Pulmonary Embolus versus Right Ventricular Infarction
Features that distinguish Pulmonary Embolus from Right Ventricular Infarction
Features that distinguish Pulmonary Embolus from Right Ventricular Infarction
Pericardial disease
Syncope is transient, self-limited loss of consciousness with an inability to maintain postural tone that is followed by spontaneous recovery. Such an event without loss of consciousness is often termed “presyncope”. Underlying cause is often not found in the emergency department (~50%)
pCO2 gap is a surrogate for cardiac output; pCO2 gap = PcvCO2 - PaCO2; pCO2 gap >6 mmHg suggests a persistent shock state that may be amenable to fluid resuscitation +/- intrope support; a “ScvO2-cvaCO2gap-guided protocol” has been proposed to guide the management of septic shock
Cardiopulmonary bypass (CPB) replaces the function of the heart and lungs while the heart is arrested to provide a bloodless, stable surgical field
Cardiac arrest occurs after 0.7 - 2.9% of cardiac surgery cases. Usually preceded by physiological deterioration but can occur in previously stable patients
Pulseless electrical activity (PEA) occurs when organised or semi-organised electrical activity of the heart persists but the product of systemic vascular resistance and the increase in systemic arterial flow generated by the ejection of the left ventricular stroke volume is not sufficient to produce a clinically detectable pulse
Causes of Acute Pulmonary Hypertension
Superior vena cava (SVC) obstruction impairs venous return through the SVC to the right atrium and has many causes, usually mediastinal masses or complications of SVC lines
Coarctation of Aorta: congenital condition characterised by narrowing of the aorta near the site where the ductus arteriosus (ligamentum arteriosum after regression) inserts.
Tetralogy of Fallot: Large VSD; RV outflow tract obstruction; RV hypertrophy; and Overriding aorta
Alteplase is a tissue plasminogen activator used as a thrombolytic medication in: Acute Ischaemic Strokes, Acute Myocardial Infarction and PE