…an achievable programme should incorporate four domains: Aerobic activity Strength training Balance exercises Flexibility exercises Walking, yoga and gardening may provide useful activity for individuals…

…parameters that must be evaluated and the final result of the test depends on an integrated assessment of six components: Symptoms Exercise performance (functional capacity…

…MALE), and improves walking distance. The role of PCSK9 inhibition in thoracic or abdominal aortic aneurysmal disease remains an emerging area of research. Pharmacological Classes…

…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…

…facts, that the paroxysm, or indeed the disease itself, is excited more especially upon walking up hill, and after a meal; that thus excited, it…

…is attempted. Sudden cardiac death is defined as an unexpected death due to cardiac causes that occur within 1 hour of symptom onset. The person…

Arrhythmias and arrhythmology Pharmacology & dosing Definition and Pathophysiology Sotalol is a nonselective beta adrenoceptor blocker devoid of intrinsic sympathomimetic activity that also prolongs cardiac repolarization…

…Lathundar Definition and aims of treatment Convulsive status epilepticus in adults is present with: an ongoing generalised tonic clonic seizure lasting at least 5 minutes…

…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…

…a focal atrial tachycardia pattern on the ECG, characterized by discrete P waves separated by an isoelectric baseline. The most likely mechanism underlying typical atrial…

…Patients require individualized progression because new symptoms during exercise may signal an adverse clinical response. Recreational activity should therefore be increased at an appropriate intensity…

…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…

…is managed following the cardiopulmonary resuscitation (CPR) algorithm, incorporating an intravenous administration of 1 mg epinephrine. Predominant causes of anaphylactic cardiac arrest include food allergies…

…when an ectopic focus within the atria generates electrical impulses at a rate exceeding that of the sinoatrial (SA) node. This enhanced atrial activity is…

…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…

…seizures, confusion, a change in behaviour, collapse or an acute neurological deficit. Hypoglycaemia can cause hemiparesis, aphasia and radiological changes resembling ischaemic stroke. Glucose measurement…

…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…

…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…

…failure. Mechanism of action Enalaprilat is the active metabolite (ester) of enalapril, an angiotensin converting enzyme (ACE) inhibitor. Enalaprilat lowers blood pressure by inhibiting ACE…

Arrhythmias and arrhythmology Emergency medicine Pharmacology & dosing Definition and Pathophysiology Bradycardia encompasses a spectrum of rhythm disturbances characterized by an inappropriately slow heart rate. Within…

…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…

…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…

…nervous system activity Improvement in cardiac metabolic efficiency, including increased oxygen delivery and beta hydroxybutyrate oxidation Reduced sodium hydrogen exchanger subtype 3 activity Attenuation of…

…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…

… however, endothelial dysfunction alone is not sufficient, and an additional trigger is required. Potential triggers include thrombus formation and sympathetic activation. Rho kinase may increase…

…the cells to threshold. Stimulation threshold is the minimum amount of energy required to reach threshold and evoke an action potential. The intensity of the…

…system. ETCO 2 is the partial pressure of carbon dioxide (CO 2 ) at the end of expiration. It provides an integrated view of ventilation , 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…

…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…

…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…

…ATPase) in the ventricular myocardium. Inhibition of Na K ATPase leads to an increase in intracellular concentration of sodium, which affects the sodium calcium exchanger…

…myocardial ischemia during exercise. ECG changes are mentioned briefly (an in depth discussion on ECG changes is provided in the next article). Physiological effects of…

…to the assessment of exercise capacity. Metabolic equivalents (METs) can be used to estimate the energy cost of physical activity. One metabolic equivalent (1 MET…

…under baseline conditions. Raw Image Analysis : Raw images are reviewed to identify potential artifacts, extracardiac tracer activity, and assess image quality and patient motion. Alignment …

…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…

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

…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…

…heart disease is angina pectoris developing during physical activity; myocardial oxygen demand increases during physical activity, but an atherosclerotic plaque may prevent oxygen supply from…

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

…tachyarrhythmia (tachycardia). Sinus tachycardia is the result of an increased rate of depolarization (i.e increased automaticity) in the sinoatrial node. This simply means that…

…cardioversion (ventricular tachycardia). Non shockable rhythm : Cardiac rhythm that cannot be defibrillated or cardioverted. These rhythms include pulse less electrical activity (PEA), asystole, and bradycardia…

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

Psykiatri Akutsjukvård Lathundar Rapid summary Alcohol withdrawal occurs after an abrupt reduction or cessation of prolonged and heavy alcohol intake. The condition can develop despite…

…failure. Mechanism of action Enalaprilat is the active metabolite (ester) of enalapril, an angiotensin converting enzyme (ACE) inhibitor. Enalaprilat lowers blood pressure by inhibiting ACE…

…uncontrolled heart failure, and concomitant valvular disease. Risk factor modification, physical activity, dietary and lifestyle measures, high intensity statin therapy, and appropriate antithrombotic treatment form…

…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…

…age, may not be fully captured by conventional risk scores and may be the first clinically important manifestation of an otherwise unrecognized inflammatory disease. Epidemiology…

…periods, but chronic coronary disease can progress or destabilize abruptly, leading to an acute coronary syndrome (ACS). Clinical manifestations may therefore change over time, including…

…infrahisian block should be maintained, particularly in older patients and those exhibiting a bundle branch block (BBB) or an intraventricular conduction defect. In severe cases…

…inhibitors and inducers. Clinical indications Heart failure with reduced ejection fraction Ivabradine is an adjunctive option for selected patients with symptomatic HFrEF. The guideline defined…

…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…

…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:…

…cholesterol and glucose levels, together with a low salt, low cholesterol diet, regular physical activity, avoidance of smoking, and adequate sleep. The process should begin…