…5. Biopsy any ulcer that has not healed within three months despite adequate treatment — malignancy (Marjolin's ulcer, basal cell carcinoma) and vasculitis do occur…

…Advantages of measuring MAP over systolic blood pressure While systolic blood pressure (SBP) indicates the maximum pressure during heart contraction, it does not provide a…

…not provide specific details regarding the physical examination or general evaluation of patients with bradycardia. Diagnostics Electrocardiographic assessment is fundamental to the diagnosis and management…

…specialist lipid assessment is required. A comprehensive cardiovascular assessment should include review of modifiable risk factors and associated disease. The supplied material does not specify…

…immediate clinical assessment by a vascular specialist or urgent transfer to a facility with vascular expertise. The initial evaluation should establish: The time of symptom…

…does not describe specific physical signs of CTO or a dedicated physical examination algorithm. Diagnostics Non invasive assessment of ischaemia and viability Objective evidence of…

…function. In the context of cardiac arrest and the post resuscitation period, assessment of the PLR has long been considered for its prognostic implications. Clinicians…

…Do not wait for laboratory results, CT or EEG before the first dose of benzodiazepine is given. Airway, breathing and circulation Perform an ABCDE assessment…

…setting of suspected ischaemia or previous infarction Dyspnoea requires assessment of dynamic LV function, valve disease, pulmonary pressure, or haemodynamics Stress imaging is not recommended…

…respiratory or circulatory compromise despite two adequate intramuscular doses of adrenaline and initial fluid treatment Adrenaline infusion and advanced resuscitation in a monitored setting The…

…pressures are reduced. The central management principle is preservation of adequate right ventricular preload while supporting left ventricular performance and systemic circulation. Improvement in left…

…can often be used for an initial assessment of pH and the metabolic component, but it should not be regarded as fully interchangeable with an…

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…

…ECG can reveal the following types of pacemaker dysfunction: Failure to capture (FTC) , which means that the pacemaker stimulations do not result in myocardial activation…

…is a poor surrogate for the hemodynamic significance of a coronary lesion, with anatomic and functional assessment discordant in a substantial minority of intermediate lesions…

ECG Video lecture: Assessment of rhythm & P wave

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…

ECG Video lecture: Assessment of the electrical axis of the heart

…not be applied as the principal risk tool in people with: Documented atherosclerotic cardiovascular disease (ASCVD) Diabetes mellitus in circumstances where diabetes specific risk assessment…

…Introduction to ECG interpretation The electrical axis of the heart Although often ignored, assessment of the electrical axis is an integral part of ECG interpretation…

…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…

…can have pathophysiological characteristics that differ from those of non obese patients, and obesity complicates assessment of intravascular volume in both ambulatory and inpatient settings…

…The QRS complex reflects the depolarization (activation, contraction) of the ventricles. Although it may not always include a Q wave, R wave and S wave…

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

…was the reason for conducting the test). Chest pain rated as 6 or above (according to the 10 point scale) should prompt termination of the…

…as misalignment can lead to incorrect interpretation of perfusion differences. Perfusion assessment The assessment of myocardial regions in myocardial perfusion imaging (MPI) is based on…

…Management of acute bradycardia in the emergency setting. Parameter Assessment A Airway Voice Breath sounds B Breathing Respiratory rate (12–20 / min) Chest wall movements…

…and diffuses freely across cell membranes, allowing for precise quantification of myocardial blood flow and assessment of coronary flow reserve. A single session can be…

…if invasive ventilation is not immediately required. 8. Document the ceiling of care and the decision on intubation early. Initial assessment Confirm that the presentation…

…a qualitative assessment of CAC on a non gated chest CT, can modify the estimated likelihood of atherosclerotic obstructive CAD. CAC is therefore not merely…

…otherwise stable patients. More than 48 hours after onset: routine PCI of an occluded infarct related artery is not recommended in stable, asymptomatic patients without…

…on treatment assessment. In most studies, its association with cardiovascular risk is at least as strong as, and often stronger than, that of LDL C…

…burden of nonviable or scarred myocardium is associated with less improvement in LVEF. Nevertheless, improvement in LVEF is not the only possible objective of revascularization…

…In contrast, haemodynamically stable patients without ST segment elevation after successful resuscitation from out of hospital cardiac arrest should not routinely undergo immediate angiography. A…

…interpretation of ischemia. All available ECG criteria for acute myocardial infarction and ischemia are based on conventional 12 lead ECG. Established ECG criteria do not…

…suffered a stroke/TIA, to assess whether the embolic source is the most likely cause of the event. Echocardiographic assessment of cardiac embolic sources re

…represents the depolarization (activation) of the ventricles. It is always referred to as the "QRS complex" although it may not always display all three waves…

…may not be causal. Renal dysfunction after PCI may reflect contrast associated injury, haemodynamic instability, cholesterol embolisation, or a combination of these mechanisms. Contrast volume…

…Out of office measurement is consequently central to diagnosis and long term management. Clinical presentation and symptoms The source material does not describe the typical…

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…

…The myocardium is capable of upregulating or downregulating metabolism (i.e contractility) according to oxygen supplies. Consequently, reduced oxygen supply would not result in ischemia…

ECG Video lecture: Assessment of the QT interval (QTc interval) Corrected QT interval (QTc) calculator Open the calculator →

…combines anatomical imaging with functional assessment. A central practical principle is that the visual severity of a stenosis does not reliably establish its haemodynamic importance…

[calc_aorta] Sinus of Valsalva (SOV) and Aortic Root Assessment The sinus of Valsalva diameter (SOVd) is a critical measurement in evaluating aortic root morphology…

…left atrium and the ventricle diminishes, and the passive filling subsides. The greater the ventricular compliance, the larger the volume of blood that flows fr

…segment deviation are not ischemic! However, T wave inversions that are accompanied by ST segment deviation (either depression or elevation) is representative of ischemia (but…

…its echocardiographic assessment Cardiac function depends on a large number of parameters, including atrial function, valvular function, and ventricular function. A large body of science…

…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…

Procedurer The value of the exercise test lies not in ST depression alone but in the overall picture : exercise capacity, symptoms, blood pressure response, heart…

…and the intubator not being an anaesthetist (1 point). A score of 3 or more indicates a difficult intubation — call for help and get out…

…genotypes. These medications mitigate adrenergic stimulation, thereby decreasing the likelihood of arrhythmia onset. However, beta blockers do not fully eliminate the risk. In LQT3 patients…

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

…calculator has significantly advanced the detection and management of CKD, clinicians should be aware of its limitations. In cases where precise GFR assessment is critical…

…This approach fails to identify a substantial subset of patients with acute coronary occlusion (ACO) who do not meet the established ECG criteria for STEMI…

…cheapest and most accessible method of objectively demonstrating peripheral arterial disease, and it is needed more often than it is used — not only in claudication…

…Checking an intrauterine device or a pessary. Assessment of prolapse. Sampling for a suspected sexually transmitted infection — although chlamydia and gonorrhoea can be tested on…

…Emergency management in brief The intensity of treatment is governed by ECG changes, symptoms, the rate of rise, renal function and the clinical context , not…

…time, coach actively, and do not accept a trace you would not be prepared to show a colleague. Indications Investigation of chronic cough, dyspnoea, wheeze…

…coagulopathy. Severe uncontrolled hypertension. Recent intracranial haemorrhage without a fresh assessment of benefit and risk. An inability to attend for sampling and follow up — relative…

…recommended in the vascular assessment. A carotid bruit is an important marker of cardiovascular risk, although the source material does not provide diagnostic sensitivity or…