…the pressure in the aorta. The greater the pressure in the aorta, the greater the load on individual muscle fibers. Also, the load on individual…

…participate in a sustained inflammatory response. Lipid accumulation, oxidative stress and immune activation progressively alter the local vascular environment. The extracellular matrix is an active…

…excited, it is accompanied with a sensation, which threatens instant death if the motion is persisted in; and, that on stopping, the distress immediately abates…

… rather, it is the biological composition and inflammatory activity of the plaque that dictate clinical risk [8] . Plaques The architecture and composition of the atherosclerotic…

…which spreads through the myocardium like a wavefront in water. Specific ion channels located on the cell membranes open and close during de and repolarization…

…Upon such damage, the plaque exposes highly thrombogenic materials which activate circulating platelets and coagulation factors, which results in thrombus formation (Figure 1). Disruption of…

…be considered. The doses and Swedish thresholds below are based on the national guideline for the management of reperfusion treatment in ischaemic stroke, Nationell arbetsgrupp…

…Proceed in parallel to definitive control of the bleeding. Activate the protocol in Activation must be based on an overall assessment, not on a single…

…a new oxygen requirement, a saturation below 93 per cent on air, or a falling PaO2 Circulation A systolic blood pressure of 100 mmHg or…

…regulation. Diagnosis is based on the coexistence of defined clinical and laboratory components; the diagnostic criteria themselves are not reproduced in the available source material…

…P wave vector is slightly curved in the horizontal plane. It is initially directed forward but then turns left to activate the left atrium ( Figure…

…The cells of the sinus node have an intrinsic rate of depolarization at approximately 70 times per minute, which results in 70 contractions per minute…

…constant PR interval. Third degree AV block: all atrial impulses are blocked in the AV conduction system and therefore cannot activate the ventricles. An escape…

…10.0 μg/kg/min + ++++ + +++++ Intermediate dose dopamine activates β1, releases noradrenaline and thereby increases contractility and chronotropy, with a slight rise in SVR…

…consultant on call early. In cirrhosis or suspected variceal bleeding, also contact a gastroenterologist with hepatology expertise 9 Activate the local major haemorrhage protocol in…

…Reduction in body weight and haemoglobin A1c Increased uricosuria, with plasma uric acid reduction of approximately 10% to 15% Possible effects on erythropoietin activity and…

…or ventricular activity (R wave). The signals causing oversensing may not be visible on surface ECG. Oversensing may also occur when electrical events in one…

…where interneurons in the pretectal area activate the Edinger–Westphal nuclei. Parasympathetic fibers (carried by CN III) then prompt sphincter muscles in the iris to…

…centre, and activate the emergency medical response system using your local emergency number. Contact the nearest intensive care unit with expertise in toxicological emergencies. Antidote…

…acute myocardial infarction who do not display bundle branch block on the arrival ECG, will in most cases not develop bundle branch block during the…

…gone from routine to exception. Activated charcoal — in Sweden usually called medicinal charcoal — is the first line measure in decontamination, and gastric lavage is today…

…arterioles and veins via generation of cyclic GMP, which then activates calcium sensitive potassium channels in the cell membrane. Time to onset of action : 1…

…on the extracellular surface of cardiac cells. Through the guanine nucleotide regulatory proteins Gi and Go, adenosine activates potassium channels (IK.Ach, K.Ado) in…

…is a prodrug activated predominantly in the liver by very long chain acyl CoA synthetase 1. This activating enzyme is not expressed in skeletal muscle…

…resting heart rate 75 beats/min, based on a retrospective subgroup analysis in which a survival benefit was observed. Inappropriate sinus tachycardia Treatment of inappropriate…

…tolerate higher pressures. Lubricant on the dorsal surface of the mask, a syringe for the cuff in the models that have one, a cuff manometer…

…0 μg/kg/min. + ++++ + +++++ Medium dose dopamine activates β1, releases norepinephrine and thus increases contractility, chronotropy and mild increase in SVR. Ventricular arrhythmias Myocardial…

…of cyclic GMP, which then activates calcium sensitive potassium channels in the cell membrane. Nitroglycerin is similar in action and pharmacokinetics to nitroprusside, although the…

…pattern on the ECG, characterized by discrete P waves separated by an isoelectric baseline. The most likely mechanism underlying typical atrial flutter is reentry. In…

Cardiology Critical care Pharmacology & dosing Definition and Pathophysiology In the management of acute heart failure and cardiogenic shock, intravenous vasoactive agents are categorised according to…

…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…

…capnograph not activated. Displacement of the tracheal tube. Cardiac arrest without adequate blood flow or ineffective compressions. While ETCO 2 is optimally measured in tracheal…

…0 μg/kg/min. + ++++ + +++++ Medium dose dopamine activates β1, releases norepinephrine and thus increases contractility, chronotropy and mild increase in SVR. Ventricular arrhythmias Myocardial…

…act as latent pacemakers (which become active when atrial impulses do not reach the atrioventricular node). The cells in the atrioventricular node itself may start…

…activation of the piezoelectric crystals. The crystals are activated from one side to the other, as illustrated in Figure 2. The sequence of activation goes…

…regular (as is the atrial) with a rate ranging between 150 and 250 beats per minute. The P wave is not visible in most cases…

…Harmful neurohormonal pathways are activated, similar to those seen in heart failure. A thorough review on the pathophysiology of tachycardia induced cardiomyopathy is provided by…

…thereby the impulse delay in the AV node. Therefore, the ventricles will be activated (depolarized) earlier than expected, which is reflected on the ECG by…

…vigorous intensity activity. Muscle strengthening exercise should additionally be performed on at least 2 days each week. Activities need not be undertaken in bouts of…

…ECG Ventricular fibrillation, pulseless electrical activity (PEA) and sudden cardiac arrest This chapter will focus on ventricular fibrillation and pulseless electrical activity (PEA). These are…

…l isomers, which share similar efficacy in prolonging repolarization. However, the l isomer is responsible for virtually all of the beta blocking activity. Sotalol does…

…activity, 2. secure oxygenation, ventilation and the circulation, 3. identify and treat the precipitating cause, 4. prevent recurrence and secondary brain injury. The doses in…

…reduce the antiplatelet effect of acetylsalicylic acid. Use with caution in patients on low dose acetylsalicylic acid for cardioprotection. Pharmacokinetic interactions Methotrexate: NSAIDs inhibit tubular…

DICTrank: The Largest Reference List of 1318 Human Drugs Ranked by Risk of Drug Induced Cardiotoxicity Using FDA Labeling . Drug Discovery Today. 2023. DICT =…

…The hypotensive effect of enalaprilat depends on plasma volume and plasma renin activity. Volume depletion and high plasma renin activity increase the effect of enalaprilat…

…crisis. Mechanism of action Phentolamine is a non selective alpha adrenergic blocker. Phentolamine reduces blood pressure while increasing catecholamine activity. Effects Primarily causes afterload reduction…

…The modern concept of rehabilitation has evolved from early post infarction physical activity programmes into a structured centre of secondary cardiovascular prevention in which exercise…

…magnitude of LDL C lowering depends partly on residual LDL receptor expression. PCSK9 monoclonal antibodies are less effective in homozygous FH when residual LDL receptor…

…of the Electrical Axis The heart's electrical axis represents the net vectoral sum of all active electrical wavefronts at any given point in time…

…bradyarrhythmias include all bradyarrhythmias, pulse less electrical activity (PEA), and asystole. Bradyarrhythmias are discussed in the chapter Management of Bradycardia (Bradyarrhythmia). Initial rhythm and the…

…per guidelines. Most patients require an immediate intravenous dose of 1 mg epinephrine . For anaphylaxis without cardiac arrest: Administer 0.5 mg epinephrine intramuscularly in…

…re entry mechanisms; triggered activity is a less frequent cause. The atrial rate typically ranges from 120 to 250 beats per minute. To fulfill the…

…likelihood of achieving spontaneous cardiac activity is a function of the duration of circulatory standstill and the underlying cause, as elaborated in earlier chapters (see…

…An ECG lead is a graphical description of the electrical activity of the heart and it is created by analyzing several electrodes. In other words…

…clinician. The examination is typically as brief as the intervals required for rhythm checks. Achieving clear echocardiographic windows during active compressions is challenging; however, subcostal…

…aspirin if acute coronary syndrome is likely and aortic dissection or active major bleeding is not suspected. 6. Call the PCI service immediately in STEMI…

…by evidence. The patient may need active treatment and prompt follow up, but not necessarily acute normalisation in the emergency department [1,3]. Step 1…

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

…electrode are connected to the inputs of the filter ("IN−" and "IN+"). The oesophageal signal is thereby displayed in the V5 channel on the printout…

…mg Oral bioavailability about 35 per cent Paracetamol PO or IV 1 g × 4 The basic analgesic; always give it in parallel unless contraindicated NSAID…