…selected cases the patient can be observed without anticoagulation Red flags and pitfalls A normal saturation and a normal ECG do not exclude pulmonary embolism…

…of Echocardiography recommendations for the assessment of valvular regurgitation. Part 1: aortic and pulmonary regurgitation (native valve disease). In European journal of echocardiography : the journal…

…precapillary PH, partly because this value has been used in therapeutic studies of pulmonary arterial hypertension (PAH). The threshold is not absolute: patient phenotype, risk…

…factors (see Risk factors below). A significant proportion of cases with pulmonary embolism require thrombolysis to dissolve the occlusion. Administration of thrombolysis requires careful consideration…

…Iatrogenic (e.g complication of catheterization) Congenital dysplasia/aplasia of the pulmonary valve Idiopathic pulmonary artery dilation Pulmonary regurgitation results in right ventricular volume overload…

…the great arteries) Dysplastic, bicuspid or unicuspid pulmonary valve Noonan syndrome : 60% of all individuals with Noonan syndrome have pulmonic stenosis. The stenosis is subvalvular…

Cardiology Emergency medicine Definition and pathophysiology Acute pulmonary embolism (PE) is classified according to haemodynamic status, clinical severity, evidence of right ventricular (RV) dysfunction, and…

Right ventricle and pulmonary artery Normal interval Mildly abnormal Moderately abnormal Severely abnormal RV DIMENSIONS Basal RV diameter (RVD 1), cm 2.0–2.8…

…Antianginal effect. Reduces afterload and preload. Effective in pulmonary edema. Can produce severe hypotension. Time to onset of action 30 seconds to 1 minute Duration…

…and lowers pulmonary artery pressure without increasing myocardial oxygen consumption. The inotropic effect of levosimendan is not affected by the concurrent use of beta blockers…

…a clinical syndromic diagnosis, not a sufficient explanation for all acute dyspnoea in a patient with COPD. Pneumonia, heart failure, pulmonary embolism, pneumothorax and acute…

…< 90 mmHg caused by the arrhythmia. Ongoing myocardial ischaemia with chest pain and ECG changes. Acute pulmonary oedema. Impaired consciousness. Synchronised cardioversion under sedation…

…and the appropriate action differs fundamentally between these cases. Pressures in the heart and pulmonary circulation Flow, resistance and oxygen transport Formulas Mean arterial pressure…

…Hypercapnic failure in cardiogenic pulmonary oedema that does not improve with CPAP alone. As ceiling therapy where intubation has been judged not to be appropriate…

…The shunt fraction (Qp/Qs) is a critical hemodynamic parameter used to quantify the ratio of pulmonary blood flow (Qp) to systemic blood flow (Qs)…

…atrial size 10 cm² or 40% of atrial size Jet orientation central variable excentric Pulmonary vein flow S dominant reduced S wave systolic flow reversal…

…Nitrostat ®, Rectiv ®, Trinipatch ® Indications Pulmonary edema, congestive heart failure. Angina pectoris. Hypertension, hypertensive crisis/emergency. Pulmonary hypertension. Blood pressure control. Mechanism of…

…heritable aortopathies, selected congenital heart diseases, pulmonary arterial hypertension and thromboembolic disorders. Most recognised heritable cardiovascular conditions demonstrate autosomal dominant transmission, in which an affected…

…pharmacodynamic mechanisms. These drugs are broadly utilised to augment myocardial contractility, manipulate systemic and pulmonary vascular resistance, and restore adequate end organ perfusion. Dobutamine is…

…or objective evidence of pulmonary or systemic congestion [3] . Within this spectrum, Heart Failure with Reduced Ejection Fraction (HFrEF) is specifically classified by the 2022…

…pulmonary, renal and neurohormonal factors. These factors, which influence cardiac function primarily by affecting ventricular function, include blood pressure, venous return, pulmonary gas exchange efficiency…

…difficulties in visualizing it. Previously, the PA catheter ( Pulmonary Artery Catheter , also called Swan Ganz catheter ) has been the first choice, but today the majority…

…intrathoracic pressure by compressing, decompressing and ventilating. These maneuvers result in arterial blood flowing through the pulmonary, coronary and cerebral circulation, as well as allowing…

…target Doses in venous thromboembolism Treatment doses in deep vein thrombosis and pulmonary embolism differ from the atrial fibrillation doses and include an initial high…

…and anticoagulation status: Tachyarrhythmia with haemodynamic compromise: hypotension, shock, pulmonary oedema, myocardial ischaemia or a falling level of consciousness. Unstable monomorphic VT with a pulse…

Procedurer The value of the exercise test lies not in ST depression alone but in the overall picture : exercise capacity, symptoms, blood pressure response, heart…

…Common manifestations are hypertensive encephalopathy, intracerebral haemorrhage, acute coronary syndrome, acute left ventricular failure with pulmonary oedema, acute aortic syndrome, acute kidney injury, microangiopathic haemolysis…

…investigation is diagnostic, not therapeutic. An unstable patient should be cardioverted, not investigated. Contraindications Haemodynamic instability — hypotension, shock, impaired consciousness or pulmonary oedema. Treat the…

…the eyes. Postpone the test in: Condition Recommended delay : : Myocardial infarction or unstable angina 1 month Pneumothorax 1 month after resolution Pulmonary embolism, until anticoagulated…

…cerebrovascular diseases, such as: Transient ischemic attacks (TIA). Stroke Contraindications Cross reactivity: Do not administer to patients with a history of asthma, rhinitis, or urticaria…

…Peripheral Vascular Disease (PVD) : Indicates systemic atherosclerosis. Chronic Obstructive Pulmonary Disease (COPD) : Associated with higher perioperative risk. Clinical Applications Personalized Decision Making : SYNTAX Score II…

…COVID 19 relies on small samples of hospitalized patients. Most reports have suggested that comorbidities – e.g. cardiovascular disease, pulmonary disease, advanced age, smoking, diabetes…

…age, may not be fully captured by conventional risk scores and may be the first clinically important manifestation of an otherwise unrecognized inflammatory disease. Epidemiology…

…pulmonary embolism, aortic emergencies, and pneumothorax. Non cardiopulmonary causes , including gastrointestinal, musculoskeletal, and anxiety related disorders. The immediate objective is not simply to establish whether…

…Other congenital anomalies include anomalous origin of a coronary artery from the pulmonary artery and anomalous origin of one coronary artery from the opposite aortic…

…venous pressure, pulmonary congestion, peripheral edema and body weight, often within days. However, diuretic treatment has not been shown formally to reduce heart failure mortality;…

…their release is not specific to left ventricular systolic dysfunction. Levels may also rise with: Left ventricular diastolic dysfunction Valvular heart disease Pulmonary hypertension Ischaemic…

…the pulmonary circulation (normally 15 mmHg in adults). Hence, the pressure in the systemic circulation is many times greater than the pressure in the pulmonary…

…severe right sided failure and cardiogenic shock. The haemodynamic disturbance results from impaired right ventricular contraction and reduced forward flow through the pulmonary circulation. Consequently…

…disease, pulmonary pressure, or haemodynamics Stress imaging is not recommended in patients undergoing urgent non cardiac surgery or those with an unstable clinical condition. In…

…Normal in newborns. Right ventricular hypertrophy. Acute cor pulmonale (pulmonary embolism). Chronic cor pulmonale (COPD, pulmonary hypertension, pulmonary valve stenosis). Lateral ventricular infarction. Pre excitation…

…is a rise and/or fall in cTn values. An elevated cTn alone does not establish MI, because myocardial injury may occur without myocardial ischaemia…

…stroke volumes. Failure to increase cardiac output sufficiently will result in the following compilations: Pulmonary edema develops due to rising LAP and LVEDP. Cardiogenic shock…

…under acute coronary syndromes (ACS). Aortic dissection Pneumothorax Pulmonary embolism Mediastinitis (rare condition) In addition to these five conditions, there are numerous other causes of…

…2), obesity, smoking, obstructive sleep apnea and chronic obstructive pulmonary disease (COPD). Moreover, certain other tachyarrhythmias predispose to developing atrial fibrillation: atrial flutter, AVNRT and…

…conditions : Tension pneumothorax Drowning Airway obstruction Hanging Pneumonia High altitude sickness Aspiration Chronic obstructive pulmonary disease (COPD) Bronchospasm (asthma) Other : Coma Central hypoventilation syndromes Neuromuscular…

…heart disease, other medical conditions (pulmonary embolism, bleeding, stroke, etc.) as well as cases where the cause does not fall into the other categories. Trauma…

…When the ventricular rate remains below this threshold, the arrhythmia is classified instead as an ectopic atrial rhythm (EAR) . Ectopic atrial tachycardia (EAT) most commonly…

…seen in certain causes of cardiac arrest (e.g. pulmonary embolism) or in case of long no flow or low flow periods. Under such circumstances…

…pulmonary capillary wedge pressure (PCWP) ≥15 mmHg at rest or ≥25 mmHg during exercise [4] . This hemodynamic criterion underscores that "preserved" ejection fraction does not…

…exceptions. Prior to the Doppler era, hemodynamic assessments were performed by means of right heart catheterization (with Swan Ganz catheter [ pulmonary artery catheter ]). However, hemodynamic…

…the pulmonary circulation (normally 15 mmHg in adults). Hence, the pressure in the systemic circulation is many times greater than the pressure in the pulmonary…

…order to come to the expression on ECG. Moderate right ventricular hypertrophy may not alter the ECG significantly. The ECG is particularly helpful in RVH…

…beats per minute. Although sinus tachycardia is the most common tachyarrhythmia, it may not always be straightforward to diagnose on the ECG. Moreover, many clinicians…

…Dilatation of the right ventricle. Dilatation of the right atrium. Pulmonary hypertension. Left to right shunt. Right ventricular dysfunction due to pressure/volume overload is…

…windows might be feasible, particularly during brief pauses. An enlargement of the right ventricle is suggestive of pulmonary embolism, though its specificity is low. Notably…

Referensvärden A diagnosis of hypertension is not made on a single reading. It requires repeated measurements on at least two occasions, and preferably confirmation by…

…and most serious dosing errors arise at the dilution step, not in the choice of dose. Paediatric doses are calculated on actual body weight unless…

…fibrosis. Here a lower target range and controlled delivery apply — not the withholding of oxygen. Previous bleomycin treatment — hyperoxia increases the risk of pulmonary toxicity…

…urine stays acidic however much bicarbonate is given. Potassium replacement is not the management of a side effect; it is part of the treatment itself…