…better maintenance of sinus rhythm in cohort studies. Obesity, reduced exercise capacity, hypertension and dyslipidaemia commonly coexist and should be considered part of the clinical…

…a previous nasal fracture or unilateral nasal obstruction. 2. Measure the depth of insertion by laying the tube from the tip of the nose to…

…ECG 2. The initial part shows QRS complexes with similar morphology as ECG 1, likely presenting a supraventricular rhythm. Three short bursts of ventricular tachycardia…

…Figure 2. The direction of the QRS complex. Axis deviation: right axis deviation (RAD) and left axis deviation (LAD) Causes of right axis deviation Normal…

…aphasia and radiological changes resembling ischaemic stroke. Glucose measurement is therefore always part of the initial stroke assessment [1]. Treat immediately when there are symptoms…

…titrated against clinical effect. 2. Parenteral thiamine early , preferably before or at the same time as carbohydrate administration. 3. Rapid identification of seizures, delirium tremens…

…compression. The reason compression nevertheless so often fails is that it is done wrongly: the patient pinches the nasal bone instead of the soft part…

…much bicarbonate is given. Potassium replacement is not the management of a side effect; it is part of the treatment itself. Indications Salicylate poisoning with…

…2. Zoghbi, William A.; Adams, David; Bonow, Robert O.; Enriquez Sarano, Maurice; Foster, Elyse; Grayburn, Paul A. et al. (2017): Recommendations for Noninvasive Evaluation of…

…segment depression in the inverted lead aVR). A notch is evident in the ascending part of the ST segment. A male patient (Figure 1) presented…

…exploring electrode is located in front of the P wave vector ( Figure 2, right hand side). This article is part of the comprehensive chapter: How…

…AV) node are located in the atria and are not part of the ventricular conduction system. The AV node transitions into the bundle of His…

…v 2 With regards to echocardiography and ultrasound imaging in general, v is the maximum velocity measured using Doppler. Moreover, the first part of the…

…become normalized as a part of the natural course of myocardial infarction (refer to Figure 2 below). However, that type of normalization is much slower…

…vasoconstriction, arrhythmia, intra aortic balloon pump. Assessment of stroke volume variation as part of fluid management. Contraindications Infection, burn or trauma over the insertion site…

…Choice of site The posterior superior iliac spine is the standard site for both aspiration and biopsy in adults. Here the posterior part of the…

…important indication and an emergency procedure . An unclear arthritis, as part of the diagnostic work up. Haemarthrosis after trauma. A symptomatic effusion causing pain or…

…retrograde (inverted) P waves, which can be located anywhere between the J point and the terminal part of the T wave. PR interval 0,22…

…one third of the patients who ultimately had a favorable neurological recovery exhibited an abnormal pupillary reflex upon initial examination. Notably, 31.2% of patients…

…retrograde (inverted) P waves, which can be located anywhere between the J point and the terminal part of the T wave. PR interval 0,22…

…a wave front in water. Figure 2 shows the appearance of the action potential in contractile myocardial cells. Figure 2. The cardiac action potential in…

…the terminal part of the P wave is negative (Figure 1, upper panel). This negative deflection is generally <1 mm deep. The amplitude of the…

…usually thickened and during systole leaflet doming appears. The proximal part of the pulmonary artery is frequently dilated. The maximum and mean pressure gradient is…

…Thus, with regards to measuring ventricular dimensions, trabeculae and papillary muscles are considered part of the left ventricular cavity. Other dimensions– including atrial dimensions, mitral…

…area ). The LAD supplies the large anteriosuperior wall (often referred to as the anterior wall ) and the apical part of the lateral wall . The LAD…

…from the dorsal aspect, one injection medial and one lateral to the base of the phalanx, 2–3 mL on each side, with the needle…

…mastoid erythema and a protruding ear are not part of the tympanic membrane, but they are the most important finding when they are present. 2…

…Venturi mask 2–15 L/min depending on the valve 24, 28, 31, 35, 40 or 50 % Gives a fixed, known FiO2 independently of the…

…73 m² Abnormal urinalysis or renal imaging Risk of progression rises with proteinuria and depends on cause 2 60 mL/min/1.73 m² Abnormal…

…and rapid deceleration (descending part). Deceleration time (DT) is the time interval from the peak of the E wave to its projected baseline (Figure 2)…

…myocardial segmentation for echocardiography and cardiac imaging Cardiovascular imaging modalities have developed rapidly in the past few decades. The repertoire of available methods includes echocardiography…

…propagate outside of the conduction system. This is reflected on the ECG as a slow start of the QRS complex and this part of the…

…the disrupted surface. Type 2 MI: Attributed to an imbalance between myocardial oxygen supply and demand, without the presence of acute atherothrombosis. Type 3 MI…

…fascicular block, the myocardium without fascicular supply will depend on impulses spreading from other parts of the ventricle (where the fascicle is intact). Figure 1…

…and the key trials supporting each. A more detailed mechanistic discussion of each index follows in Section 2, and a guideline oriented comparison (procedural requirements…

…apically 0.8 mm/m 2 BSA. Basal segments of the right ventricle (i.e parts on the atrial side of the tricuspid annulus) function…

…of morbidity in patients with structural heart disease, VT necessitates a nuanced, multidisciplinary approach to diagnosis and management. Over the past decade, the landscape of…

…2] . Epidemiologically, BrS is responsible for up to 20% of sudden cardiac deaths in patients without structural heart disease and is the leading cause of…

…systemic inflammation [7] . The dominant risk factors for HFpEF include hypertension (present in 80% of cases), obesity, type 2 diabetes mellitus, chronic kidney disease (CKD…

…biopsy instead. 2. Photograph the lesion — it will disappear, and the documentation is all that remains. 3. Pare down any hyperkeratosis with a scalpel; nitrogen…

…in the past three weeks, even before a blood count is available. The nadir often occurs 7 to 14 days after a course of chemotherapy…

…Right dominant system is by far the most common anatomy, occurring in 90% of all individuals. Figure 2. Coronary arteries in a right dominant system…

…1 and Figure 2. Figure 1. Echocardiogram showing takotsubo cardiomyopathy in acute phase (A) and resolution phase (B). Note the apical ballooning of the apical…

…the use of the Cabrera format in order to facilitate ECG interpretation. Lead –aVR: the inverted lead aVR As evident in Figure 2 there is…

…(2) Whereas reflections from erythrocytes have low amplitude, sound waves reflected from myocardium have high amplitude. This is due to the high density of myocardium…

…arm. 2. Ankle pressure. Place the cuff just above the malleoli, with its lower edge about 2 cm above the tip of the malleolus. 3…

…NSTEMI and a corresponding decrease in unstable angina in the past two decades (many of those who would previously have been classified as unstable angina…

…It does not progress to ventricular tachycardia or ventricular fibrillation and it does not affect cardiac output to the point of hemodynamic compromise. Figure 2…

…introduced the 1 2 3 LQTS Risk model, a validated tool designed to estimate the 5 year risk of life threatening arrhythmic events in individuals…

…introduced the 1 2 3 LQTS Risk model, a validated tool designed to estimate the 5 year risk of life threatening arrhythmic events in individuals…

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

…43 years History : None Medications : None ECG 1 . Sinus rhythm interrupted by rapid ventricular tachycardia (VT). ECG 2 . VT progressing to ventricular fibrillation. ECG 3 …

…difficult to differentiate between Mobitz type 1 and Mobitz type 2. A very simple rule of thumb can be applied to do this: whenever there…

CPR ECG 1 . Sinus rhythm interrupted by ventricular tachycardia (VT). ECG 2 . Spontaneous termination of ventricular tachycardia (VT). ECG 3 . A single ventricular beat, followed…

CPR ECG 1 . Sinus rhythm interrupted by polymorphic VT. ECG 2 . Polymorphic VT. ECG 3 . Polymorphic VT progresses to ventricular fibrillation (VF). ECG 4 . Polymorphic…

…Pseudonormal (grade 2 dysfunction) Reversible restrictive filling (grade 3 dysfunction) Irreversible restrictive filling (grade 4 dysfunction) E/A ratio 1–2 1–2 <1 1…

…A convenient, bedside, clinical score for risk assessment at presentation: An intravenous nPA for treatment of infarcting myocardium early II trial substudy. Circulation. 2000 Oct…

…pharmacological basis Sodium glucose cotransporter 2 (SGLT2) inhibitors are a class of oral agents initially developed for glucose lowering in type 2 diabetes mellitus (T2DM…

…is 1% to 2% in most Western populations. Individuals with bicuspid aortic valves may develop symptomatic aortic stenosis already at the age of 60 years…

…bradycardia is caused by beta blockers. Adrenaline (Epinephrine) α and β agonist Infusion of 2–10 μg/min (titrate as needed). T½ 5 min…