…by cells near the node. The following must be noted: There are cells with pure automaticity around the atrioventricular node. These cells are capable of…

…by hyperpolarisation and contributes to spontaneous diastolic depolarisation. By inhibiting the intracellular portion of its transmembrane pore, ivabradine reduces the slope of diastolic depolarisation and…

…Utstein guidelines (Table 1). The broad categories of causes are considered necessary due to the uncertainties prevailing in the pre hospital setting ( Perkins et al. )…

…Unstable monomorphic VT with a pulse. Pre excitation with atrial fibrillation and a very rapid ventricular rate. Elective or subacute: Symptomatic persistent atrial fibrillation where…

…of each drug according to its vasoconstrictor effect (vertical axis) and its positive inotropic effect (horizontal axis). Grey = pure vasopressors, orange = phosphodiesterase inhibitors…

…suffered a stroke/TIA, to assess whether the embolic source is the most likely cause of the event. Echocardiographic assessment of cardiac embolic sources re

…markedly impaired renal function [3]. Urine output can change before creatinine but is not a pure marker of filtration. Oliguria may be due to hypovolaemia…

…failure. Without urine production there is no urine to alkalinise, and the sodium and volume load becomes pure harm. Dialysis is then the way forward…

…The effusion itself may consist of serous fluid (transudate), protein rich fluid (exudate) to pure blood (exudate). Often pericardial effusion is detected randomly (for example…

…an ischaemic mechanism. Clinical assessment and estimation of pre test probability Symptoms and clinical context The assessment begins with the clinical presentation, including the character…

…prolonged. Individuals with accessory pathways (Kent's bundle) only display pre excitation on the ECG when impulses are actually conducted over the accessory pathway. In…

Cardiology Clinical medicine Definition and clinical classification Hypertensive disorders of pregnancy comprise chronic or pre existing hypertension, gestational hypertension, and preeclampsia. Collectively, they affect approximately…

…low pre test probability is usually a false positive. Indications Evaluation of chest pain with an intermediate pre test probability of coronary artery disease. Assessment…

…coronary ischaemia. These findings determine the urgency and type of intervention. The assessment should also clarify: Whether AF is pre existing, newly detected, or newly…

…flutter, atrial tachycardia, multifocal atrial tachycardia, AVNRT, AVRT (pre excitation, WPW), junctional tachycardia. These tachyarrhythmias arise in the atria and are very rarely life threatening…

…acute kidney injury, microangiopathic haemolysis, and severe pre eclampsia or eclampsia. The blood pressure is often at least 180/120 mmHg, but no absolute threshold…

…MAP) by decreasing systemic vascular resistance (SVR). Clevidipine does not reduce cardiac filling pressure (pre load), since it has no effects on the venous capacitance…

…MAP) by decreasing systemic vascular resistance (SVR). Clevidipine does not reduce cardiac filling pressure (pre load), since it has no effects on the venous capacitance…

…atrial tachycardia, multifocal atrial tachycardia, AVNRT, AVRT (pre excitation, WPW). Note that narrow complex tachyarrhythmia rarely causes circulatory compromise or collapse. Causes of tachycardia (tachyarrhythmia…

…constitutes a major clinical problem. It can manifest as an increase in the frequency of a pre existing arrhythmia, the sustenance of a previously non…

…focal neurological symptoms. Asymptomatic disease may be discovered during targeted duplex ultrasound (DUS), pre operative assessment, or evaluation of other atherosclerotic disease. Routine population screening…

…Isolated postcapillary PH (IpcPH) 20 mmHg 15 mmHg ≤2 Wood units Combined pre and postcapillary PH (CpcPH) 20 mmHg 15 mmHg 2 Wood units Unclassified…

…rupture with tamponade, and less common causes such as severe pre existing valvular disease or excessive beta blocker or calcium channel blocker exposure. The incidence…

…involvement The anatomical territory, including anterior, inferoposterolateral or right ventricular involvement Pre existing abnormalities such as prior infarction, left bundle branch block, Wolff–Parkinson–White…

…the nocebo effect : negative expectations, contextual cues and attribution of pre existing symptoms to the medication. No single diagnostic test can distinguish a pharmacological SAMS…

…dependent. The interval from symptom onset to reperfusion is determined by patient recognition and help seeking, pre hospital assessment and transport, diagnostic and treatment delays…

…are therefore very brief. Indications Paroxysmal supraventricular tachycardia (PSVT), which includes forms that are caused by pre excitation. Myocardial perfusion scintigraphy. Contraindications Asthma and COPD…

…Moreover, certain other tachyarrhythmias predispose to developing atrial fibrillation: atrial flutter, AVNRT and AVRT (pre excitation, WPW syndrome) being the most common. Atrial fibrillation with…

…AVNRT should not be confused with AVRT, which is the result of pre excitation (accessory pathway). AVNRT is caused by reentry in the atrioventricular (AV…

…the smaller the current used. Software settings The pacemaker software includes pre programmed algorithms and settings, which can be tailored to the patient's needs…

…of the following symptoms: Syncope, pre syncope Ventricular tachycardia Ventricular fibrillation Cardiac arrest with or without sudden cardiac death Hence, the Brugada syndrome is a…

…with potential tracheal deviation to the opposite side Distended jugular veins Management Decompression using a venous cannula Can be executed in a pre hospital setting…

…MAP) by decreasing systemic vascular resistance (SVR). Clevidipine does not reduce cardiac filling pressure (pre load), since it has no effects on the venous capacitance…

…follow up after one month, and at least annually thereafter, more often in impaired renal function. Red flags and pitfalls Atrial fibrillation with pre excit

…aortic dissection, acute renal failure, pre eclampsia) — intravenous treatment with a controlled reduction, as a rule no more than 25% during the first hour. The…

…and less controllable depth of freeze). A size 15 scalpel or a pumice stone to pare down hyperkeratotic lesions. A cone or an otoscope speculum…

…300 ms may become haemodynamically significant. Pre excitation: PR < 120 ms with a delta wave and QRS 110 ms. Brugada pattern type 1: ST…

…not necessarily acute normalisation in the emergency department [1,3]. Step 1: confirm the blood pressure and stabilise the patient Immediate assessment 1. Assess airway…

…drainage bag and a catheter valve, and lubricant containing a local anaesthetic (lidocaine gel) in a pre filled syringe. Catheter size is given in Charrière…

…no no INFED IRON DEXTRAN IRON DEXTRAN Mixed ar less patients with pre existing cardiovascular disease/cardiac arrest Solu Cortef HYDROCORTISONE SODIUM SUCCINATE HYDROCORTISONE SODIUM…

…IIa C Pre hospital logistics Management Recommendation Level of evidence The pre hospital care of STEMI patients should be organized regionally (including all components from…

…the presence of substantial pre existing CKD, particularly when congestive heart failure or other causes of ischaemic AKI coexist. Risk assessment Patient related risk factors…

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

…intoxication, or other sympathomimetic exposure, including methamphetamine. Abrupt withdrawal of antihypertensive medication, particularly clonidine, can also precipitate a hypertensive crisis. Pregnancy Hypertensive emergencies in pre

…stratification in specific populations, such as asymptomatic patients with pre excitation who have high risk occupations or participate in competitive athletics. In the context of…

…statin therapy during ACS hospitalization. European recommendations support intensification of pre existing lipid lowering therapy during the index ACS admission. In treatment naïve patients unlikely…

…PET. Evaluate myocardial viability, particularly when combined with metabolic imaging. Contribute to assessment of cardiac inflammation, infective endocarditis, and cardiac amyloidosis using appropriate radiopharmaceuticals. Functional…

…therapy. Furthermore, acute heart failure and cardiogenic shock can present de novo in pregnant women without pre existing heart disease, such as in peripartum cardiomyopathy…

…Assessment Before Prescription Physical activity should be assessed and prescribed using the components of: Frequency Intensity Time or duration Type Progression The prescription should be…

…Juvenile T wave pattern'. PR interval <120 ms with a delta wave and wide QRS is indicative of 'Ventricular pre excitation', and QRS duration ≥140…

…coronary artery disease (CAD). It combines echocardiographic assessment of left ventricular (LV) structure and function with exercise or pharmacological stress. The physiological basis is an…

…axis of the heart Although often ignored, assessment of the electrical axis is an integral part of ECG interpretation. The electrical axis reflects the average…

…heart (heart axis) Although often ignored, assessment of the electrical axis is an integral part of ECG interpretation. The electrical axis reflects the average direction…

…is performed by paramedics, nurses or physicians, depending on the design of the pre hospital system. ACLS involves placing an advanced airway, defibrillating shockable rhythms…

…the lungs to the left ventricle, which therefore contracts without pre load (the ventricle is empty or nearly empty). In patients with an initial shockable…

…individuals (n=2670) (n=1999) (n=1300 1062) (n=1062) (n=765) (n=187) Pre Hospital ROSC (%) 17.3 7.2 1.7 3.4 3.7 2.1 Total ROSC…

…the clinical labor test (working ECG) , the value of echocardiographic examination depends on the pre test probability, which is the probability that the patient actually…

…atrial tachycardia, multifocal atrial tachycardia, AVNRT, AVRT (pre excitation, WPW). Note that narrow complex tachyarrhythmia rarely causes circulatory compromise or collapse. Causes of tachycardia (tachyarrhythmia…

…Parameter Assessment A Airway Voice Breath sounds B Breathing Respiratory rate (12–20 / min) Chest wall movements Chest percussion Lung auscultation Pulse oximetry ( 95%) C…

…RBBB) and pre excitation Left ventricular hypertrophy (LVH) , right ventricular hypertrophy (RVH) , left bundle branch block (LBBB) , right bundle branch block (RBBB) and pre excitation…