…palmar arches and the lowest complication rate. The femoral artery is the second choice and is often the best in marked shock or during high…

…a new cardiac murmur, or jugular venous distension in the days after MI should prompt immediate consideration of a mechanical complication. Clinical deterioration may be…

…former). Even small pressure elevations on the right side can compromise venous return to the right ventricle. Therefore, in the presence of a tamponade, chest…

…2,3]. Respiratory complications occur, but untreated convulsive status itself carries a considerable risk of hypoxia and respiratory failure. In placebo controlled trials, respiratory depression…

…risk of complications calls for careful consideration of contraindications. Contraindications may be absolute or relative. Briefly, exercise stress testing must not be performed in the…

Echocardiography Cardiac thromboembolism Thromboembolism is a leading cause of death worldwide (1). Emboli originating in the atria, left atrial appendage (LAA), ventricles, valves, and proximal…

…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…

…HF), atrial fibrillation and cardiovascular events. In clinical practice, obesity is conventionally defined by a body mass index (BMI) of ≥30 kg/m2. Severe obesity…

Procedurer What determines the outcome of a central venous catheter insertion is decided before the needle goes in: the choice of site, the use of…

…when peripheral access fails or is judged futile. Children in an emergency, where peripheral venous access often takes too long. Intraosseous access accepts all drugs…

…heals venous leg ulcers; everything else is supportive. But the same compression applied to a limb with arterial insufficiency can cause necrosis and, in the…

…which represent contraindications for thrombolysis. Venous thromboembolism is a chronic and serious condition. Mortality in pulmonary embolism is up to 20%, and roughly 30% of…

…blockers). Effects Induces arteriolar vasodilation without effects on venous circulation. The reduction in systemic vascular resistance (SVR) is rapid and may cause reflex sympathetic stimulation…

…syndrome (ODS). It is therefore recommended to raise serum sodium by a maximum 8 mEq/L in the first 24 hours. Hyponatremia of unknown duration…

…the superior and inferior vena cava, impeding or halting venous return to the heart. In instances of tension pneumothorax, the accumulated pressure can shift the…

…in the groin or on the neck Bleeding, vascular injury, pseudoaneurysm Surgeon, ultrasound first Other situations that argue for the operating theatre rather than the…

…even though incidence and prognosis vary widely between patient groups and care settings [2]. Practical first actions Do the following in parallel, not sequentially: 1…

…0 A mechanical valve may require a higher target Doses in venous thromboembolism Treatment doses in deep vein thrombosis and pulmonary embolism differ from the…

…The condition occurs above all in: treatment with SGLT2 inhibitors pregnancy prolonged fasting or a very low carbohydrate intake excessive alcohol consumption vomiting or othe

…physical activity and any other precipitating factor. Thresholds The thresholds below are used above all in diabetes. The severity of the symptoms and the patient…

…in the emergency department, the intensive care or coronary care unit, and the operating theatre. Careful electrocardiographic and haemodynamic monitoring with ECG, a central venous…

…or a smaller measured blood loss if there is physiological compromise. Do not wait for hypotension in young, pregnant or previously athletic patients. Beta blockade…

…adherence, pregnancy after the first trimester under specialist care). Rheumatic mitral stenosis with atrial fibrillation. In uncomplicated atrial fibrillation and in ordinary venous thromboembolism, a…

…the venous capacitance vessels. Hence, Clevidipine reduces blood pressure without affecting cardiac filling pressures. • Clevidipine is more effective than nitroglycerin, nitroprusside, and nicardipine in hypertensive…

…the venous capacitance vessels. Hence, Clevidipine reduces blood pressure without affecting cardiac filling pressures. • Clevidipine is more effective than nitroglycerin, nitroprusside, and nicardipine in hypertensive…

…Central Venous Pressure (CVP) This equation illustrates that MAP is determined by the volume of blood the heart pumps and the resistance encountered in the…

…especially in patients in their mid 60s or older [10]. Physical examination may reveal a normal or low pulse pressure, an elevated jugular venous pressure…

…and near equalization of diastolic pressures in the cardiac chambers, with chamber pressures approaching intrapericardial pressure. The jugular venous waveform typically has a prominent x…

…including: Coronary arteritis Accelerated atherosclerosis Coronary microvascular dysfunction Pericarditis Myocarditis Valvular disease APS and Behçet disease can cause both arterial and venous thrombosis. In SLE…

…left ventricular filling and reduce systemic output. In this setting, venous congestion is generally treated initially with diuretics, whereas norepinephrine and/or inotropes are reserved…

…pressure minus coronary venous pressure Normal coronary driving pressure: mean aortic pressure minus coronary venous pressure In routine clinical practice, coronary venous pressure is generally…

…or both. Consequently, relatively small increases in venous return can produce disproportionate increases in left ventricular and left atrial pressure. At rest, filling pressures may…

…and calcific aortic valve stenosis. Lp(a) is not associated with venous thromboembolism in prospective epidemiological studies. Its biological effects appear to differ from those…

…and pulmonary congestion. In pregnant patients presenting with suspected acute heart failure, urgent hospital admission and referral to an expert centre with advanced heart failure…

…most common risk factor for PH. It produces postcapillary PH through elevation of left atrial and pulmonary venous pressure. In some patients, chronic postcapillary pr

…particularly useful. ST segment elevation in these leads, especially lead V_R, is frequently observed during the first 24 hours in patients with RVI. The…

…reflex response to posture, venous pooling, or external stimuli. The underlying pathophysiology is rooted in autonomic dysregulation within a structurally normal heart. During an episode…

…a cardiac arrest in a pregnant patient, immediate consultation with an obstetrician, neonatologist, and anesthesiologist is essential. Figure 1 . When a pregnant woman is supine…

…A rapid increase in preload (e.g by increasing venous return to the heart in supine position) leads to an immediate increase in ejection fraction…

…Extracorporeal Life Support (ECLS) encompasses several extracorporeal systems designed to assist in cases of cardiac or respiratory failure by means of an extracorporeal pump and…

…the venous capacitance vessels. Hence, Clevidipine reduces blood pressure without affecting cardiac filling pressures. • Clevidipine is more effective than nitroglycerin, nitroprusside, and nicardipine in hypertensive…

…These factors, which influence cardiac function primarily by affecting ventricular function, include blood pressure, venous return, pulmonary gas exchange efficiency, the concentration of catecholamines, angiotensin…

…arterial line, PiCCO, central venous catheter). The hemodynamic effects persist for 7–10 days after the end of infusion. Refer to Table 2 for a…

…and previous venous thromboembolism. A documented decision on the ceiling of care. Signs of a serious condition Finding Significance : : Inability to speak in full sentences…

…exhaustion and, in the most severe cases, hypotension, pneumothorax and respiratory arrest [1]. The first few minutes 1. Sit the patient up and minimise physical…

…or a recently inserted venous port. Procedure 1. Arm pressure. Place the cuff on the upper arm. Locate the brachial signal in the antecubital fossa…

…acidosis or alkalosis in a haemodynamically stable patient A venous blood gas is often sufficient as the first sample Precise pCO₂ in suspected ventilatory failure…

…premedication, plus further atropine drawn up in a syringe as a standby dose. Glycopyrronium (Robinul) 0.2 mg is an alternative premedication. Peripheral venous cannula…

…anticipated, whether the position and the equipment are in order, and whether there is an explicit plan for what happens when the first attempt fails…

…3. Insert a peripheral venous cannula. 4. Measure the blood pressure in both arms at the first assessment, particularly in chest pain, back pain or…

…and checked before the first intravenous dose is given. Oxygen with a mask and a bag available. The opioid drawn up in a 1 mL…

…ventilation before decompression where possible: anaesthesia and intubation can precipitate circulatory collapse in a tamponaded patient , since positive airway pressure further reduces the venous return…

…used in atrial fibrillation. Follow the Swedish medicines compendium (FASS) and the local protocol. Low molecular weight heparin is the first choice in pregnancy and…

…4]. The first hour, in order The measures should in practice overlap. Document the time of the suspicion of sepsis, the first dose of antibiotic…

…untreated Addisonian crisis in progress: treat first, test later. Preparation and equipment Tetracosactide (Synacthen) 0.25 mg/mL, one ampoule. A peripheral venous cannula and…

…Procedure 1. Start temperature management early — within the first hour after ROSC, in parallel with coronary angiography, the search for the cause and the rest…

…pacing: the relative contraindications are the same as for a central venous catheter — coagulopathy, infection at the puncture site, known thrombosis in the target vein…

…in older protocols but is no longer routinely recommended — alkaline urine increases the precipitation of calcium phosphate. Contraindications Hypokalaemia — must be corrected first or in…

…Definition and pathophysiology Acute limb ischaemia (ALI) is an abrupt reduction in arterial perfusion of an upper or lower limb that causes tissue metabolic requirements…

…in the sinus rate. In the AV node, adenosine produces a transient, rate dependent prolongation of the A H interval, frequently manifesting as transient first…