, pulmonary gas exchange efficiency, the concentration of catecholamines, angiotensin, hemoglobin, etc. A vivid example of how cardiac function can be affected by targeting…

…rapid acting) Corrects a currently high value As required, in addition to the mealtime dose Never stop basal insulin in a person with type 1…

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…

…kind of damage to native (own) valves is required to become vulnerable and contaminated by bacteria . Infections are difficult to heal because the heart valves…

…reversible causes. Because the prognosis is described as benign, treatment is directed primarily at symptom relief and may not be required in asymptomatic patients. Before…

…anticoagulant? The unstable patient Immediate electrical cardioversion, without delay, in any of the following: A systolic blood pressure < 90 mmHg caused by the arrhythmia…

…Availability in Sweden. Several of the drugs in this overview are not routinely marketed in Sweden and may require a named patient licence, among them…

…the preferred initial combination drug. It is also an appropriate first line pharmacological option when a patient is unable to tolerate any statin regimen. The…

…across the full range of LVEF, and echocardiographic measurement is subject to meaningful variability. HFmrEF may therefore represent several clinically distinct trajectories: A patient whose…

…further reduction is required. Combination therapy should be selected according to the magnitude of additional LDL C lowering needed and the patient’s prior treatment…

…Complete intolerance: inability to tolerate any dose of any statin. Partial intolerance: inability to tolerate the dose required to achieve the patient’s LDL C…

…a cardiac arrest occurs, VF/VT can be detected and defibrillated promptly. Survival is around 70% when defibrillation is performed within 3 minutes of the…

…may lead to misclassification. Blood pressure should be measured with a validated and calibrated device using a consistent method for the individual patient. The recommended…

…may be required. Evaluation and physical examination Assessment begins by establishing that the patient has a clinical heart failure syndrome and by determining the LVEF…

…by patient recognition and help seeking, pre hospital assessment and transport, diagnostic and treatment delays, and the time required for the selected treatment to restore…

…Syncope : Syncope without a clear cause may indicate underlying arrhythmias. Age : Younger patients are generally at higher risk of SCD due to the progressive nature…

…subacute worsening of dyspnoea, cough and sputum in particular that exceeds the patient's normal variation and requires a change of treatment. Common precipitants are…

…during sampling raises the potassium, calcium and proteins. Fasting is required for triglycerides but not for cholesterol, nor for glucose when the diagnosis is based…

…3.0 mmol/L A seriously low glucose; immediate treatment is required Level 3, severe hypoglycaemia No defined threshold The patient has cognitive or physical…

…troponin identifies injury to myocardial cells, but infarction requires additional clinical evidence that the injury resulted from acute myocardial ischaemia. Thus, a patient may have…

…Such patients require a mechanism based assessment rather than reassurance based solely on the absence of obstructive CAD. Evaluation and Physical Examination Clinical assessment The…

…The patient cannot perform an adequate treadmill test but can undergo pharmacological stress Local expertise and adequate echocardiographic facilities are available Risk stratification is required…

…in patients who are markedly larger or smaller than average. Higher doses may be required in the critically ill patient. Intravenous antibiotics Drug eGFR 90…

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

…tailored to the suspected mechanism. No antianginal class has demonstrated consistent superiority for symptom relief in direct comparative studies, and combinations are frequently required. The…

… switching from a potent P2Y12 inhibitor to clopidogrel; reducing the dose of prasugrel; extending DAPT beyond 12 months in carefully selected patients with high ischemic…

…can be tailored to the patient's needs. Programming is done through an external device that communicates wirelessly with the pacemaker. A wide range of…

…the principles that are common to all protocols. Children, pregnant women and patients with advanced renal failure, marked heart failure or circulatory shock require a…

…is required. Contraindications Atrial fibrillation or flutter of unknown or excessive duration without adequate anticoagulation or exclusion of thrombus — the most important relative contraindication to…

…to need 5–15 mg of morphine in total. If more than that is required without effect, reconsider the pain mechanism instead of continuing to…

…Duplication. Check that the patient is not already on an opioid patch, a modified release tablet and an as required opioid at the same time…

…patients with CAD, endothelial disruption may convert normal vasodilator responses to vasoconstriction; however, endothelial dysfunction alone is not sufficient, and an additional trigger is required…

…acute myocardial ischaemia are required for a formal diagnosis of Type 2 MI. However, clinical presentations can be heterogeneous. In the context of acutely decompensated…

…adjustments are required in certain patient populations: Pediatric patients: For patients weighing less than 50 kg, the dosing should be 0.05 to 0.3…

…7.5% to <20% Intermediate ≥20% High Management should incorporate the estimated risk, risk enhancing factors and a clinician–patient discussion regarding the expected net…

…typically causes a short lasting second or third degree AV block which may be unpleasant to the patient. This side effect lasts a few seconds…

…is a risk of developing tachycardia induced cardiomyopathy. In pediatric populations, a distinct form of atrial tachycardia may occur due to embryological remnants within the…

…waves may result in incorrect recordings. Patient data Gender, age, weight and height are required to evaluate the examination. Most echocardiographic parameters vary with age…

…required treatment; biphasic reactions occur. Everyone must go home with an adrenaline auto injector and written instructions. Patients taking beta blockers may respond poorly to…

…PE refers to refractory cardiogenic shock or the need for ongoing cardiopulmonary resuscitation. Mechanical circulatory support, including extracorporeal membrane oxygenation (ECMO), may be required in…

…angina, with increasing frequency or severity Symptoms that awaken the patient from sleep Clinical assessment must be integrated with vital signs, a 12 lead ECG…

…although coronary angiography may be required when acute native vessel or stent thrombosis must be excluded. Diagnostics Echocardiography TTE is the principal initial imaging method…

…is related to the intervention. Diagnostic criteria General principles For events occurring within 48 hours of the index procedure, diagnosis requires both: A defined postprocedural…

…Examination Initial assessment should establish whether the presentation represents ACS and whether the patient is clinically unstable. Particular attention is required for evidence of: Ongoing…

…with diaphoresis [4]. Aortic Dissection Severe, often sharp pain radiating to the back [5]. N/A N/A Acute Pericarditis Pleuritic, often retrosternal, radiating to

…from the suspected focus, but avoid sampling that delays antibiotics 6 Take a targeted history and examine the patient, with particular attention to the mouth…

…becomes and the greater the risk of chondral and neurovascular injury. Aim for reduction within a few hours. Contraindications A fracture dislocation requiring operative treatment…

…a fresh injury, before surgery, or while swelling is progressing. Take care in impaired sensation (neuropathy, spinal cord injury) — the patient does not feel the…

…the room: a fire hazard. Preparation and equipment A pulse oximeter, and the ability to take an arterial blood gas. An oxygen source with a…

…seconds to start and can keep a patient alive until a transvenous lead is in place — but only if it is working, and the commonest…

…a straight course to the superior vena cava, compressible if bleeding occurs, low risk of pneumothorax Uncomfortable for an awake patient, harder to keep the…

…triage requires a cervical sample. Screening is for the asymptomatic. Symptoms must be investigated wherever in the screening interval the patient happens to be — a…

…target organ damage. Although BP reduction is required, these patients generally do not need hospital admission or intravenous treatment. Some patients with acute pain, anxiety…