…infarction (STEMI). The principal lesions are: Ventricular septal rupture (VSR), producing an acute left to right shunt. Ventricular free wall rupture, producing haemopericardium and cardiac…

…first time dislocation , so as not to reduce a fracture dislocation or to miss a posterior dislocation. The exceptions are an obvious recurrent dislocation in…

Myocardial ischemia and infarction Definition and Clinical Significance In stent restenosis (ISR) is recurrent narrowing within a previously implanted coronary stent. It represents a form…

Myocardial ischemia and infarction Pharmacology & dosing Definition and pathophysiological basis Secondary prevention after myocardial infarction (MI) encompasses long term interventions intended to reduce recurrent infarction…

…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…

…Recurrent or extensive MI with necrosis and scar formation Diffuse myocardial fibrosis Reversible ischemic dysfunction Chronic hypoperfusion with hibernating myocardium Post ischemic stunning Adverse left…

…and from secondary prevention, which addresses patients with established disease to reduce recurrent events and mortality. Risk factor modification is therefore directed at identifying individuals…

…diagnostic ECG, the ECG must be repeated, particularly with ongoing or recurrent pain [1,3,4]. This quick reference gives internationally established doses. Drug availability…

Procedurer Almost all nosebleeds arise from Kiesselbach's plexus on the anterior septum and stop with correctly performed compression. The reason compression nevertheless so often…

…an iodine solution. Lidocaine 10 mg/mL without adrenaline for the block (adrenaline is safe in fingers and toes according to modern data, but there…

Procedurer The oesophagus runs directly behind the left atrium. An electrode placed in the oesophagus at the right level therefore records atrial depolarisation with an…

…Before audiometry or the fitting of a hearing aid. Recurrent otitis externa in which the wax retains moisture. Contraindications Absolute contraindications to irrigation: A known…

…straightforward: ultrasound to find the fluid, an insertion site in the left lower quadrant lateral to the rectus sheath, and a cell count plus albumin…

…haemothorax, a symptomatic or large pneumothorax, recurrent malignant effusion (often combined with pleurodesis), and in chest trauma and postoperatively. Emergency needle decompression: a clinical suspicion…

…risk—such as those with a history of cardiac arrest, recurrent syncope despite beta blocker therapy, or markedly prolonged QT intervals—the implantation of an…

…risk—such as those with a history of cardiac arrest, recurrent syncope despite beta blocker therapy, or markedly prolonged QT intervals—the implantation of an…

…of STEMI remain at substantial risk of recurrent cardiovascular events. Long term prognosis is influenced particularly by: Resting left ventricular function The amount of residual…

…Pharmacology & dosing Definition and pathophysiology Heart failure is a clinical syndrome in which the heart cannot provide blood flow commensurate with the body’s requirements…

…recurrent symptoms, myocardial infarction, or other major adverse cardiovascular events. Complete revascularization is therefore considered an important therapeutic objective, particularly in patients with left ventricular…

…of patients, while clinically evident restenosis, manifested by recurrent angina attributable to the treated segment, occurred in 10–15% during the first year. The dominant…

…in this setting. The duration of therapy requires an individualized balance between: Ischaemic risk, including recurrent myocardial infarction and stent thrombosis. Bleeding risk, particularly major…

…of cholesterol than LDL cholesterol. Clinical implications High Lp(a) is independently associated with first and recurrent atherosclerotic cardiovascular disease events. The strongest observed associations…

…that indicate particularly high risk and should influence the urgency of management: Recurrent or ongoing chest pain despite medical treatment Acute heart failure presumed to…

…myocardial infarction, premature death, recurrent infarction and limb threatening complications. Among patients with established peripheral artery disease, those who stop smoking have approximately twice the…

…of cardiac arrest. Recurrent VT or VF after ROSC in a patient with a coronary risk profile should lead to consideration to perform early angiography.

…the main cause of left ventricular dysfunction among patients with atrial fibrillation and other supraventricular tachyarrhythmias. Moreover, ventricular tachyarrhythmias (including recurrent episodes of ventricular tachycardia…

…completely relieved and ST segment elevation is completely normalized spontaneously or after nitroglycerin administration (provided there is no recurrence of symptoms or ST segment elevation)…

…performed to assess for glottic inflammation, which can be a manifestation of recurrent reflux to the level of the throat, though it remains a nonspecific…

…drug overdose, hypothermia, and hyperkalemia. For recurrent symptomatic bradycardia, temporary or permanent pacing may be required. However, transcutaneous pacing in the setting of cardiac arrest…

…despite optimal or maximally tolerated guideline directed therapy, or when recurrent cardiovascular events occur despite such treatment. The trials did not establish a mortality benefit…

…are elevated. Consequently, congestion may occur across the full range of left ventricular ejection fraction and may result from systolic dysfunction, diastolic dysfunction, or both…

…a 50% reduction from baseline. For a patient who experiences a recurrent atherothrombotic event while receiving maximally tolerated statin therapy, an LDL C goal below…

…ACS cardiopulmonary disease. Patients with persistent or recurrent chest pain require repeat blood sampling even when an accelerated algorithm has already been initiated. Evaluation and…

…aorta. Type III: originates in the descending aorta, usually just distal to the left subclavian artery. Type IIIa: remains confined to the descending thoracic aorta…

…when treatment decisions remain uncertain. Secondary prevention Individuals with established clinical ASCVD require LDL C lowering to reduce recurrent major cardiovascular events, including myocardial infarction…

Echocardiography Myocardial ischemia and infarction Definition and pathophysiology Left ventricular (LV) thrombus is an intracavitary clot attached to the LV endocardium, typically overlying an akinetic…

…50% from baseline. In patients who experience a recurrent atherothrombotic or cardiovascular event within 2 years while receiving maximally tolerated statin based treatment, an LDL…

…Structural CMD: resting vascular tone is increased, potentially reflecting capillary rarefaction, fibrosis, or left ventricular hypertrophy. Hypertension, diabetes, and elevated NT proBNP are more frequent…

…Possible manifestations include: Persistent or recurrent myocardial ischemia Deterioration in ventricular function Hemodynamic instability Periprocedural myocardial infarction Cardiogenic shock Cardiac arrest The severity may be…

…maximally tolerated statin therapy and ezetimibe. For patients with a recurrent atherothrombotic event while receiving maximally tolerated statin therapy, an LDL C goal below 1…

ECG Myocardial ischemia and infarction Definition and Pathophysiology Posterior myocardial infarction is myocardial necrosis involving the posterior region of the left ventricle, usually as part…

…Presentation and Symptoms The dominant manifestation is chronic, recurrent angina or an anginal equivalent caused by reversible ischaemia. Symptoms may remain present daily or weekly…

…Acute native vessel thrombosis Stent thrombosis Mechanical complications of myocardial infarction Pericarditis Dynamic recurrence of ST segment elevation is particularly concerning for a new infarction…

…recurrent chest discomfort. Haemodynamic instability. Electrical instability or arrhythmia. Heart failure. Cardiogenic shock. Recent myocardial infarction. Important alternative diagnoses. Physical examination findings are not s

…should be considered in patients with symptoms suggestive of carotid sinus syncope and in patients older than 40 years with recurrent syncope of unknown etiology…

…who identified four processes that defined the victim's outcome: Neurological injury Myocardial dysfunction Systemic response to reperfusion and ischemia Effects of the underlying cause…

…Unstable coronary artery disease. Stable angina pectoris. Secondary prophylaxis to prevent recurrence of cerebrovascular diseases, such as: Transient ischemic attacks (TIA). Stroke Contraindications Cross reactivity…

…fibrillation (VF). ECG 6 . Delivery of shock, followed by asystole. ECG 7 . Asystole after shock. ECG 8 . Recurrence of supraventricular rhythm. ECG 9 . Supraventricular rhythm.

…tachycardia. ECG 3 . Spontaneous termination of the ventricular tachycardia. ECG 4 . Recurrence and spontaneous termination of ventricular tachycardia. ECG 5 . Polymorphic ventricular tachycardia, self terminating…

…ulcer Diabetic foot ulcer : : : : Site Gaiter area, above the medial malleolus Toes, heel, lateral malleolus, pressure points Beneath the metatarsal heads, toes, heel Edge Irregular…

…cause, 4. prevent recurrence and secondary brain injury. The doses in the treatment ladder below follow the Swedish local sequence given in the original article…

…access without any recurring costs. Purchasing this membership grants you permanent access to the website and there are no additional costs and no recurring costs…

…acute myocardial infarction, pericarditis/myocarditis or pulmonary embolism is often a reversible arrhythmia with low risk of recurrence. Atrial fibrillation in other circumstances (particularly those…

…10 . Recurrence of supraventricular complexes (red arrows). ECG 11 . Relapse of VF and new shock. ECG 12 . Sinus rhythm. ECG 13 . Recurring VT. ECG 14…

…the pretreatment inadequate and the cardioversion must be postponed. Alternative when more rapid cardioversion is needed: transoesophageal echocardiography (TOE) excluding thrombus in the left atr

…low risk of recurrence vancomycin 125 mg × 4 PO 10 days Clostridioides difficile, high risk of recurrence fidaxomicin 200 mg × 2 PO 10 days In…

…a pause. Position the patient semi recumbent with the chin slightly towards the chest — an extended neck directs the tube towards the larynx. Procedure 1…

…is a clinical diagnosis supported by echocardiography: Finding Comment : : Hypotension, distended neck veins, muffled heart sounds Beck's triad; complete in a minority Tachycardia, tachypnoea…

…Extended treatment in unprovoked pulmonary embolism, a persisting risk factor, or recurrence. Special situations Situation Comment : : Pregnancy Leg ultrasound first. CT pulmonary angiography or lung…

…indicated if the patient remains significantly decompensated, because recurrence is frequent while the precipitating haemodynamic and sympathetic abnormalities persist. Immediate cardioversion is reserved primarily for…