…the result of a perfect storm scenario , where ischemia, hemodynamics, the autonomous nervous system, electrolyte concentrations, and other factors (potentially also genetic predisposition) interact to…

…30–120 seconds of cardiac arrest and light reactivity is lost when cerebral blood flow ceases. In other words, during prolonged cardiac arrest without effective…

…leads. Electrocautery is the most frequent source of EMI, although radiofrequency procedures, nerve stimulators, and other electronic equipment may also interfere with device function. The…

…and the condition is classified as cardiac tamponade. The classical signs of cardiac tamponade are hypotension, muffled heart sounds and jugular venous distention. Other frequent…

…of them are myxomas and next papillary fibroelastoma is most common. Among children, rhabdomyoma is most common. Myxoma Myxoma is the most common primary cardiac…

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

…partial occlusion of the artery (i.e. coronary blood flow is not completely obstructed). NSTE ACS typically presents with ST segment depressions and/or T…

…from out of hospital cardiac arrest should not routinely undergo immediate angiography. A selective or delayed approach is recommended in this setting unless other findings…

…dissection. Coronary embolism of cardiac or non cardiac origin. Oxygen supply–demand mismatch, including demand related events in the presence of fixed coronary disease. More…

…peripheral artery disease (PAD), and other manifestations of systemic atherosclerosis. The principal clinical concern is cerebral embolism or haemodynamic compromise leading to transient ischaemic attack…

…should establish: The nature and stability of symptoms Exercise capacity The presence of active chest pain or other evidence of ongoing ischaemia Symptoms suggesting haemodynamic…

…Cardiac toxicity presents as various arrhythmias, ranging from bradycardias related to enhanced vagal effect to life threatening tachyarrhythmias. Evaluation and Physical Examination Physical examination of…

…electrocardiographic changes, and with or without acute elevations in cardiac troponin concentrations. Based on the presenting electrocardiogram (ECG) and the presence of troponin elevation, ACS…

…researchers compared the effectiveness of milrinone and dobutamine . The primary composite outcome included in hospital mortality, resuscitated cardiac arrest, cardiac transplantation or mechanical circulatory support…

…the presence of abnormal clinical risk assessment. Low risk PE is characterized by clinical low risk features, negative cardiac biomarkers, and no imaging evidence of…

…possibility of thrombolytic treatment. Cardiac and pulmonary complications Acute hypertension may precipitate myocardial ischemia or infarction, acute heart failure, or pulmonary oedema. Patients may present…

…arteries (MINOCA). Ventricular fibrillation and sudden cardiac death are important potential complications. Approximately one third of patients may have severe fixed coronary obstruction. Such patients…

…been extremely valuable. Echocardiography is used to assess the morphology of valves, the presence of vegetations, hemodynamic status, and the extent of endocarditis. Endocarditis gives…

…the interaction between the cardiac and renal axes may produce cardiorenal syndrome. Worsening renal function in the presence of persistent congestion is particularly associated with…

…In the setting of acute coronary syndrome (ACS), DAPT is used to reduce recurrent myocardial infarction, stent thrombosis and other ischemic events after coronary angiography…

…and ischaemic thresholds vary substantially between individuals depending on the magnitude of the stressor, the presence of non cardiac comorbidities, and the extent of underlying…

…present and whether left ventricular systolic function is depressed or preserved Whether hypotension is present Whether an accessory pathway is suspected, particularly before administration of…

…present Factors that may be contributing to elevated blood pressure Other cardiovascular risk factors and relevant comorbidities Evidence of hypertension mediated organ damage Existing cardiac…

…recognition, specialist assessment and restoration of perfusion are essential. The abrupt arterial obstruction may result from progression of peripheral arterial disease, cardiac or aortic embolisation…

…of coexisting CAD, previous myocardial infarction or HF. Nevertheless, the risk of arrhythmia and sudden cardiac death is most often determined by the presence and…

…Infection, hypovolaemia, cardiac dysfunction, haemodynamic instability, anaemia and other nephrotoxic exposures may contribute to tubular injury, making attribution to contrast alone difficult. In patients with…

…impaired ventricular function, does not allow for adequate filling of the ventricles, which results in reduced stroke volume and reduced cardiac output. Most patients experience…

…and myocardial flow reserve with PET. Evaluate myocardial viability, particularly when combined with metabolic imaging. Contribute to assessment of cardiac inflammation, infective endocarditis, and cardiac…

…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…

…presence of symptoms alone is insufficient. Anaemia and pulmonary, renal, thyroid or hepatic disease may produce a similar symptom complex; in the absence of cardiac…

Arrhythmias and arrhythmology ECG Mechanisms of cardiac arrhythmias: from automaticity to re entry This section introduces the most common arrhythmias encountered in clinical practice, beginning…

…result in prehospital cardiac arrest and death. As in other acute coronary events, the thrombotic process is dynamic, with varying degrees of occlusion that may…

…collapse, loss of consciousness, and sudden cardiac arrest. Unlike ventricular tachycardia, ventricular fibrillation seldom self terminates and death is imminent without immediate and resuscitative efforts…

…cardinal symptom, chest pain can be present [5]. Distinguishing Features: Pleuritic pain suggests pulmonary infarction, and a history of pain exacerbation with inspiration, along with…

…pacemaker therapy. Treatment of AV block in the acute setting Treatment in the acute setting is directed at managing bradycardia and reduced cardiac output. Bradycardia…

…an increased risk of sudden cardiac death and ventricular arrhythmias. Figure 2. Fragmented QRS complex. These QRS configurations are also indicate of previous myocardial infarction…

…causes of pericardial effusion. Important clinical associations include: Idiopathic or viral pericarditis Malignant pericardial disease Tuberculosis Purulent or bacterial pericarditis Trauma Cardiac surgery and other…

…propelled by breakthroughs in engineering, software development, and progress in our understanding of the pathophysiology of cardiac disease. Ultrasound systems have become cheaper, more portable…

…typically larger, present with more severe neurological deficits, and carry higher rates of mortality and long term disability compared to non cardioembolic ischemic strokes. Consequently…

…accounting for approximately 80% of cases. Other causes include acute mechanical complications—particularly ventricular septal defect (VSD) and papillary muscle rupture with acute severe mitral…

…Adenosine is an endogenous nucleoside present throughout the body that interacts with G protein coupled A1 receptors located on the extracellular surface of cardiac cells…

…Presentation and Symptoms The clinical spectrum of ACS is broad. Patients may be asymptomatic at presentation, have persistent chest discomfort, or present with cardiac arrest…

…definition of MI. Type 1 MI is generally related to an atherothrombotic event, whereas Types 2–5 MI have other mechanisms of myocardial ischaemia and…

…intend to present an ECG with early repolarization (which is associated with 5 times as great a risk of ventricular fibrillation and sudden cardiac death…

…beats per minute. Note that with a paper speed of 25 mm/s, which is standard in the US and many other countries, a 2…

…signs of end organ hypoperfusion. In severe cases, bradycardia may progress to bradyarrhythmic arrest or pulseless electrical activity (PEA), presenting as cardiovascular collapse and cardiac…

…major target—where MR activation promotes sodium transport—MRs are also present in cardiac myocytes, vascular smooth muscle, endothelial cells, macrophages, neurons and other tissues…

…may also present in individuals without identifiable cardiac disease. Contributing factors include pulmonary disorders, particularly obstructive pulmonary disease, the use of theophylline, and elevated catecholamine…

…ventricular dysfunction, peripheral vascular disease and other manifestations of diffuse atherosclerosis. Percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are revascularization procedures. Both…

…impulse reaches the atrioventricular node when there are two pathways, one being refractory and the other capable of conducting the impulse, re entry may arise…

…injury leads to release of cardiac troponin, but troponin elevation is not specific for myocardial infarction. Other conditions may produce cardiomyocyte injury and elevated troponin…

…easy to separate from those in Brugada syndrome and the risk of ventricular arrhythmias and sudden cardiac death is considerably lower than the risk among…

…definitions and recommendations presented in this chapter are in line with recent guidelines (2020) issued by the American Heart Association (AHA), American College of Cardiology…

…transmural ischemia. On the other hand, leads V1–V3 (occasionally V4) may detect the injury currents and present them as ST segment depressions. These depressions…

…ECG lead is presented as a diagram (sometimes called a curve). The 12 lead ECG Numerous ECG lead systems and constellations of leads have been…

…demyelination HINTS plus by a trained examiner if nystagmus is present, neurological examination, gait and truncal stability Acute balance syndrome Acute persistent unsteadiness or ataxia…

…intraluminal mass and lesion haziness raise suspicion of thrombus, although haziness is not specific. Intravascular imaging can identify plaque disruption, thrombus and other structural features…

…adults with elevated blood pressure (BP), in whom absolute cardiovascular risk varies considerably according to age and the presence of concomitant risk factors. In contrast…

…in older people and in patients with diabetes. The haemodynamic consequences depend on lesion location, severity, length, the presence of multilevel disease and collateral circulation…

…preserve an antithrombotic surface, and control the adhesion and migration of inflammatory cells. Dyslipidaemia, cigarette smoking, hypertension, diabetes mellitus and other adverse influences disturb these…