…an obstetric procedure or angiographic intervention. Summon anaesthesia, the operating specialty, the blood bank and, where needed, coagulation expertise at the same time [1]. Activate…

…peripheral cannulae. Consider an arterial line if the patient is unstable or frequent blood gases are needed 3 Blood grouping and cross matching. Order red…

…activity level, psychological factors, goals and the intended setting. Pre participation screening should follow applicable cardiovascular exercise screening guidance. In individuals with cardiovascular disease, an…

…This immediately leads to syncope and soon death, unless resuscitation is attempted. Sudden cardiac death is defined as an unexpected death due to cardiac causes…

…His Purkinje system, and ventricle. It extends the A H interval, which serves as an index of AV nodal conduction, but does not significantly alter…

…Airway, breathing and circulation Perform an ABCDE assessment and document the time of seizure onset, or the time the patient was last known to be…

…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…

…on a central area of block, which encompasses both an anatomical barrier (the inferior vena cava) and a functional component. When the direction of the…

…beyond exercise training to incorporate individualized physical activity counselling, risk factor modification, nutritional care, education, psychosocial support, vocational guidance, medical surveillance, and appropriate pharmacological treatment…

…despite maximally tolerated statin therapy and ezetimibe. For patients with a recurrent atherothrombotic event while receiving maximally tolerated statin therapy, an LDL C goal below…

…nearly empty). In patients with an initial shockable rhythm, compressions and ventilation can extend the duration of the shockable rhythm by several minutes, allowing for…

…0.01 mg/kg. Administer 100% oxygen promptly and ensure oxygen saturation remains 94%. Provide an intravenous or intraosseous fluid bolus, beginning with 500 ml…

…the use of theophylline, and elevated catecholamine states. EAT typically has an abrupt onset, although a brief warm up phase lasting approximately 5 to 10…

…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…

…the skin and enables the recording of electrical currents. An ECG lead is a graphical description of the electrical activity of the heart and it…

…warning symptoms are due to sympathetic activation: sweating tremor palpitations hunger anxiety pallor paraesthesiae Neuroglycopenic symptoms An inadequate supply of glucose to the brain can…

…adenosine, which can be given during the recording and unmask the atrial activity. The investigation is diagnostic, not therapeutic. An unstable patient should be cardioverted…

…Chronotropic support is given as an infusion of isoprenaline, adrenaline or dopamine according to local practice, and does not replace pacing when the patient is…

…® Indications Hypertension and hypertensive emergency. Acute left ventricular failure. Mechanism of action Enalaprilat is the active metabolite (ester) of enalapril, an angiotensin converting enzyme…

…50 beats per minute in the first 4 to 6 hours after an acute infarction—patients may develop hypotension and signs of end organ hypoperfusion…

…is an established anti inflammatory drug that may inhibit inflammasome activity, reduce interleukin 1β and interleukin 6 signalling, lower C reactive protein, and impair…

…sinus baroreceptor activity and acts centrally and peripherally to enhance vagal tone. These sympatho inhibitory effects decrease serum norepinephrine levels, plasma renin levels, and potentially…

…these mechanisms, levosimendan also exhibits some type 3 phosphodiesterase inhibitor (PDEI) activity, which may contribute to its inotropic profile. The drug possesses an active, acetylated…

…body weight and haemoglobin A1c Increased uricosuria, with plasma uric acid reduction of approximately 10% to 15% Possible effects on erythropoietin activity and erythropoiesis SGLT2…

…100 containing lipoproteins and exert effects beyond LDL C reduction, including modulation of inflammation, oxidative stress, endothelial function, plaque stability, thrombogenic responses and immune activity…

…required. Potential triggers include thrombus formation and sympathetic activation. Rho kinase may increase vascular smooth muscle sensitivity to calcium by inhibiting myosin phosphatase activity. Patients…

…not sense depolarization outside these boundaries, which may lead to undersensing of true intrinsic activity and thus inappropriate pacemaker activity. As discussed in the previous…

…the partial pressure of carbon dioxide (CO 2 ) at the end of expiration. It provides an integrated view of ventilation , metabolism , and perfusion . Carbon dioxide…

…minutes, pulseless electrical activity (PEA) develops. PEA progresses to asystole within minutes, as outlined in the studies by DeBehnke et al. and Safar et al…

…JE, Gwyther R, Kirkman E. Closed chest compressions reduce survival in an animal model of haemorrhageinduced traumatic cardiac arrest. Resuscitation 2019; 140:37 42. Endo…

…small to be detected by skin electrodes; the ECG presents the electrical activity of the atrial and ventricular myocardium. Automaticity of pacemaker cells The automaticity…

…electrons depolarize the myocardium and thus trigger an action potential that will spread through the myocardium. The electrodes are also used to record electrical activity…

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

…ECG changes and vice versa (i.e. ECG changes may be pronounced without any arrhythmias occurring). Plasma levels 2 ng/mL are considered an overdose…

…physical activity. It is based on the subjective physical sensations experienced during exercise, including increased heart rate, increased respiratory rate and depth, increased sweating, and…

…SA) node and atrioventricular (AV) node. Parasympathetic stimulation reduces the automaticity in the sinoatrial node, which lowers the heart rate. The parasympathetic activity also diminishes…

…It should be noted that 85% is an arbitrary number and the exercise test must never be terminated once the patient has reached 85% of…

…with signal intensity comparable to background activity, typically representing infarcted tissue or non viable myocardium. Perfusion patterns and reversibility Perfusion patterns are systematically analyzed by…

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

…Figure 3. Spontaneous atrial activity is sensed by the atrial lead and triggers ventricular stimulations. The QRS complex is wide due to ventricular depolarization proceeding…

…coordinated and efficient atrial and ventricular activity. The conduction system includes the sinoatrial (SA) node, atrioventricular (AV) node, Bundle of His, bundle branches (left and…

…by atrial activity. In endless loop tachycardia, the ventricular impulse manages to propagate to the atria where the atrial electrode records the impulse (and assumes…

…and A3 receptors, which are associated with adverse effects such as bronchoconstriction and atrioventricular block. Adenosine is an agonist on A1, A2A, A2B and A3…

…An ideal tracer exhibits high extraction from blood to tissue and high retention, with a linear relationship between myocardial blood flow and measured tracer activity…

…since the myocardium adapts and downregulates metabolism to avoid developing ischemia. According to this theory, ischemia occurs only if there is an absolute lack of…

…blockers) without the risk of worsening the bradycardia. Persons with sick sinus syndrome should receive an artificial pacemaker to reduce symptoms and increase function. However…

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

…shockable rhythm : Cardiac rhythm that cannot be defibrillated or cardioverted. These rhythms include pulse less electrical activity (PEA), asystole, and bradycardia. No Flow : Circulatory standstill…

…the ventricles to have any electrical (and thus pumping) activity at all, an escape rhythm must arise in an ectopic focus (located distal to the…

…and several syndromes can overlap [1,4]. Time after a clear reduction or the last intake Common clinical picture : : 4 to 12 hours Tremor, sweating…

…blood pressure by inhibiting ACE. Effects • The hypotensive effect of enalaprilat depends on plasma volume and plasma renin activity. Volume depletion and high plasma renin

…and concomitant valvular disease. Risk factor modification, physical activity, dietary and lifestyle measures, high intensity statin therapy, and appropriate antithrombotic treatment form the broader management…

…of an acute myocardial infarction during long term follow up. Moreover, several potentially high risk plaques may coexist within one coronary tree, and inflammatory activity…

…Excess mortality becomes apparent approximately 7–10 years after diagnosis and is associated with persistent disease activity, rheumatoid factor and anti cyclic citrullinated peptide antibodies…

…in patients with diabetes and autonomic neuropathy, as well as in older adults with markedly limited physical activity. Traditional labels such as “typical” and “atypical”…

…or pulseless electrical activity (PEA). Evaluation and Physical Examination The source material does not provide specific details regarding the physical examination maneuvers for patients with…

…70 beats/min; persistent symptoms despite evidence based therapy with an ACE inhibitor or ARNI, a beta blocker and a mineralocorticoid receptor antagonist. In this…

…Reduced activity may lead to progressive functional decline, sedentary behaviour and loss of independence. Identification of PAD also provides an opportunity to recognise atherosclerosis in…

…an acute tear causes haemopericardium, tamponade, and sudden: Loss of pulse. Loss of blood pressure. Loss of consciousness. Electromechanical dissociation or pulseless electrical activity despite…

…Bundle Branch Block, defined by an rSR' pattern in lead V1 and a qRS pattern in lead V6 with QRS duration <120 ms, is listed…