Echocardiography Echocardiographic assessment of left ventricular diastolic function Methods for evaluating left ventricular diastolic function have evolved considerably in the past two decades. Currently recommended…

Cardiology Myocardial ischemia and infarction Definition and pathophysiology Ischemic cardiomyopathy is severe myocardial dysfunction caused by coronary artery disease (CAD). The clinical syndrome may resemble…

…particularly HFpEF. Assessment of congestion may be difficult because physical findings and natriuretic peptide concentrations can be altered by adiposity. An “obesity paradox” has bee

…metabolic disorders, hypoxemia, antiarrhythmic drugs, or electromagnetic disturbance caused by other machines/devices. Below follows ECG tracings demonstrating each type of failure. Figure 1. Failure…

…of cardiac arrest patients—can induce such pupillary responses. In a comprehensive study by Javaudin et al., involving more than 11,000 cardiac arrest cases…

…anatomic and functional assessment discordant in a substantial minority of intermediate lesions. Over the past three decades, invasive physiological indices, led by fractional flow reserve…

ECG Myocardial ischemia and infarction The ECG in the assessment of myocardial reperfusion The ECG is an invaluable tool to assess whether an occlusion has…

…AKI coexist. Risk assessment Patient related risk factors The principal determinant of risk is baseline renal function. The risk is increased by: CKD, especially advanced…

…non HDL C primarily reflect cholesterol content. The amount of cholesterol carried by individual particles varies according to particle size and composition. As a result…

Visual assessment of regional wall motion (left ventricle) TYPE OF MOTION DEFINITION WALL MOTION SCORE Normal Normal thickening (typically 30% thickening from end diastole to…

Echocardiography Echocardiographic assessment of regional contractile function Systolic ventricular function is one of the strongest predictors of total and cardiovascular mortality. Previous chapters have discussed…

Echocardiography Left ventricular function and its echocardiographic assessment Cardiac function depends on a large number of parameters, including atrial function, valvular function, and ventricular function…

[calc_123lqts] Long QT Syndrome (LQTS) is an inherited cardiac channelopathy characterized by prolonged ventricular repolarization, which predisposes individuals to malignant ventricular arrhythmias, notably torsade…

ECG Introduction to ECG interpretation The normal T wave Assessment of the T wave represents a difficult but fundamental part of ECG interpretation. The normal…

CPR Basic life support (BLS) can be provided by anyone, including laypeople. As shown in Table 1, BLS is an exceptionally effective treatment, with a…

Echocardiography Diastolic function and echocardiographic assessment The importance of systolic function can be understood on an intuitive basis. Consider the fact that the left ventricle…

…for the assessment of tricuspid stenosis. Yet, there is no consensus regarding grading of tricuspid stenosis severity. Tricuspid stenosis is visually characterized by thickened leaflets…

…symptoms, or the clinical risk is high [1,2]. 1. Perform an ABCDE assessment, attach cardiac monitoring, secure intravenous access and record an ECG. 2…

Cardiology Endocrinology & metabolism Definition and pathophysiology Hypertriglyceridaemia (HTG) is defined by an increased concentration of circulating triglycerides. Both fasting and non fasting measurements provide prognostic…

…axis of the heart Although often ignored, assessment of the electrical axis is an integral part of ECG interpretation. The electrical axis reflects the average…

…Consequently, the CHA₂DS₂ VA score was developed to provide a more accurate risk assessment by omitting the sex category component. Components of the CHA₂DS₂ VA…

5 Year Risk of Life Threatening Ventricular Arrhythmias [calc_123lqts] Long QT Syndrome (LQTS) is an inherited cardiac channelopathy characterized by prolonged ventricular repolarization, which…

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…

ECG Exercise stress test Definition and clinical role Exercise electrocardiographic testing is a standardized assessment in which a patient performs progressively increasing external work, usually…

…medicine Definition and pathophysiology Peripheral artery disease (PAD) is a clinical disorder caused by stenosis or occlusion of the aorta or arteries supplying the limbs…

…to suspected chronic coronary syndrome, is evaluated by estimating the likelihood of obstructive coronary artery disease (CAD) before diagnostic testing. This pre test probability is…

…heart (heart axis) Although often ignored, assessment of the electrical axis is an integral part of ECG interpretation. The electrical axis reflects the average direction…

…ischemia and infarction Definition and Pathophysiology Unstable angina (UA) is an acute coronary syndrome characterized by myocardial ischaemia occurring at rest or with minimal exertion…

…are routinely missed. The third thing to know by heart is that an arterial line must never be confused with a venous access. Indications Continuous…

…is not compatible with a DCD process. The assessment of medical suitability is made by the transplant team. Never rule out a possible donor on…

…technically correct performance is only half the task. The examination must be preceded by information about each step, take place with the patient's ongoing…

…wait for complete diagnostic certainty. Sepsis is defined as life threatening organ dysfunction caused by a dysregulated host response to infection. Clinically this usually corresponds…

…BSA is utilized in various medical applications: Calculation of drug dosages, particularly in chemotherapy Determination of fluid administration Assessment of various hemodynamic and echocardiographic parameters.

Emergency medicine Myocardial ischemia and infarction Definition and pathophysiology Acute coronary syndrome (ACS) comprises a spectrum of clinical presentations caused by suspected acute myocardial ischaemia…

…ostia. It remains the reference standard for defining the extent of coronary artery disease because it provides anatomical information while permitting functional assessment and, when…

…and scope Familial and genetic screening in cardiovascular medicine is the systematic assessment of relatives and other individuals who may carry an inherited predisposition to…

…conditions Definition and pathophysiology Familial hypercholesterolaemia (FH) is an inherited disorder characterized by persistently elevated plasma low density lipoprotein cholesterol (LDL C) from early life…

…injection under fluoroscopy. The procedure is performed by advancing guidewires and diagnostic catheters from a percutaneous arterial access site to the aortic root, engaging the…

…myocardial viability. Both techniques rely on intravenous radiopharmaceuticals that are taken up by myocardial tissue. The distribution of retained tracer provides tomographic information about relative…

…PR interval and PR segment ECG interpretation starts with assessment of the P wave and PR interval. The P wave is generated by depolarization (activation…

…of the P wave, PR interval and PR segment The P wave ECG interpretation usually starts with assessment of the P wave. The P wave…

ECG Introduction to ECG interpretation QT duration and corrected QT (QTc) duration ECG interpretation always includes an assessment of the QT interval (QT duration). The…

…coronary artery disease (CAD). It combines echocardiographic assessment of left ventricular (LV) structure and function with exercise or pharmacological stress. The physiological basis is an…

…structural and ischemic heart disease. Assessment of ischemia on ECG is difficult in the presence of left bundle branch block. This is because left bundle…

…mass is, however, an important parameter in the assessment of ventricular hypertrophy and cardiomyopathy. Numerous formulas have been developed to approximate ventricular mass. Most formulas…

…radiotracers emit gamma photons directly. These gamma rays are detected by gamma cameras to create tomographic images of the left ventricle. In PET (Positron Emission…

…generally not recommended. If deemed necessary after careful individual benefit risk assessment by the prescribing physician: Initial dose : 60 mg single loading dose. Maintenance dose…

…limb salvage. Evaluation and physical examination ALI requires immediate clinical assessment by a vascular specialist or urgent transfer to a facility with vascular expertise. The…

…of breathing, level of consciousness and PEF improve at the same time. Acute severe asthma is characterised by bronchospasm, mucosal oedema and mucus plugging. Expiratory…

…gas describes the physiology at the moment of sampling, but does not by itself identify the cause. The result must always be weighed together with…

…Suspected bone marrow metastasis. Assessment of treatment response and measurement of residual disease (MRD). Fever of unknown origin or suspected granulomatous disease with marrow involvement…

…an asymptomatic rise in blood pressure must be treated urgently, which is not supported by evidence. The patient may need active treatment and prompt follow…

…aphasia and radiological changes resembling ischaemic stroke. Glucose measurement is therefore always part of the initial stroke assessment [1]. Treat immediately when there are symptoms…

…treatment protocols that are available where you practise. Initial management of all poisonings ABCDE Step Assessment and action : : A Assess the airway, the pharyngeal reflexes…

…Despite their proven morbidity and mortality benefits, their use is limited by specific adverse effects. Most of these adverse events are related to the suppression…

…biomarkers, or neither of these abnormalities in the presence of abnormal clinical risk assessment. Low risk PE is characterized by clinical low risk features, negative…

…oxygen demand and coronary blood supply, resulting in myocardial hypoperfusion or ischaemia. Ischaemia is commonly precipitated by exertion, emotional stress, or another form of physiological…

…compartments. Heart failure is defined physiologically by the inability of the heart to provide blood flow appropriate to tissue requirements unless filling pressures are elevated…

…perfused organs, including the kidneys. BNP is additionally removed through the natriuretic peptide clearance receptor and degraded by circulating and tissue enzymes, including neprilysin. Their…

…of stent diameter and length; identification of the proximal and distal reference segments; assessment of stent expansion and apposition; recognition of edge dissection, tissue prolapse…