…to be maintained. For older adults, an achievable programme should incorporate four domains: Aerobic activity Strength training Balance exercises Flexibility exercises Walking, yoga and gardening…

…s perceived exertion is a way of estimating the intensity of the physical activity. It is based on the subjective physical sensations experienced during exercise…

…Thus, increased sympathetic activity results in increased heart rate and stronger contractions. Physical exercise increases the venous return to the heart, which results in increased…

…any exercise. The energy cost is expressed as multiples of the resting metabolic rate. For example, 5 METs imply that the energy cost of activity…

…secondary prevention intervention for patients with cardiovascular disease, including those recovering from myocardial infarction. It extends beyond exercise training to incorporate individualized physical activity counselling…

…Thus, vasodilators replicate the effects of exercise on coronary arteries, without the need for physical activity. Advantages of regadenoson over adenosine Regadenoson has advantages over…

…Image acquisition and evaluation Stress Imaging : Initially performed using exercise or pharmacologic agents to elevate myocardial oxygen demand (or simulate increased demand using vasodilatory agents…

…dysfunction and sick sinus syndrome Sinus node dysfunction is an umbrella term for conditions that either affect the automaticity of the sinoatrial node or block…

…exercise (chronotropic incompetence). Although agents such as theophylline and terbutaline can increase the sinus rate, there are generally no reliable and safe drugs available for…

…50 beats/min? A: Proceed directly to an exercise ECG test without repeating the resting ECG. B: Repeat the ECG after mild aerobic activity. C:…

…a clinical syndrome rather than a permanently stable state. Patients may remain stable for prolonged periods, but chronic coronary disease can progress or destabilize abruptly…

…suggested measures include: reassurance; exercise training; volume expansion; avoidance of cardiac stimulants. Beta blockers have been used for symptomatic patients, but effective doses may produce…

…classic claudication. Asymptomatic or atypical PAD remains clinically important. Reduced activity may lead to progressive functional decline, sedentary behaviour and loss of independence. Identification of…

…the overlapping of vulnerable plaque and thrombogenic blood, which are critical determinants for infarction occurrence and extension. Plaque rupture or erosion leads to thrombus formation…

…activity can improve metabolic control and exercise capacity, even when cardiovascular event reduction is not demonstrated in every intervention study. Cardiovascular Risk Assessment Screening for…

…ventricular tachycardia, which may degenerate into ventricular fibrillation at any age. Exercise, or any other activity causing adrenergic stimulation, increase the risk of syncope, ventricular…

…ischemic ST T changes. This is acknowledged in the latest recommendation issued by the International Society for Holter and Non Invasive Electrocardiology , where it is…

…of cardiovascular disease. It has been the number one killer in Western and high income countries for more than half a century, causing approximately 20…

…field of intense research activity. This is partly due to the rise of cardiac imaging and invasive electrophysiological methods which allow for detailed in vivo…

…digitalis effect, marked LVH with ST T changes — is an argument for imaging rather than a conventional exercise test. Preparation and equipment Cycle ergometer with…

…normal FEV₁/FVC. Set aside time, coach actively, and do not accept a trace you would not be prepared to show a colleague. Indications Investigation…

…while awaiting the antidote and specific treatment. Bradyasystole during and after cardiac arrest with persisting electrical activity. Overdrive pacing in bradycardia dependent torsades de pointes…

…bank and, where needed, coagulation expertise at the same time [1]. Activate the local major haemorrhage protocol early. Protocols improve above all the logistics, the…

…or suspected variceal bleeding, also contact a gastroenterologist with hepatology expertise 9 Activate the local major haemorrhage protocol in uncontrolled bleeding, shock or a rapid…

…primarily due to the misuse of prescription medications and illicit substances. Currently, opioid overdose stands as a predominant etiological factor for cardiac arrest within this…

…treated according to the resuscitation algorithm. Cardiac arrest and sudden cardiac death For details regarding sudden cardiac arrest and death, please refer to Sudden Cardiac…

…unchanged primarily by the kidneys, creatinine clearance must be assessed prior to initiation and monitored continuously during therapy. Hypokalemia is a significant risk factor for…

…patient regaining consciousness between them. Five minutes is the practical threshold for treatment, known as t1. After about 30 minutes of continuous convulsive activity, t2…

…a non selective alpha adrenergic blocker. Phentolamine reduces blood pressure while increasing catecholamine activity. Effects Primarily causes afterload reduction. Time to onset of action 1…

…and frequently coexist in the same patient population. AF can act as a trigger for atrial flutter, and the development of AF is common following…

…cholesterol (LDL C). Increased PCSK9 activity therefore contributes to higher LDL C concentrations. The genetic evidence provides the rationale for therapeutic inhibition. Gain of function…

…VF) and pulseless ventricular tachycardia (VT). The bradyarrhythmias include all bradyarrhythmias, pulse less electrical activity (PEA), and asystole. Bradyarrhythmias are discussed in the chapter Management…

…and drug induced reactions. Approximately 90% of anaphylactic cardiac arrests present with pulseless electrical activity (PEA) as the initial rhythm, while the remainder manifest ventricular…

…triggered activity is a less frequent cause. The atrial rate typically ranges from 120 to 250 beats per minute. To fulfill the diagnostic criteria for…

…spontaneous cardiac rhythm. The likelihood of achieving spontaneous cardiac activity is a function of the duration of circulatory standstill and the underlying cause, as elaborated…

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

…for example after relatives have given carbohydrate or glucagon. In a person without diabetes, a hypoglycaemic disorder is defined primarily by Whipple's triad : 1…

…Rostock filter or an equivalent amplifier unit between the electrode and the ECG machine. Lidocaine spray for the pharynx and lidocaine gel for the electrode…

…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…

…pressure or other conventional risk factors. Colchicine is an established anti inflammatory drug that may inhibit inflammasome activity, reduce interleukin 1β and interleukin 6…

…via the autonomic nervous system. It attenuates carotid sinus baroreceptor activity and acts centrally and peripherally to enhance vagal tone. These sympatho inhibitory effects decrease…

…PDEI) activity, which may contribute to its inotropic profile. The drug possesses an active, acetylated metabolite with a half life exceeding 80 hours, allowing for…

…signalling, thereby reducing inflammatory mediator expression and glycolytic activity in relevant renal and cardiovascular cells. These cellular mechanisms remain proposed explanations for observed clinical effects…

…plaque stability, thrombogenic responses and immune activity. Statin intolerance refers to adverse effects attributed to statin treatment that improve or resolve after reducing the dose…

…thrombus formation and sympathetic activation. Rho kinase may increase vascular smooth muscle sensitivity to calcium by inhibiting myosin phosphatase activity. Patients with VA are generally…

…behavior of the pacemaker in the presence and absence of intrinsic cardiac activity, Modern pacemakers are packed with algorithms that optimize the function. For example…

…it is exhaled. The final partial pressure of carbon dioxide in exhaled air represents the sum of ventilation, metabolic activity, and perfusion. Increased aerobic metabolism…

…finding in acute coronary syndromes). Between 3 8 minutes, pulseless electrical activity (PEA) develops. PEA progresses to asystole within minutes, as outlined in the studies…

…followed. Moreover, for optimal management in the context of sepsis induced cardiac arrest, consider the following recommendations: Administer 100% oxygen at the maximum flow rate …

…can be detected using electrodes. The electrocardiograph (ECG machine) records and processes these electrical currents and presents them as the electrocardiogram (ECG). As mentioned earlier…

…The battery is used to deliver pacing pulses, sensing (analyzing electrical activity in the heart) and store electrocardiograms. The pacemaker is powered by a lithium…

…which is synonymous with tachyarrhythmia. Except for sinus tachycardia during physical activity, all tachycardias should be considered pathological and the task is to clarify the…

…effects and lack of compelling data regarding morbidity and mortality benefits, digoxin has been ousted repeatedly from the standard of care for these conditions. However…

…These age variations in heart rate are due to variations in the activity of the autonomic nervous system and changes in the automaticity of the…

…the lowest heart rate allowed by the pacemaker; intrinsic cardiac activity below the base rate will trigger pacing. The base rate is usually set to…

…system ensures rapid and synchronized spread of depolarization, which is essential for coordinated and efficient atrial and ventricular activity. The conduction system includes the sinoatrial …

…cause of pacemaker mediated tachycardia is endless loop tachycardia, which also depends on the ventricular stimulation being triggered by atrial activity. In endless loop tachycardia…

…and high retention, with a linear relationship between myocardial blood flow and measured tracer activity over a wide range (Murthy et al.). As evident in…

…predictors of total and cardiovascular mortality. Previous chapters have discussed several methods for assessment of global and regional ventricular function. Assessment of regional wall motion…

…of sinus tachycardia are as follows: Normal (physiologic) sinus tachycardia: The automaticity (rate of spontaneous depolarization) in the sinoatrial node is increased during physical activity…