…blood gas in the same order every time. Skipping a step is a common reason why mixed acid base disorders are missed. The blood gas…

…the circumference, do not guess. Measure the blood pressure in both arms when fitting the device. Use the arm with the higher pressure, or the…

…and blood pressure are monitored. The test is generally symptom limited and is stopped when limiting symptoms, significant electrocardiographic changes, arrhythmias or an abnormal haemodynamic…

…failure (HF) is a clinical syndrome in which the heart cannot deliver blood at a rate appropriate to tissue requirements unless filling pressures are elevated…

…regurgitation results in blood flowing back from the pulmonary artery into the right ventricle during diastole. The most common cause of abnormal pulmonary regurgitation is…

…In acute PE, obstruction of pulmonary blood flow increases RV pressure load and may impair RV filling and forward output. The resulting syndrome may progress…

…and reduced LV systolic function. The principal mechanisms are the combination of an abnormal thrombogenic endocardial surface and blood stasis. During the acute infarction phase…

…discussion. A premature ventricular complex is recognized on the ECG as an abnormal and wide QRS complex occurring earlier than expected in the cardiac cycle…

…an important consideration in older populations. Risk prediction is particularly relevant in adults with elevated blood pressure (BP), in whom absolute cardiovascular risk varies considerably…

…coronary flow reserve (CFR), reduce microcirculatory conductance, or cause abnormal vasoconstriction of coronary arterioles. Structural and functional mechanisms may coexist. The formal diagnostic construct for…

…increased demand using vasodilatory agents). A radiotracer is administered at peak stress to capture blood flow distribution under these conditions. If stress imaging results are…

…Evidence such as increased left atrial size, left ventricular hypertrophy or abnormal LV filling supports the diagnosis Unlike HFpEF, objective evidence of structural or functional…

…intramural haematoma. Spontaneous coronary artery dissection is defined as spontaneous dissection of the coronary artery wall with accumulation of blood within the false lumen, which…

…mastering the nuances of anticoagulation requires an intimate understanding of the underlying pathophysiology, which is classically framed by Virchow’s triad: blood stasis, endothelial dysfunction…

…8%. This implies that approximately one third of the patients who ultimately had a favorable neurological recovery exhibited an abnormal pupillary reflex upon initial examination…

…there is increased resistance across the aortic valve, making it more challenging to pump blood into the aorta. The most common causes are hypertension (in…

…circulation. It is possible to detect elevated levels of myocardial proteins in blood within 2 to 3 hours after the onset of myocardial infarction. Cardiac…

…rhythms. Increased automaticity (in His Purkinje fibers), abnormal automaticity (in contractile myocardium), re entry (anywhere) or triggered activity (anywhere) may all cause ventricular arrhythmias. Indeed…

Endokrinologi & metabolism Akutsjukvård Lathundar Emergency overview Measure the plasma glucose immediately in everyone with a reduced level of consciousness, seizures, confusion, a change in behaviour…

…renal disease are bidirectionally related: hypertension accelerates CKD progression, while impaired renal function further increases blood pressure. Non traditional cardiovascular mechanisms include: Uraemia associated inflammation…

…PAWP ≤15 mmHg, and PVR ≤2 Wood units may have increased pulmonary blood flow rather than pulmonary vascular disease. This state is termed unclassified PH…

…P mitrale (left atrial enlargement) and P pulmonale (right atrial enlargement) Abnormal P waves: atrial enlargement If an atrium becomes enlarged (typically as a compensatory…

…the heart cannot provide blood flow commensurate with the body’s requirements, or can do so only at the expense of abnormally high filling pressures…

…adult Abnormal relaxation (grade 1 dysfunction) Pseudonormal (grade 2 dysfunction) Reversible restrictive filling (grade 3 dysfunction) Irreversible restrictive filling (grade 4 dysfunction) E/A ratio…

…11.029. Pulmonary valve Pulmonary valve regurgitation Mild regurgiation Moderate regurgitation Severe regurgitation Pulmonary valve morphology normal normal/abnormal abnormal Density CW Doppler weak, slow…

…size and volume Women Men Normal range Mildly abnormal Moderately abnormal Severely abnormal Normal range Mildly abnormal Moderately abnormal Severely abnormal ATRIAL DIMENSIONS LA diameter…

Pulmonary valve regurgitation Mild regurgiation Moderate regurgitation Severe regurgitation Pulmonary valve morphology normal normal/abnormal abnormal Density CW Doppler weak, slow deceleration variable dense, steep…

ECG Introduction to ECG interpretation The QRS complex (ventricular complex): normal and abnormal configurations and intervals A complete QRS complex consists of a Q , R…

…imbalance ECG Definition and Pathophysiology Acquired long QT syndrome (LQTS) is characterised by an abnormal prolongation of the QT interval on the surface electrocardiogram (ECG)…

…formerly termed Prinzmetal or variant angina, is myocardial ischaemia caused by transient abnormal vasoconstriction of one or more coronary arteries. Epicardial spasm produces a reversible…

…risk factors, ECG diagnosis and management Atrial fibrillation is the most common abnormal tachyarrhythmia (only sinus tachycardia is more common). The prevalence of atrial fibrillation…

…the liver are the prothrombin time (INR) , the albumin and the bilirubin — and they become abnormal late. A cirrhotic liver can have entirely normal transaminases…

…of the sinoatrial (SA) node. This enhanced atrial activity is most commonly attributable to abnormal automaticity or re entry mechanisms; triggered activity is a less…

…during ventricular contraction and relaxation. Pericardial effusion is the presence of an abnormal amount of fluid in the pericardial space. It can be caused by…

…Because the conduction system is crucial for rapid and synchronized activation of the ventricles, conduction defects will typically cause abnormal ventricular activation (i.e. contraction)…

…V6. Refer to Figure 1 . Abnormal R wave progression implies that the gradual increase from V1 to V5 is absent. It may be broken, as…

…scores. Each incorporates various clinical parameters to stratify bleeding risk. HAS BLED: Incorporates factors such as hypertension, abnormal renal/liver function, stroke history, bleeding history…

…54 30–44 <30 2D, Two dimensional. Ejection fraction (EF) Normal Mildly abnormal Moderately abnormal Severely abnormal Ejection fraction (%), biplan, males 52 72 41 51…

…wave systolic flow reversal, Qualitative parameters Mild regurgiation Moderate regurgitation Severe regurgitation Mitral valve apparatus normal or mildly abnormal often abnormal abnormal, possibly flail CW…

…actually originate from the atria but the QRS complexes become wide due to abnormal ventricular depolarization (e.g sinus tachycardia with simultaneous left bundle branch…

…inversion can occur without coronary artery disease. Proposed explanations in the source material include cardiac memory after abnormal ventricular activation, transient rate related conduction abnormalities…

…in ascertainment and imaging technique. Coronary fistulae represent abnormal communications between a coronary artery and a cardiac chamber or vessel. Other congenital anomalies include anomalous…

…leads [7]. These stricter parameters correlate more closely with abnormal LV mechanical function and the potential benefit of resynchronization pacemaker therapy [7]. R Wave Peak…

…2nd AV block, prolonged QT interval, and profound sinus bradycardia are typically considered abnormal or profound findings that may require further investigation. 2. What heart…

…risk must be considered alongside thromboembolic risk. The HAS BLED score includes hypertension, abnormal renal or liver function, prior stroke, bleeding tendency or previous bleeding…

…clarity, however, tachyarrhythmia is defined as an abnormal and rapid heart rate, whereas tachycardia is defined as the subjective perception of a rapid heart rate…

…changes. Specific electrolyte disorders 1. Sodium Increased (hypernatremia) and decreased (hyponatremia) sodium levels do not have any effect on the ECG, nor cardiac rhythm, or…

…this chapter, you will learn the physiological basis of all ECG waves and how to determine whether the ECG is normal or abnormal. Although heart…

…the rhythm is referred to as sinus rhythm . An arrhythmia is defined as an abnormal heart rhythm or heart rate, which is not physiologically justified …

…slow propagation leads to a delayed and abnormal activation sequence of the right ventricle, resulting in a prolonged and abnormal QRS complex on the ECG…

…This is also a normal finding. Abnormal (pathological) causes of sinus bradycardia In all other situations, sinus bradycardia should be regarded as a pathological finding…

…the QRS complex head in opposite directions, the T wave is said to be discordant which is abnormal. Because most ECG leads have net positive…

…decline and increased mortality [3,4]. Do this first 1. Assess vital signs and level of consciousness immediately. 2. Check oxygen saturation and capillary glucose…

…11.029. Pulmonary valve Pulmonary valve regurgitation Mild regurgiation Moderate regurgitation Severe regurgitation Pulmonary valve morphology normal normal/abnormal abnormal Density CW Doppler weak, slow…

…which abnormal plasma cells produce misfolded immunoglobulin light chains [8, 19]. Light chains are directly toxic to cardiomyocytes, inducing the elaboration of high levels of…

…of myocardial ischaemia and presumed new ischaemic ECG changes, occurring before cTn values become available or abnormal. Type 4a MI: Represents a periprocedural myocardial infarction…

…impaired coronary flow reserve, reduced microcirculatory conductance, or abnormal arteriolar vasoconstriction. More than one mechanism may coexist. Supply–demand mismatch MINOCA may result from a…

…acute coronary atherothrombosis. Type 3 myocardial infarction: presumed fatal myocardial infarction in which death occurs before biomarkers can be obtained or become abnormal, in the…

…High Obesity 35.0–39.9 II Very high Extreme obesity ≥40 III Extremely high BMI is useful for screening and population level risk estimation…

…3 MI. A diagnosis of MI should not be made solely from an abnormal cTn concentration in the absence of evidence of ischaemia. Classification of…