…the value of echocardiographic examination depends on the pre test probability, which is the probability that the patient actually has endocarditis (this the probability should…

…AMI, although descriptions of the syndrome include a broader interval of approximately 1–8 weeks. The pathogenesis is presumed to be immune mediated. Pericardial injury…

…The patient lies on their side with the knee slightly flexed. Place the palm on the greater trochanter with the index finger towards the anterior…

…electronic equipment may also interfere with device function. The clinical consequences depend on the device, the patient's dependence on pacing, the presence of CRT…

…cells. The resulting voltage gradient between normal and ischaemic myocardium generates currents of injury that are expressed on the surface ECG as ST segment displacement…

…ventricular fibrillation. The combination of early repolarization pattern on ECG and ventricular fibrillation or sudden cardiac arrest is referred to as early repolarization syndrome . Early…

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

…and infarction ST elevation myocardial infarction (STEMI) without ST segment elevations on 12 lead ECG This chapter covers situations in which the 12 lead ECG…

…or severity; angina that awakens the patient from sleep. Patients receiving modified antiplatelet therapy require clinical surveillance for both recurrent ischemia and bleeding. The source…

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…

…ECG in acute coronary syndromes & chest pain patients An ECG must be performed on all patients seeking medical attention due to chest discomfort or other…

Njurmedicin Lathundar Acute management on call Acute kidney injury, AKI, is a syndrome of rapidly deteriorating renal function. Management is governed not by the creatinine…

…older patients, patients with diabetes and anyone with dizziness Definitions White coat hypertension: a raised office reading but normal readings at home or on 24…

Procedurer Catheterisation is straightforward in most patients and dangerous in a few. The male urethra is about 25 cm long with two curves and a…

…angiotensin converting enzyme (ACE) inhibitor. Enalaprilat lowers blood pressure by inhibiting ACE. Effects • The hypotensive effect of enalaprilat depends on plasma volume and plasma renin…

…post I would like to discuss hot topics related to coronary artery disease and I will emphasize on issues that are typically raised by patients…

…angiotensin converting enzyme (ACE) inhibitor. Enalaprilat lowers blood pressure by inhibiting ACE. Effects • The hypotensive effect of enalaprilat depends on plasma volume and plasma renin…

Echocardiography Left ventricular function and its echocardiographic assessment Cardiac function depends on a large number of parameters, including atrial function, valvular function, and ventricular function…

ECG ECG leads and recording ECGs in pediatric patients (children) Principles of ECG leads, lead anatomy and electrical vectors have been discussed in the chapter…

Akutsjukvård Psykiatri Lathundar Delirium in older adults: quick reference A quick reference for ward and on call physicians: recognise hypoactive delirium, stabilise the patient, work…

Infektionssjukdomar Akutsjukvård Lathundar Purpose and scope A quick reference for the doctor on call faced with suspected sepsis in adults: rapid recognition, microbiological sampling, empirical…

…HEMORR₂HAGES bleeding risk score is a clinical tool developed to assess the risk of major bleeding in patients with atrial fibrillation (AF) on anticoagulation therapy…

…contribute to hyperuricaemia. Uric acid may promote hypertension through effects on the endothelium. Increased asymmetric dimethylarginine, an endogenous inhibitor of nitric oxide synthase, provides an…

…85%). Many patients appreciate the exercise test because it offers them an opportunity to evaluate their performance and symptoms under the supervision of their clinician…

…AV block 1, 2 & 3) Evaluation of patients with suspected AV blocks requires a thorough medical history (with emphasis on causes of AV blocks; please…

…seconds. Case reports have indicated that the risk of high degree AV block and ventricular arrhythmias is greater in patients on digoxin or verapamil, although…

…interpretation difficult, including left bundle branch block (LBBB) or pacemaker rhythms. Atrial fibrillation or atrial flutter Patients on medications such as nitrates, beta blockers, or…

…three weeks of adequate anticoagulation before cardioversion — an INR ≥ 2.0 checked weekly on warfarin, or documented well managed DOAC therapy with no missed doses…

…in atrial fibrillation patients. By excluding the sex parameter, the CHA₂DS₂ VA score addresses concerns about overestimating stroke risk in women based solely on gender…

…Cardiac Amyloidosis Demographic and Clinical Context Cardiac amyloidosis should be suspected in patients older than 65 years presenting with heart failure and increased left ventricular…

…The specific voltage thresholds vary based on patient age, sex, and lead location, as detailed below [8, 10]: Patient Demographic Lead Group ST Elevation Threshold…

…and Pathophysiology Angina with non obstructive coronary arteries (ANOCA) describes anginal symptoms in patients whose epicardial coronary arteries are normal or show no obstructive disease…

…significant proportion of patients with acute coronary occlusion (ACO) do not exhibit classic ST segment elevation on ECG, leading to substantial delays in reperfusion therapy…

Drugs and electrolyte imbalance ECG Digoxin ECG changes: arrhythmias, conduction defects and waveform changes Digoxin may be used in patients with heart failure, atrial fibrillation…

…therapies have failed. Patients with structural heart disease or reduced left ventricular function are not eligible. Effects of propafenone and flecainide on ECG, heart rhythm…

CPR Extracorporeal Life Support (ECLS) and ECMO (Extracorporeal Membrane Oxygenation) Survival after cardiac arrest depends on the restoration of spontaneous cardiac rhythm. The likelihood of…

…in the catheterization laboratory in patients undergoing acute PCI. The PCI operator may use the ECG to obtain immediate confirmation on whether the intervention was…

…Lip GYH. Evaluation of the HAS BLED, ATRIA, and ORBIT bleeding risk scores in atrial fibrillation patients on warfarin. Am J Med . 2016;129(6…

…be considered. The doses and Swedish thresholds below are based on the national guideline for the management of reperfusion treatment in ischaemic stroke, Nationell arbetsgrupp…

…protocols. Children, pregnant women and patients with advanced renal failure, marked heart failure or circulatory shock require a specific protocol and early specialist involvement. DKA…

…amputees, patients with hepatic cirrhosis — creatinine based eGFR substantially overestimates renal function. Staging of chronic kidney disease Stage eGFR Description : : : G1 ≥ 90 Normal or high…

…measurement in evaluating aortic root morphology. Age stratified formulas help determine expected normal values based on body surface area (BSA), aiding in the diagnosis of…

…calcium channel blocker. Clevidipine is highly selective for vascular smooth muscle cells and has little or no effect on myocardial contractility or conduction. Clevidipine reduces…

…degenerate to VF, necessitating immediate defibrillation. In the context of cancer therapy, patients may develop new cardiac symptoms such as syncope, pre syncope, or rapid…

…duration , sex , and genetically influenced effects on the cardiovascular system. Acute exposure produces transient haemodynamic and myocardial effects, whereas sustained heavy consumption is associated with…

…ECG Definition and Pathophysiology Atrial flutter is defined by a macroreentrant atrial circuit, which manifests on the electrocardiogram (ECG) as organized, continuous atrial electrical activity…

…fatigue and oedema. This definition does not depend on left ventricular ejection fraction (LVEF). Heart failure with reduced ejection fraction (HFrEF) is defined by the…

…threatening tachyarrhythmias. Evaluation and Physical Examination Physical examination of a patient on digoxin therapy should focus on identifying signs of heart failure decompensation, which may…

…test Definition and clinical role Exercise electrocardiographic testing is a standardized assessment in which a patient performs progressively increasing external work, usually on a treadmill…

…Addition of a PCSK9 inhibitor when the target remains unmet despite maximally tolerated statin therapy and ezetimibe. For patients with a recurrent atherothrombotic event while…

…benefit from preventive drug therapy. Secondary prevention Although outside the principal scope of primary prevention, secondary prevention provides an important contrast. Patients with manifest clinical…

…despite restoration of epicardial flow. The electrocardiographic appearance depends on several interacting factors: The stage of the ischaemic process: acute, evolving or chronic The severity…

…infarction (STEMI) is a working diagnosis based on persistent ST segment elevation or an equivalent electrocardiographic pattern in a patient with symptoms of myocardial ischaemia…

…functional cardiac imaging technique used primarily to identify inducible myocardial ischaemia and to estimate prognosis in patients with suspected or established coronary artery disease (CAD)…

…Conduction disease and the need for pacemaker therapy may be more frequent in T2DM, although management follows the same principles as in patients without diabetes…

…relative to the cardiac cycle, since a shock delivered asynchronously on the T wave during ventricular tachycardia can precipitate ventricular fibrillation, whereas a synchronized shock…

…ST depressions and/or T wave inversions. Patients with NSTE ACS (NSTEMI, unstable angina), on the other hand, may only display ST depressions and/or…

…However, most clinicians who encounter patients with pacemakers only have access to conventional surface ECGs. Being able to assess pacemaker function and perform troubleshooting should…

…challenges. These complexities led researchers to study patients presenting with LBBB and suspected acute myocardial infarction (AMI) by referring them for urgent reperfusion therapy, which…

…disease. The stenosis can be fixed or dynamic, depending on the underlying etiology. Pulmonary stenosis can be valvular (i.e stenosis localized in the valve)…