…combination with single photon emission computed tomography (SPECT) or positron emission tomography (PET) to assess myocardial perfusion and blood flow. These imaging modalities are highly…

…gamma cameras to create tomographic images of the left ventricle. In PET (Positron Emission Tomography), radiotracers emit positrons. When a positron collides with an electron…

…Myocardial perfusion imaging (MPI) with single photon emission computed tomography (SPECT) or positron emission tomography (PET) is a radionuclide based method for assessing regional myocardial…

…cardiac computed tomography (CT), single photon emission computed tomography (SPECT), positron emission computed tomography (PET) and coronary angiography. These modalities aim to image the myocardium…

…recovery of ejection fraction, and survival has been challenged by randomized trials. Relationship between viability and LV recovery Observational studies and positron emission tomography (PET…

Procedurer The insertion itself is rarely the difficult part — it is the confirmation of the position that determines whether the tube is safe. A misplaced…

…pulses. Each pulse consists of a few sound waves emitted in 1 to 2 milliseconds. These sound waves travel through the skin, chest, pericardium, myocardium…

…oxygenation despite maximal oxygen or non invasive ventilation. Inadequate ventilation with a rising pCO₂ and respiratory acidosis, or a markedly increased work of breathing with…

…from a previous value of at least 50%. A patient with persistently mildly reduced systolic function. This dynamic nature makes prior imaging particularly important when…

…tip, using the thumb and the forefinger, while remaining fingers stabilize the grip. The transducer tends to glide out of position due to the gel…

…but only if the examiner is trained. Brief attacks triggered by the position of the head relative to gravity: perform Dix Hallpike and, if needed…

…the left side. A positive test in the posterior canal is characterised by: A latency of 1–5 seconds before the nystagmus begins. Upbeating and…

…Nitroprusside Figure 1. The approximate position of each drug according to its vasoconstrictor effect (vertical axis) and its positive inotropic effect (horizontal axis). Grey =…

…devices. Electrode position (anterior posterior vs. antero lateral) does not affect success, but active compression of the pads lowers defibrillation thresholds and improves success, and…

…quality. Determining ventilation rate. Verifying the position of the tracheal tube. Evaluating the efficacy of chest compressions. Identifying return of spontaneous circulation (ROSC). Prognostication. Potential…

…Additional offloading of the vena cava can be accomplished using a wedge board (or any hard material) to tilt the body 15 to 30° to…

…features or an inadequate response. First line treatment is oxygen in hypoxaemia, repeated doses of an inhaled short acting β2 agonist, ipratropium in more severe…

…What usually ruins the examination is not the technique but the handling of the specimen — an aspirate that clots before the smears are made is…

…that position until the cast has set. 2. Pull on the stockinette so that it extends a few centimetres beyond the planned ends of the…

…cooperate — consider sedation, a different position or a different vessel. Choice of site Vessel Advantages Disadvantages : : : Internal jugular vein (right) Best ultrasound conditions, a straight…

…oxygen and complete equipment for intubation and ventilation must be to hand before the lavage begins. The head of the trolley must be able to…

…or ruptured membranes in pregnancy — a speculum may be used, but not digital examination until the position of the placenta is known. Recent gynaecological surgery…

…important indication and an emergency procedure . An unclear arthritis, as part of the diagnostic work up. Haemarthrosis after trauma. A symptomatic effusion causing pain or…

…the number of attempts. Laryngeal mask sizes Size Patient weight Maximum cuff volume (air filled mask) : : : 1 under 5 kg 4 mL 1.5 5…

…a lumbar puncture is rarely the needle itself. It is the decision whether to perform it now or after imaging, how the patient is positioned…

…Choose a point with at least 15 mm depth of fluid throughout the respiratory cycle and where the lung does not come up against the…

…be lowered, preferably allowing the prone position. Monitoring: pulse oximetry, blood pressure, ECG and capnography during sedation, with oxygen and a bag available. Drugs for…

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

…pacemaker or to resolution of the underlying cause. Contraindications Hypothermia with a body temperature below about 30 °C — the hypothermic myocardium is irritable and pacing…

…promote atherosclerosis. The principal anatomical distributions are: Abdominal aorta and iliac arteries, involved in approximately 30% of symptomatic patients. Femoral and popliteal arteries, involved in…

…thorough questioning of eyewitnesses, and a complete physical and neurologic examination. Blood pressure and heart rate should be measured in the supine position and after…

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

…ischemic heart disease does not cause symptoms at rest unless the stenosis is so grave that myocardial oxygen demands cannot be satisfied even at rest…

…to save 1 person Reference Early detection of cardiac arrest Yes 11 Berdowski et al Bystander CPR Yes 15 Hasselqvist et al Early defibrillation Yes…

…the relationship of the great arteries (segmental analysis). Ventricular function is evaluated using ejection fraction, fractional shortening, stroke volume, and myocardial thickness. Strain imaging is…

…heart in supine position) leads to an immediate increase in ejection fraction. Similarly, a decrease in afterload (e.g by means of decreased resistance in…

…in particular computed tomography (DT) and/or magnetic resonance imaging (MRI). Anatomy of the pericardium The pericardium consists of a parietal layer and a visceral…

…tachycardia and anxiety; all of which are common in acute myocardial infarction. Clinical examination may reveal pericardial friction rub and the echocardiogram may show increased…

…of the sternum. It provides imaging planes of the long axis of the heart. Figure 2 illustrates the position of the transducer, the orientation of…

…quantification of regional myocardial function. These methods analyze the motion and deformation (change in shape) of the myocardium during systole and diastole. Deformation imaging has…

…elevation myocardial infarction. Due to their clinical presentation, these patients are immediately referred to angiography but no coronary artery occlusion can be identified. Injection of…

…posterolateral) acute myocardial infarction (STEMI) The heart is rotated 30° to the left in the thorax. This positions the basal portion of the left lateral…

…the left in the thorax. This positions the basal portion of the left lateral wall posteriorly in thorax (Figure 1). This area is most frequently…

…to ECG interpretation Standard display of ECG leads in the 12 lead ECG Numerous conditions that can be diagnosed using the 12 lead ECG require…