…systole. Transesophageal echocardiography and surgical pathology demonstrate that over 90% of thrombi in non valvular AF originate within this specific anatomical cul de sac [19] …

…oxygenation, never intubation in itself — and every difficult airway algorithm is at bottom a timetable for when to stop doing what you are doing. Indications…

…Prognosis and Survival The presence of LBBB has several implications for patient outcomes: Mortality in STEMI : Patients presenting with ST elevation myocardial infarction (STEMI) and…

…high income countries, idiopathic pericarditis, radiation to the pericardium and surgical interventions are the most common causes of constrictive pericarditis. Of these three, idiopathic pericarditis…

…and shaped before induction , a syringe for the cuff, a cuff manometer. A laryngeal mask of the correct size as a rescue airway, and surgical…

…retention — the commonest indication on a surgical ward. Decompression in severe vomiting where the stomach does not empty. Intraoperatively and postoperatively after major abdominal surgery…

…local protocol. Alternatives when there is a contraindication: catheter directed treatment or surgical embolectomy where available. A vasopressor (noradrenaline) and cautious fluid administration. Large fluid…

…haemodynamic responses, arrhythmias and prognosis, with diagnostic interpretation reserved for appropriately selected patients. Pathophysiological basis Exercise progressively increases myocardial oxygen demand through increases in heart…

…advantage for CABG over PCI in multivessel disease. A British Cardiovascular Intervention Society myocardial jeopardy score is an alternative method for estimating the extent and…

…It is uncommon for chronic pericardial effusions to cause sudden cardiac arrest since these cases tend to be recognized and managed before circulatory collapse occurs…

…alter disease progression. Diuretics may be used for symptom relief. Surgical repair or valve replacement is considered when medical therapy is insufficient, or when concomitant…

…severe, a rapid course, skin discolouration, systemic upset — is an acute surgical emergency, not an abscess. Preparation and equipment No. 11 scalpel, curved haemostat, scissors…

…Calculation: for each leg, the highest of the dorsalis pedis and posterior tibial pressures is divided by the highest arm pressure of the two arms…

…and a culture taken without clinical suspicion leads only to unnecessary antibiotics. 5. Biopsy any ulcer that has not healed within three months despite adequate…

…needle tip before you start. Apply the tourniquet only after the block has taken effect, and note the time. It must not stay on for…

…mm), loculated or purely posterior effusion with no safe route for puncture — surgical drainage or pericardiotomy instead. Relative: uncorrected coagulopathy, thrombocytopenia and ongoing anticoagulant treatment…

…toothed surgical forceps, scissors, a needle holder. Sutures: 5 0 or 6 0 non absorbable for the face, 4 0 for the trunk and limbs…

…flow and circular LVOT/RVOT geometry, which may not hold in all patients. Error in Calculation : The original formula’s inclusion of “ 100” for Qp…

…from a peripheral artery to the aortic root and coronary ostia. It remains the reference standard for defining the extent of coronary artery disease because…

…preceding 12 months and an ICD within the preceding 6 months. Remote monitoring may be used for these assessments. More immediate interrogation and reprogramming are…

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

…and Symptoms In up to one half of STEMI cases, a precipitating factor such as vigorous physical exercise, emotional stress, or a medical or surgical…

…precipitants include vigorous physical activity, emotional stress, and an intercurrent medical or surgical illness. Events may occur at any time, although clustering in the morning…

…SGB) or cardiac surgical sympathetic denervation can be performed to mechanically reduce sympathetic output [4]. Evaluation of Treatment and Alternatives for Drug Failure The provided…

…prolongation of survival. Neonatal screening with pulse oxymetry The majority of all congenital heart defects are detected early in infancy or childhood. For obvious reasons…

…for survival in cardiac arrest. Life saving interventions must be initiated momentarily to maximize the probability of survival. Several actions must be executed systematically and…

CPR Extracorporeal Life Support (ECLS) and ECMO (Extracorporeal Membrane Oxygenation) Survival after cardiac arrest depends on the restoration of spontaneous cardiac rhythm. The likelihood of…

…In impaired consciousness or DKA: remove the pump and change to an infusion or injections Drugs for type 2 diabetes in inpatients Agent The acutely…

…catheter, ECG monitoring, blood gases. Drugs for sedation, analgesia and control of shivering. Procedure 1. Start temperature management early — within the first hour after ROSC…

…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…

…only suicide attempts have lower survival outcomes. Nonetheless, prompt interventions can reverse cardiac arrest and survivors of traumatic cardiac arrest often exhibit favorable neurological outcomes…

…et al 1 ). Representative single beat morphs for a low risk patient (blue) and the corresponding high risk morph (red). Beyond the difference in R…

…ischemic events are major determinants of subsequent LV deterioration and long term survival. Viable, stunned, and hibernating myocardium Viable dysfunctional myocardium is myocardial tissue whose…

…artery was associated with lower five year survival than a more distal lesion. Revascularisation improves myocardial blood flow and angina related health status but does…

…depends on the mechanism responsible for symptoms and ischaemia. The increasing prevalence of refractory angina reflects population ageing and improved survival among patients with CAD…

…year survival of those who continue. After acute coronary syndrome, tobacco abstinence has been associated with reductions in reinfarction of approximately 30–40% and in…

…among underserved groups and ethnic minority communities. Late presentation is clinically important: Within 12 hours of symptom onset: reperfusion therapy is recommended for all patients…

…survival exist during the first few minutes from collapse. Table 1 shows the number needed to treat (NNT) for various interventions involved in BLS and…

…factors for coronary heart disease (atherosclerosis). The average age at diagnosis of aortic stenosis is 75 years in high income countries. In low and middle…

…quality of CPR, and a prognostic indicator for survival. In the nationwide Swedish Cardiopulmonary Resuscitation Registry, 30 days survival in OHCA, in relation to initial…

…requires training and experience). Thus, for laypeople, examinations 1 and 2 are sufficient to confirm a cardiac arrest. All 3 examinations are recommended for medical…

…1 . Expected cardiopulmonary function and alertness in decreasing body temperature according to HOPE (Hypothermia Outcome Prediction after Extracorporeal Life Support for Hypothermic Cardiac Arrest Patients)…

…of survival. It includes diagnosis of post cardiac arrest syndrome (PCAS), optimization of ventilation, oxygenation, hemodynamics, antiischemic treatment, temperature treatment, treatment of seizures, and infections…

…evaluate angina pectoris, evaluate exercise performance, evaluate the effect of interventions and medications, and prognosticate survival. However, exercise stress testing must not be performed within…

…condition with a poor long term prognosis. The 5 year survival rate after hospitalization for heart failure is 60%, which is comparable to common cancers…

…condition with a poor long term prognosis. The 5 year survival rate after hospitalization for heart failure is 60%, which is comparable to common cancers…

…3D) echocardiography has become increasingly common, and may be as precise as cardiac MRI (magnetic resonance imaging) for calculating ejection fraction. References Yancy et al:…

…The low survival reflects the sudden and hyperacute nature of the condition. This has prompted researchers to develop strategies and tools for long term prevention…

…VF/VT can be detected and defibrillated promptly. Survival is around 70% when defibrillation is performed within 3 minutes of the collapse (Hessulf et al…

…The association between compression depth and survival to hospital discharge ( Stiell et al ). Right panel : The association between compression rate and survival to hospital discharge …

…e. septal bulging ). Bedside echocardiography allows for immediate recognition of tamponade. Typically, acute tamponade arises from aortic dissection, and survival among such patients is, unfortunately…

…MAP − ICP RASS −2 to 0 Lightly sedated to awake and calm CAM ICU Negative Screen for delirium every shift BIS (during neuromuscular blockade) 40…

…factors for poor outcomes. The vast majority of infections with COVID 19 result in mild disease, with symptoms similar to seasonal flu (influenza) and other…

…for patients with HFrEF, LVEF <35%, sinus rhythm and resting heart rate 75 beats/min, based on a retrospective subgroup analysis in which a survival…

…be considered. Effective lipid lowering improves survival and reduces cardiovascular mortality in patients with coronary artery disease irrespective of the baseline cholesterol concentration. Intensive statin…

CPR Hypoxia and asphyxiation Hypoxia refers to a reduced partial pressure of oxygen in the blood. Asphyxia is characterized by insufficient ventilation, leading to hypoxia…

…needle decompression. Thoracostomy with drainage typically serves as a stabilizing intervention. References Debehnke DJ, Hilander SJ, Dobler DW, Wickman LL, Swart GL. The hemodynamic and…

…of timely and appropriate interventions. In patients presenting with concurrent sepsis and cardiac arrest, standard cardiopulmonary resuscitation (CPR) protocols are followed. Moreover, for optimal management…

CPR Hyperthermia and malignant hyperthermia Hyperthermia is characterized by a body temperature exceeding the typical range of 36.5 37.6°C (97.7 99.7°F…

…25% in 2017. Location and witnesses About 60% of all out of hospital cardiac arrests are witnessed, which is fundamental for survival. About 50% of…