…organs are maintained physiologically for as long as the assessment takes. The task of the health service is to give effect to the deceased person…

…a targeted history and examine the patient, with particular attention to the mouth, throat, skin, perianal region, vascular access, lungs, abdomen, urinary tract and neurology…

…showing severe hypercholesterolaemia. A personal history of premature CAD, cerebral vascular disease or peripheral vascular disease. A family history of premature myocardial infarction, vascular disease…

…body mass index Asian ancestry Previous muscle disease or a personal or family history of muscle disorders Acute infection Renal or hepatic impairment Hypothyroidism Vitamin…

…minute At least 110 per minute Bradycardia or arrhythmia PEF Over 50 percent of personal best or predicted 33 to 50 percent Under 33 percent…

…It requires a fasting history, two people, full monitoring and airway preparedness With procedural sedation, one person must manage the sedation and another the reduction…

…population screening test. It may also be considered in selected lower risk individuals with a family history of premature coronary artery disease. CAC findings incidentally…

…compression. The reason compression nevertheless so often fails is that it is done wrongly: the patient pinches the nasal bone instead of the soft part…

…organ structure and function. Ultrasound imaging, including echocardiography, has become a standard tool for clinicians worldwide (Narula et al). This chapter discusses the principles of…

…SYNTAX Score is a semi quantitative scoring system designed to assess the complexity of coronary artery disease (CAD) and guide the choice between percutaneous coronary…

…urgently Perianal and perirectal Often larger than it appears; risk of fistula Surgeon, often operative management Breast Cosmesis, milk ducts, malignancy differential Surgeon or mammography…

…95 % of a healthy reference population, which means that one healthy value in twenty falls outside them . Order twelve tests in a healthy person and…

…SCORE2 and SCORE2 Older Persons (SCORE2 OP) are European risk prediction models designed to estimate 10 year risk of both fatal and non fatal CVD…

…occlusions of arteries in the brain, limbs or other organs. However, the increased risk in mortality is not completely explained by the increased risk of…

…among persons with significant heart disease, predominantly ischemic heart disease. However, most cardiac conditions may be associated with atrial flutter. As compared with several other…

…less than 80% diagnoses chronotropic incompetence) Management of chronotropic incompetence Treatment of chronotropic incompetence and other bradyarrhythmias are discussed in the chapter Treatment of bradyarrhythmias.

…a high risk of hypoglycaemia 8–12 mmol/L The critically ill patient in intensive care According to the local protocol Avoid tight targets in…

…cardiac arrest when the person ventilating is not experienced in intubation. Planned anaesthesia for short procedures in a fasted patient at low risk of aspiration…

…the presumed cause of bleeding, and how the products are to be delivered. 2. Designate a team leader and one person responsible for recording the…

…If a person with ECG signs of SND is symptomatic, the condition is classified as sick sinus syndrome (SSS) . Causes of tachycardia (tachyarrhythmia) with narrow…

…Other mechanisms include thrombosis, embolism, vasculitis, fibromuscular dysplasia, arterial entrapment, cystic adventitial disease and trauma. Atherosclerotic PAD is a manifestation of systemic arterial disease rather…

…skeletal health, muscular strength, quality of life and psychological well being. Physical inactivity is itself a major cardiovascular risk factor. Sedentary behaviour may confer risk…

…Intervention BLS or ACLS NNT to save 1 person Reference Early detection of cardiac arrest BLS 11 Berdowski et al Bystander CPR BLS 15 Hasselqvist…

…Intervention Included in BLS NNT to save 1 person Reference Early detection of cardiac arrest Yes 11 Berdowski et al Bystander CPR Yes 15 Hasselqvist…

…predictor of survival. This is because cardiac arrest presenting with ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT) can be defibrillated to restore an organized…

…If a person with ECG signs of SND is symptomatic, the condition is classified as sick sinus syndrome (SSS) . Causes of tachycardia (tachyarrhythmia) with narrow…

…Fortunately, most children (even the youngest) can be distracted by a parent or other personnel. Distracting the child during ECG recording may be recommended to…

…ventricular filling). Persons with premature beats might perceive this as palpitations, because of the stronger ventricular contractions caused by the increased filling. Frequent premature beats…

…a premature ventricular contraction. Classification of premature ventricular contractions When every other beat on the ECG is a premature ventricular complex (PVC), the rhythm is…

…The person may have some circulation despite circulatory collapse (e.g., with sustained ventricular tachycardia). Experimental and clinical understanding of hypoxic neuronal cell death stems…

Arrhythmias and arrhythmology ECG Definition of sinus arrhythmia (respiratory sinus arrhythmia) Sinus arrhythmia and respiratory sinus arrhythmia both refer to the same phenomenon. Sinus arrhythmia…

…aphasia, hemianopia or hand paresis in a person of working age Blood pressure Measure initially in both arms if this does not delay reperfusion treatment…

…physical activity and any other precipitating factor. Thresholds The thresholds below are used above all in diabetes. The severity of the symptoms and the patient…

…probability of ongoing myocardial ischemia. IIa C Pre hospital logistics Management Recommendation Level of evidence The pre hospital care of STEMI patients should be organized…

…Exercise training can reverse deconditioning and increase functional capacity, while risk factor treatment and lifestyle modification reduce the burden of recurrent coronary risk. Nutritional counselling…

…However, left bundle branch block morphology is more common (regardless of heart rate) among persons with heart disease. Alternating block (right and left bundle branch…

…referred to as high sensitive cardiac troponin, may actually detect the presence of troponins in most normal persons. In 2017 it was possible to detect…

…RATING LEVEL OF EXERTION COMMENT 6 No exertion at all 7 7.5 Extremely light exertion 8 9 Very light exertion For a healthy person…

…fascicular block, the myocardium without fascicular supply will depend on impulses spreading from other parts of the ventricle (where the fascicle is intact). Figure 1…

…and other emergency instruments. Personnel conducting the test must be formally trained to assess cardiovascular response, symptoms, and ECG changes. Although the risk of cardiac…

…the wall of the artery. Such atherosclerotic plaques start building up early in childhood and by middle age, most persons have some degree of atherosclerosis…

…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…

…for adequate (high) dosing of rate controlling drugs (e.g beta blockers) without the risk of worsening the bradycardia. Persons with sick sinus syndrome should…

…STEMI The diagnosis is straightforward using the electrocardiogram (ECG). Prehospital personnel have proven to be capable of recognizing STEMI using 12 lead ECG. The sensitivity…

…the likelihood of bystander CPR, laymen in the community must be trained in basic cardiopulmonary resuscitation (BLS, basic life support). Training should be organized by…

…an unexpected death due to cardiac causes that occur within 1 hour of symptom onset. The person may or may not have known cardiac disease…