Akutsjukvård Lathundar Basic principle Anaphylaxis is a rapidly developing systemic hypersensitivity reaction that can cause life threatening compromise of the airway, breathing or circulation. Skin…

…systemic inflammatory response syndrome (SIRS), disseminated intravascular coagulation (DIC), and hypoperfusion manifesting as hypotension. The high mortality associated with sepsis underscores the critical importance of…

…Fenoldopam Drug Fenoldopam Brand names Corlopam ® Indications Short term management of hypertension, including hypertensive emergency. Mechanism of action • Systemic Dopamine 1 (D1) receptor agonist…

…The shunt fraction (Qp/Qs) is a critical hemodynamic parameter used to quantify the ratio of pulmonary blood flow (Qp) to systemic blood flow (Qs)…

…systemic vascular resistance (SVR) is rapid and may cause reflex sympathetic stimulation, including tachycardia. May therefore induce or worsen angina pectoris. The rapid reduction of…

…Because of the drug's unusual pharmacokinetics, serious arrhythmia indications, and potential adverse effects, consideration should be given to initiating therapy with the patient hospitalized…

…focal arterial lesions. Although epicardial coronary arteries are a major site of disease, atherosclerosis is systemic and may affect multiple arterial territories. The arterial wall…

…higher cardiovascular risk than the general population. This excess risk has been documented across a broad range of conditions, including gout, vasculitis, systemic sclerosis, myositis…

…peripheral artery disease (PAD), and other manifestations of systemic atherosclerosis. The principal clinical concern is cerebral embolism or haemodynamic compromise leading to transient ischaemic attack…

…or physical reactions (radiation therapy), frequently involves the conduction system. In these conditions, involvement of the AVN and the conduction system occurs more often than…

…manipulate systemic and pulmonary vascular resistance, and restore adequate end organ perfusion. Dobutamine is a synthetic catecholamine that functions as an agonist of both beta1…

Cardiology Clinical medicine Definition and pathophysiology Peripheral artery disease (PAD) is a clinical disorder caused by stenosis or occlusion of the aorta or arteries supplying…

…ECG tracing lasting ≥30 seconds, characterized by irregularly irregular R R intervals and the absence of distinct P waves [1] [2] . Stroke Risk Scores: CHA2DS2…

…increases. This results in increased left ventricular load, while simultaneously affecting systemic perfusion. Aortic stenosis is a serious condition with poor long term outcomes. Patients…

…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 hyperthermia is…

…transmural myocardial infarction. Rupture of the free ventricular wall. Neoplasms (particularly breast and lung cancer). Inflammatory conditions, such as rheumatoid arthritis, systemic lupus erythematosus, scleroderma…

…cardiovascular societies, defines HF as a clinical syndrome corroborated by elevated natriuretic peptide levels and/or objective evidence of pulmonary or systemic congestion [3] . Within…

…of a disproportionate response to increased ventricular loading. The presence of systemic hypertension or aortic stenosis does not rule out hypertrophic cardiomyopathy. Epidemiological aspects of…

…5. Give a systemic corticosteroid if the exacerbation is more than mild. 6. Assess the indication for antibiotics on the basis of sputum purulence, the…

…a systemic steroid early. 7. Insert intravenous access, but do not let blood sampling or cannulation delay inhaled treatment. 8. Reassess speech, work of breathing…

…the visual acuity before anything else is done. The second most important is to look for signs of perforation — Seidel's sign, an irregular pupil…

…line is necessary to achieve an optimal result. Overview of vasopressors and inotropes Vasoconstriction Vasodilatation Positive inotropy Phenylephrine Vasopressin Midodrine Noradrenaline Adrenaline, high dose Dopamine…

…110/min, a systolic blood pressure < 100 mmHg and a saturation < 90 per cent. An sPESI of 0 indicates low risk. Anticoagulation A…

…patient with known lung disease. Follow up of treatment effect and of disease progression. Assessment of pulmonary involvement in systemic disease, for example rheumatoid arthritis…

…effect on myocardial contractility or conduction. Clevidipine reduces mean arterial blood pressure (MAP) by decreasing systemic vascular resistance (SVR). Clevidipine does not reduce cardiac filling…

…of smooth muscle cells. As compared with nitroprusside, nicardipine induces relatively greater venodilation than arteriolar dilation. Effects Nicardipine causes dilation of the coronary and systemic…

…increased risk of cardiovascular diseases, such as stroke, and mortality. Stability : MAP readings tend to be more accurate than systolic blood pressure when using non…

…of smooth muscle cells. As compared with nitroprusside, nicardipine induces relatively greater venodilation than arteriolar dilation. Effects Nicardipine causes dilation of the coronary and systemic…

…II Anatomical SYNTAX Score : Derived from the original SYNTAX Score, which evaluates the complexity of coronary lesions. Clinical Variables : Age : Older patients have a higher…

…In stable patients, it is advisable to add therapy with beta blocking agents before full target doses of ACE inhibitors are reached. Medication doses should…

…an emergency management pathway. Patients without haemodynamic instability require more detailed prognostic evaluation using two complementary domains: Indicators of acute PE severity , including clinical findings…

…exaggerated inspiratory fall in systemic systolic blood pressure, termed pulsus paradoxus. Tamponade is therefore characterized haemodynamically by elevation and near equalization of diastolic pressures in…

Cardiology Clinical medicine Definition and Pathophysiology Dietary patterns are the overall combinations of foods habitually consumed rather than isolated nutrients considered independently. For cardiometabolic health…

…the His Purkinje system and ventricular muscle are minimal, except in cases of toxic concentrations. In most patients, the sinus rate and P wave duration…

…occurs in more than 90% of patients presenting with the syndrome. Its severity and temporal pattern vary considerably. Symptoms of systemic venous congestion include: Peripheral…

…of ventricular adaptation to the resistance that must be overcome by the ventricles. The left ventricle must overcome the pressure in the aorta and systemic…

…or systemic causes producing myocardial oxygen supply–demand imbalance. Coronary mechanisms Coronary mechanisms include: Plaque rupture or plaque erosion with thrombosis, despite the absence of…

Clinical chemistry & laboratory medicine Myocardial ischemia and infarction Definition and Pathophysiology Myocardial injury Myocardial injury is a biochemical diagnosis defined by at least one cardiac…

…low output, or persistent severe symptoms require close monitoring and consideration of invasive haemodynamic assessment when precise measurements are needed to guide therapy. Diagnostics Electrocardiography…

…FMD was identified in 86% of patients with SCAD. SCAD should therefore prompt consideration of systemic arteriopathy rather than being regarded solely as an isolated…

…and other systemic influences. The severity of myocardial injury is determined not only by the epicardial obstruction but also by the vulnerability of the myocardium…

…chemistry & laboratory medicine Myocardial ischemia and infarction Definition and pathophysiology Myocardial infarction (MI) is a clinical diagnosis that integrates myocardial injury, evidence of acute myocardial…

…systemic vasculitis, extrinsic compression, myocardial bridging and radiation induced coronary disease. The distinction between UA and NSTEMI has become increasingly dependent on the use of…

…local revascularization must be accompanied by systemic treatment aimed at stabilizing the broader atherosclerotic disease. Pathophysiology Mechanisms of acute coronary syndrome The major mechanisms producing…

…embolization in the systemic circulation. The complications can be fatal. Approximately 500 Swedes are affected annually by endocarditis and the median age of 70 years…

…of smooth muscle cells. As compared with nitroprusside, nicardipine induces relatively greater venodilation than arteriolar dilation. Effects Nicardipine causes dilation of the coronary and systemic…

…of ventricular adaptation to the resistance that must be overcome by the ventricles. The left ventricle must overcome the pressure in the aorta and systemic…

…by systemic risk factors such as hypertension, hyperglycemia, smoking, and turbulent hemodynamic shear stress. This dysfunction compromises the endothelial barrier, upregulating the expression of vascular…

…90% of the cases. As compared with the right ventricle, the left ventricle contracts against much greater resistance (i.e. the pressure in the systemic…

…somewhere that makes incision in the emergency department the wrong move — in the hand, in the medial triangle of the face or perianally. Indications Fluctuant…

…topical steroids in high doses can also cause systemic suppression. Corticosteroids mask fever and peritonitis. The abdomen of a patient on corticosteroids can be silent…

…kinase inhibitors and drugs directed against vascular endothelial growth factor. Episodes of headache, palpitations, sweating and pallor that may suggest phaeochromocytoma. Systemic sclerosis, kidney disease…

…vasculitis Individual assessment Repeat the ABI every three to six months during ongoing compression therapy, and always in the event of new or increasing pain…

…CHADS VASc Score Risk of ischemic stroke Risk för stroke/TIA/systemisk tromboembolism 0 0.2% 0.3% 1 0.6% 0.9% 2 2…

…with ECG, central vein catheter and intra arterial catheter (A line) is warranted. Overview of vasopressors and inotropes Inotropes and vasopressors. Table 1. Drug manual…

…include: Systemic hypertension Marfan syndrome Loeys–Dietz syndrome Ehlers–Danlos syndrome Inflammatory aortitis, including Takayasu arteritis and giant cell arteritis Bicuspid aortic valve Coarctation of…

…and distal to the suspected obstruction Arterial and venous Doppler signals Evidence of systemic disease or a potential embolic source Neurological assessment is central to…

Cardiology Clinical medicine Definition and scope Alcohol has dose , pattern , duration , sex , and genetically influenced effects on the cardiovascular system. Acute exposure produces transient haemodynamic…

…and impaired ventricular relaxation [10]. There is also an increased risk of intracardiac thrombus and stroke or systemic embolization, even in patients in sinus rhythm…

…Systemic inflammation results in increased levels of circulating pro inflammatory cytokines that may cause plaque rupture (i.e the risk of atherosclerotic plaque rupture is…