…retinal signature includes flame haemorrhages, cotton wool spots, and papilloedema. Associated complications may include encephalopathy, acute heart failure, disseminated intravascular coagulation, and abrupt deterioration in…

…prolonged, produces multiorgan dysfunction and death. In the setting of ST elevation myocardial infarction (STEMI), cardiogenic shock most commonly reflects severe left ventricular (LV) dysfunction…

…influenced by the clinical setting, vascular access route, anticoagulation, renal function, age, comorbidity, and procedural complexity. Overall incidence and major complications Complications during diagnostic coronary…

…risk mechanical complications. Determination of symptom onset time and anticipated time to primary PCI. Patients with STEMI should be monitored in a setting capable of…

…than the brain. Patients with AF in the setting of ACS have more comorbidities and a higher risk of complications than patients without AF; both…

…the setting of acute coronary syndrome, AF is the most frequent supraventricular arrhythmia. It may predate the coronary event, be detected for the first time…

…patients with left ventricular dysfunction and/or MVD. Nevertheless, the optimal extent and timing of intervention depend on the clinical setting, haemodynamic status, coronary anatomy…

…events (MACE) and stent thrombosis. Premature DAPT interruption is described as the strongest predictor of stent thrombosis in this setting. The duration of therapy requires…

…however, increase peri procedural complications and bleeding. Clinical presentation The available source material does not provide a detailed description of the presenting symptoms of NSTEMI…

…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…

…equivalent (1 MET) is defined as the amount of oxygen consumed while sitting at rest and is equal to 3.5 ml O2 per kg…

…volume status. Because fluid retention can attenuate the effects of ACE inhibitors, it is preferable to optimize the dose of diuretic first. However, clinicians may…

…to participation Occupational and sporting goals Current pharmacological treatment Early assessment of left ventricular ejection fraction is recommended before hospital discharge because the first we

…pausing the compressions. Anaphylaxis Intramuscular adrenaline into the lateral thigh is the first line treatment and must be given before anything else. An antihistamine and…

…VF). It is primarily intended for use in an emergency setting. The manual includes the following sections (click to navigate to the section): Classification of…

…does not convert atrial flutter to sinus rhythm. Vernakalant is only administered in a monitored clinical setting appropriate for cardioversion. Administration of vernakalant Vernakalant (Brinavess)…

…denotes treatment with aspirin plus a P2Y12 receptor inhibitor. In the setting of acute coronary syndrome (ACS), DAPT is used to reduce recurrent myocardial infarction…

…syndrome (DI LQTS) [1]. The condition arises in the setting of both modifiable and nonmodifiable risk factors. Modifiable risk factors include electrolyte abnormalities such as…

…VF). It is primarily intended for use in an emergency setting. The manual includes the following sections (click to navigate to the section): Classification of…

…arrest (OHCA), it can be used in any setting until advanced cardiac life support (ACLS) can be initiated by healthcare professionals. The purpose of basic…

…dependent. Similarly, angioedema occurring in the setting of ACE inhibitor therapy is bradykinin mediated rather than mast cell mediated, distinguishing it from classic allergic reactions…

…MI). MI denotes cardiomyocyte necrosis occurring in the clinical setting of acute myocardial ischaemia and is diagnosed according to the fourth universal definition of MI…

…including extracorporeal membrane oxygenation (ECMO), may be required in this setting. Clinical presentation and symptoms The clinical presentation reflects the severity of RV pressure overload…

…of antiplatelet therapy must always be balanced against bleeding. This balance changes according to the clinical setting, time from MI or percutaneous coronary intervention (PCI…

…systole. With auscultatory measurement, it corresponds to the appearance of the first Korotkoff sound. Diastolic blood pressure: the minimum arterial pulsatile pressure during diastole. It…

…such as less than 40 to 50 beats per minute in the first 4 to 6 hours after an acute infarction—patients may develop hypotension…

…The LDL C response varies with background therapy: Treatment setting Approximate LDL C reduction versus placebo Monotherapy 23% Added to background statin therapy 18% Fixed…

…phenothiazine, phenytoin, carbamazepine), and various chemotherapeutic agents. In the acute setting, bradyarrhythmic cardiac arrest or asystole may result from reversible systemic insults, including hypovolemia, hypoxia…

…have a rate reducing effect in selected circumstances. Ivabradine undergoes extensive first pass hepatic metabolism through CYP3A4. Dose adjustment is required in severe hepatic or…

…exercise volumes; therefore, prevention strategies should address both increasing activity and reducing time spent sitting. The relationship between activity and cardiovascular benefit is curvilinear. The…

…the first 24 hours in patients with RVI. The ECG should therefore include right sided precordial leads when RVI is suspected in the setting of…

…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…

…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. )…

…who do not achieve satisfactory effects using first line therapies. Digoxin is also used frequently in the emergency setting to control ventricular rate during supraventricular…

…must be normal. For example, in the setting of left bundle branch block (LBBB), fractional shortening is not representative of ventricular function, since the activation…

…A transcutaneous pacemaker is often necessary in the acute setting and is currently the only treatment with class I recommendation according to European (ESC) and…

…Figure 1. Management of acute bradycardia in the emergency setting. Parameter Assessment A Airway Voice Breath sounds B Breathing Respiratory rate (12–20 / min) Chest…

…a sound wave. A familiar example is human speech. Humans speak by setting their vocal cords in motion. When vocal cords vibrate, they generate vibrations…

…aneurysm : Aortic aneurysms may compresses the RVOT. Echocardiography in pulmonic stenosis In the setting of pulmonary valve stenosis, the pressure in the right ventricle rises…

…of wall motion abnormalities. Assessment of wall motion abnormalities is particularly important in the setting of chronic or acute coronary artery disease. All types of…

…degree of hypoxia in all neurons. There is one fundamental difference between neurons and myocardium in the setting of hypoxia. Myocardium ceases contracting immediately when…

…contraction). Traditional methods for investigating left ventricular function — e.g ejection fraction (EF), fractional sorting (FS), etc — do not elucidate regional variations in contractile function…

…advanced resuscitation in a monitored setting The grade can change within minutes. Treat the current physiological threat, not the grading label. The first minute 1…

…saw, protective sheeting Hot water gives faster setting and more heat production — a risk of burns Document the distal neurovascular status before casting : sensation, motor…

…valve. Masks in several sizes. An oronasal mask is first choice in the acute setting ; nasal masks and total face masks are alternatives in intolerance…

…instead by temporarily withdrawing the cholinesterase inhibitor, under monitoring in a setting where the airway can be secured. Preparation and equipment Edrophonium 10 mg/mL…

…artefact ruins an exercise test more often than anything else. Record a resting ECG both supine and sitting, and resting blood pressure in both arms…

…lamp — the cornea should not be instrumented without magnification. With a suspected chemical injury the priorities are reversed: irrigate first , for at least 30 minutes…

…pressure can cause serious organ damage even at lower levels, particularly in pregnancy [1,2]. Malignant hypertension is not entirely synonymous with a hypertensive emergency…

…Infection of the skin over the puncture site. Marked haemodynamic instability — stabilise the patient first. CT before the puncture Swedish practice differs here from several…

…of known HPA suppression to determine whether replacement can be stopped. The test is not the first line investigation in a suspected acute crisis. There…

…at low workloads; its role in improving death or MI outcomes is more limited and depends on the coronary anatomy and clinical setting. Beta blockers…

…may occur even in the absence of pulmonary congestion. Patients may obtain relief by sitting forward. Other symptoms depend on the extent of reduction in…

…is recurrent clinical deterioration despite careful follow up and appropriate therapy. In this setting, the risk of sudden death and end stage heart failure is…

…systemic congestion. Interventricular dependence may impair left ventricular filling and reduce systemic output. In this setting, venous congestion is generally treated initially with diuretics, whereas…

…initial combination drug. It is also an appropriate first line pharmacological option when a patient is unable to tolerate any statin regimen. The treatment sequence…

…ECG, and normal initial troponin may be observed in a chest pain unit or another non intensive care setting while serial testing is completed. Diagnostic…

…useful in both acute and ambulatory presentations, but the appropriate thresholds differ substantially according to the clinical setting. Values obtained in the emergency department for…

…Causes of myocardial injury Important causes include: Mechanism or clinical setting Examples Acute coronary atherothrombosis Plaque disruption or erosion with thrombosis Reduced myocardial perfusion Coronary…

…the ischemic area!) [2]. Take home message: in the setting of acute coronary syndromes, be quick to administer antithrombotic medications and reperfusion. Refer to G…