…coronary angiography or other invasive procedures, and affected patients may be relatively painless compared with those with spontaneous dissection. Clinical manifestations may result from rupture…

…are: Plaque rupture with exposure of thrombogenic material. Superficial plaque erosion. Thrombosis associated with a calcified nodule. Epicardial or microvascular coronary spasm. Spontaneous coronary artery…

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

…plaque rupture, coronary artery spasm, coronary microvascular dysfunction (encompassing endothelial dysfunction, smooth muscle cell dysfunction, and dysregulation of sympathetic innervation), coronary embolism, and spontaneous coronary…

…plaque rupture, thrombus, spontaneous coronary artery dissection (SCAD), or another occult structural abnormality. IVUS IVUS generates images by transmitting ultrasound from an intracoronary catheter and…

…in other reports. It is more frequent in women and in patients presenting with NSTEMI than in those presenting with STEMI. Approximately one third of…

…Definition and pathophysiology Spontaneous coronary artery dissection (SCAD) is an acute coronary disorder caused by separation within the coronary arterial wall, usually through formation of…

…or extrapolation from other fields (e.g. sepsis research) or physiological reasoning. Cardiac arrest care is advanced and should preferably only be conducted in specialized…

…ECG should be recorded in all patients after return of spontaneous circulation (ROSC). The purpose of a 12 lead ECG is to detect ST elevation…

…ECG 1 . Sinus rhythm interrupted by ventricular tachycardia (VT). ECG 2 . Spontaneous termination of ventricular tachycardia (VT). ECG 3 . A single ventricular beat, followed by…

…Procedure Choice of insertion site The left lower quadrant is the first choice : the abdominal wall is thinner there than on the right, and the…

…and then pushed into the circulation via the artery. ECPR is indicated when conventional cardiopulmonary resuscitation (CPR) fails to achieve a stable return of spontaneous…

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

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

…affects the effectiveness of the interventions. Numerous studies demonstrate that the available interventions are time sensitive, and to maximize the likelihood of restoring spontaneous circulation…

…persistent unsteadiness or ataxia without clear spontaneous nystagmus Cerebellar or brainstem infarction, intoxication, Wernicke's encephalopathy, other central disease Neurological examination, gait and truncal stability…

…sole determinant for terminating CPR or initiating ECMO ( Paiva et al ). If both ETCO 2 and other indicators suggest ROSC, compressions may be temporarily paused.

…of Cardiology (ESC) guidelines have universally solidified the LVEF categories: HF with reduced EF (HFrEF, ≤40%), HF with mildly reduced EF (HFmrEF, 41–49%), and…

…These cells are capable of spontaneous depolarization (i.e they display automaticity) and can therefore act as latent pacemakers (which become active when atrial impulses…

…right of the sternal border. V2: placed in the fourth intercostal space, to the left of the sternal border. V3: placed diagonally between V2 and…

…are as follows: Normal (physiologic) sinus tachycardia: The automaticity (rate of spontaneous depolarization) in the sinoatrial node is increased during physical activity, stress, and nervousness…

…PE) ↓ ↑ ↑ ↓ Vital signs and measures of perfusion Parameter Normal Comment : : : Heart rate 50–100/min MAP 70–105 mmHg Target ≥ 65…

…The test presupposes that the patient has spontaneous nystagmus at the time of examination and that the examiner is experienced with the head impulse test…

…signs of overdose. Sedation precedes respiratory depression; monitor it. Naloxone is titrated to spontaneous breathing, not to wakefulness. It has a short half life, and…

…return of spontaneous circulation , whether the arrest occurred in or out of hospital and whatever the initial rhythm. It applies to both shockable and non…

…or VT <30 seconds terminated by therapy. Non sustained VT (NSVT) : VT with ≥3 beats and spontaneous termination. Classification according to morphology: Monomorphic VT : VT…

…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…

…1, formerly termed glucocorticoid remediable aldosteronism, and other familial forms associated with adrenal adenoma or bilateral adrenal hyperplasia. A family history is therefore important, particularly…

…myocardial ischaemia caused by transient abnormal vasoconstriction of one or more coronary arteries. Epicardial spasm produces a reversible functional occlusion and usually causes transmural ischaemia…

…or VT <30 seconds terminated by therapy. Non sustained VT (NSVT) : VT with ≥3 beats and spontaneous termination. Classification according to morphology: Monomorphic VT : VT…

…result, pupils often dilate widely within 30–120 seconds of cardiac arrest and light reactivity is lost when cerebral blood flow ceases. In other words…

…and programming. The simplest pacemaker systems consist of a pulse generator and one lead, which is located either in the right atrium or the right…

…5% of all hangings exhibit VF on the initial ECG recording ( Kitamura et al, Deasy et al ). A complete airway obstruction results in PEA and…

…efficacy of these interventions at low temperatures. Additionally, the return of spontaneous circulation (ROSC) is typically not sustained at temperatures below 30°C. Concurrent Hypothermia and…

…is responsible for the spontaneous repetitive depolarization. The depolarization spreads from the sinoatrial node to the atrial and ventricular myocardium. Propagation of the action potential…

…enables blood flow from the right to the left atrium. Echocardiography is of importance for cardioembolic stroke, cryptogenic stroke, and for emboli arising in the…

…of 1 year survival rate was 7.7% (95% CI 5.8–9.5%). Survival in IHCA Survival in IHCA was 25% in 2006 and…

…to the QRS morphology during LBBB. Stimulation in other regions of the ventricle may result in a different QRS morphology. If the lead tip is…

…High aortic pressure and low right atrial pressure favor coronary blood flow. A CPP of approximately ≥ 15 mmHg is required to induce spontaneous electrical activity…

…rhythm. A brief run of polymorphic ventricular tachycardia (VT) occurs after the 4th beat. The VT terminates spontaneously after a few beats, and reoccurs again…

…The pinch is applied to the lower third of the nose, the soft part , and held continuously for at least 10 minutes without letting go…

…with multiple ventricular premature beats) spontaneously converting to Torsade de Pointes ventricular tachycardia. Notice how arterial blood pressure (ABP) drops at the onset of TdP…

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

…node) and intrinsic automaticity The sinus node is a small oval structure located near the entrance of the superior vena cava in the right atrium…

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…

…bundles of myocytes that form the slow conducting isthmuses critical for re entry [6] . Non ischemic dilated cardiomyopathy (NICM), hypertrophic cardiomyopathy (HCM), and arrhythmogenic right…

…asystole and cardiac arrest. Importantly, the progress from VT to cardiac arrest may be aborted either spontaneously or by means of treatment. Interestingly, treatment of…