…or post revascularization states, and heart failure of ischaemic or cardiometabolic origin. Major clinical presentations The principal outpatient presentations include: Reproducible stress induced angina or…

…myocardial injury. Clinical Presentation and Symptoms In up to one half of STEMI cases, a precipitating factor such as vigorous physical exercise, emotional stress, or…

…a disorder of autonomic reflexes. It typically occurs after attaining an upright posture or following painful stimuli and emotional stress. By the age of 60…

…changes occur. Hypertension and oestrogen exposure. Emotional or chronic mental stress. Fibromuscular dysplasia (FMD), which may produce arterial wall abnormalities and intramural haematomas. Inherited connective…

…factor is identifiable in up to one half of cases. Reported precipitants include vigorous physical activity, emotional stress, and an intercurrent medical or surgical illness…

…sustained shift of water [3]. Severity of DKA The classification helps in choosing the level of care. The clinical state, the circulation, comorbidity and the…

…output and lower blood pressure. Cardiogenic shock may develop as a result of stunning. The systemic response to reperfusion and ischemia causes a state similar…

Critical care Myocardial ischemia and infarction Definition and Pathophysiology Cardiogenic shock is a state of inadequate tissue and end organ perfusion caused by cardiac insufficiency…

…integrates early catheter ablation and sophisticated device therapy [1] [2] . This exhaustive review provides a comprehensive synthesis of the current state of VT management for…

…words massive haemorrhage , and state the patient's location and identity, the presumed cause of bleeding, and how the products are to be delivered. 2…

…or both. The clinical consequences of extracellular volume expansion include elevated cardiac filling pressures, pulmonary congestion, systemic venous hypertension, and peripheral interstitial edema. These abnormalities…

…state similar to the Systemic Inflammatory Response Syndrome (SIRS). Body temperatures surpassing 40°C (104°F) are potentially hazardous and may precipitate cardiac arrest. The classification of…

…and mildly obese HF patients exhibit better survival than normal weight counterparts—remains a subject of intense epidemiological debate, likely reflecting the catabolic state of…

…the higher stage. A patient can thus be stage 3 by urine output despite a less marked rise in creatinine. Limitations of creatinine and urine…

…a systemic hypercoagulable state, characterized by elevated biomarkers such as D dimer, von Willebrand factor, and increased thrombin generation. The clinical consequence of this triad…

…but rather to a state where stroke volume is maintained only at the expense of pathologically elevated filling pressures. Epidemiology and risk factors HFpEF has…

…it sets the anatomical and biochemical stage for sudden, life threatening acute coronary syndromes when the structural stability of the plaque is acutely compromised [7…

…to quickly acquire state of the art knowledge and practical training. Professor Smith published a book as well, which we've read and recommend to…

…Give small boluses, for example 250 to 500 mL, with immediate reassessment of the blood pressure, pulse, peripheral perfusion, mental state and chest findings. Avoid

…concavity of the ST segment and positive T waves. In ECG (B) they state something similar. Unfortunately, these ECGs do not show any sign of…

…In patients with HFpEF, acute hypertension is a frequent trigger of decompensation and may produce abrupt pulmonary oedema, sometimes requiring non invasive ventilation or intubation…

…NT proBNP) are circulating markers of myocardial wall stress. They are released principally by ventricular cardiomyocytes in response to increased transmural stress and ventricular stretch…

… progression of calcific aortic stenosis; enhancement of a prothrombotic state. Its atherogenic and inflammatory effects may be mediated partly by oxidized phospholipids carried on the…

…Dyslipidaemia A prothrombotic state Albuminuria and declining estimated glomerular filtration rate Development of type 2 diabetes mellitus Atherosclerotic cardiovascular events HF and atrial fibrillation Obesity…

…This state is termed unclassified PH. Potential explanations include congenital heart disease, liver disease, airway or lung disease, and hyperthyroidism; follow up and investigation of…

…steady state concentration before further adjusting the dose. Electrophysiology Sotalol prolongs the effective refractory periods of the atrium, atrioventricular (AV) node, His Purkinje system, and…

…Type 2 myocardial infarction (MI) is defined as an ischaemic myocardial injury occurring in the context of a mismatch between myocardial oxygen supply and demand…

…Q waves and guidelines do not state any ECG criteria specific to R wave progression. Figure 1. Pathological R wave progression is indicative of previous…

…research has been devoted to it in recent years. Most cases (70%) of takotsubo cardiomyopathy occur in situations with extreme stress, such as car accidents…

…up of the cause or for imaging. 6. Document the starting time, the baseline plasma sodium, the target for the first few hours, and the…

…nor desethylamiodarone is dialyzable. The volume of distribution is large, averaging 60 L/kg, and the drug is highly protein bound (96%). The elimination half…

…This functional definition encompasses several physiological states. Brief coronary occlusion or relatively prolonged moderate ischemia may produce post ischemic stunning. In the absence of infarction…

…The depolarization spreads from the sinoatrial node to the atrial and ventricular myocardium. Propagation of the action potential is possible because all cardiac cells are…

…stunning . This is a protective mechanism since the cessation of contractions leads to a marked reduction in cell metabolism and thus prolongs survival. Myocardial stunning…

…health care exposure and the risk of resistant organisms 0 to 60 min Empirical intravenous antibiotics in septic shock or in certain or highly likely…

CPR It is commonly stated that approximately 80% of all cardiac arrests are caused by acute or chronic coronary artery disease, with the latter being…

…United States. No trends, with regard to age or sex, have been observed in Sweden between 1990 and 2021 ( Rawshani et al ). Incidence of cardiac…

…and wall thickness is rather complicated and not within the scope of this discussion. The bottom line, however, is of direct clinical relevance and states…

…for Holter and Non Invasive Electrocardiology , where it is stated that it is extremely uncommon to have a non ischemic ECG (absence of ST T…

…the setting of valvular stenosis or regurgitation, the proximal velocity (v 1 ) is very small compared to the distal velocity (v 2 ), and the difference…

…aVR, aVL and aVF. Figure 1 shows the traditional presentation of the 12 lead ECG. This presentation format is the standard in the United States…

…stroke volume is the product of area and VTI in LVOT. However, the continuity equation states that the stroke volume can be calculated by quantifying…

…usually unaffected, but the shock volume and ejection fraction (EF) may be reduced because the end diastolic volume of the ventricle (EDV) is reduced. Constrictive…

…= a · v states that flow (Q) is the product of area (a) of the cylinder and the velocity (v) of the fluid (i.e…

…second attempt). Vasoactive infusions Drug Dose range Primary effect Used in : : : : Noradrenaline 0.05–0.5 µg/kg/min α₁ — vasoconstriction Septic and distributive shock

…medicine Definition and pathophysiology Cardiovascular disease (CVD) is the leading cause of death among women worldwide and in the United States. In the United States…

…dilatation of chambers. The mechanism underlying ventricular and atrial dilation proceeds from Laplace's law, which states that increased pressure results in increased wall stress…

…the prescription list and the findings of the ambulance crew The stated dose is often unreliable and must never be used on its own to…

…Triglyceride synthesis and hepatocellular lipid accumulation consequently increase, with variable inflammation and oxidative stress. Metabolic dysfunction associated fatty liver disease affects approximately 10% of non…

…presence of hypotension, end organ hypoperfusion, shock states, and pulmonary congestion. In pregnant patients presenting with suspected acute heart failure, urgent hospital admission and referral…

ECG Exercise stress test Exercise stress test (exercise ECG) protocols & equipment: cycle ergometer (bicycle) vs. treadmill The choice of exercise equipment and protocol depends mainly…

…or to confirm a creatinine based value The mean of creatinine and cystatin C The most reliable in routine clinical practice Cockcroft–Gault Still used…

…perfusion of an upper or lower limb that causes tissue metabolic requirements to exceed available blood flow. The resulting ischaemia threatens skeletal muscle and peripheral…

…Classification of CKD CKD severity is classified by eGFR and albuminuria. The following categories describe the principal eGFR stages: CKD stage eGFR Clinical context Cardiovascular…

…difficult bag mask ventilation or failed intubation — and already at the planning stage when the MACOCHA score or the LEMON assessment indicates that difficulties are…

…risk of skin and fat atrophy. Lederspan states in addition that the dosing interval should not be shorter than four weeks . Mix the corticosteroid and…

…A maintenance dose of 10 mg is not recommended due to higher exposure to the active metabolite and increased bleeding risk compared to patients weighing…

…failure, and end stage renal disease, may produce elevated troponin concentrations. The probability of MI increases continuously as the absolute hs cTn concentration rises. Early…

…blood flow states. MPI is used principally to: Diagnose and quantify stress induced myocardial ischaemia. Detect and characterize myocardial scar. Estimate the risk of major…

…ergospirometry (exercise stress testing), and cardiac catheterization. Principles of management of congenital heart disease and GUCH Complex malformations often require intervention (surgical or catheter based…