…or other extracorporeal therapy (requires a large bore dialysis catheter, not an ordinary triple lumen catheter). Measurement of central venous pressure and central venous oxygen…

…not borne fruit. Our current ability to predict cardiac arrest remains poor at best. A key explanation for this is the stochastic nature of sudden…

…discussion: the ECG blog ECG The best ECG book is not the one making it simple In the thrilling and ever evolving field of medicine…

…beat). This yields more time to fill the ventricles with blood (increased ventricular filling). Persons with premature beats might perceive this as palpitations, because of…

CPR ECG 1 . The initial rhythm is atrial fibrillation. The fifth beat is a ventricular premature beat. A ventricular tachycardia (VT) emerges. As evident, ventricular…

…dislocation is reduced with muscle relaxation, not with force. The methods that work best exploit time, gravity and slow movement; those that fail usually do…

…Table 1. Normal limits for ECG parameters during neonatal period (Davignon et al) These reference values are the best available for the neonatal period. The…

…Table 1. Normal limits for ECG parameters during neonatal period (Davignon et al) These reference values are the best available for the neonatal period. The…

…tachycardia (VT). ECG 2 . Spontaneous termination of ventricular tachycardia (VT). ECG 3 . A single ventricular beat, followed by a three ventricular beats (VT). ECG 4…

…in the emergency department with simple equipment. Two principles determine the outcome: the first attempt is the best attempt , and a button battery is an…

…low risk beat — the previously undescribed biomarker identified by the deep learning model. Predicting sudden cardiac arrest Sudden cardiac death (SCD) remains one of the…

…are supraventricular beats during sinus rhythm. A brief run of polymorphic ventricular tachycardia (VT) occurs after the 4th beat. The VT terminates spontaneously after a…

…hypertension and a rightward shifted autoregulation [1,3]. The term hypertensive urgency is best avoided. It implies that an asymptomatic rise in blood pressure must…

Procedurer A corticosteroid injection into soft tissue gives rapid but time limited pain relief and rarely alters the natural history of the disease. In lateral…

…Additional PISA parameters Mild regurgiation Moderate regurgitation Severe regurgitation Regurgitation volume (ml/beat) < 30 30 59 59 Regurgitation volume = EROA x TVI Regurgitation…

…sinus beat typically exhibits a longer QT interval, and the T wave is interrupted by a PVC, which serves as the first beat of the…

Cardiology Genetic and miscellaneous conditions Clinical Red Flags Raising Suspicion of Cardiac Amyloidosis Demographic and Clinical Context Cardiac amyloidosis should be suspected in patients older…

…left bundle branch block alternating from one beat to another) is uncommon. Ashman's phenomenon : This type of aberration occurs when the RR interval is…

…by means of dialysis. Substance Antidot e Paracetamol (Acetaminophen) N Acetylcysteine Anticholinergics Physostigmine Anticoagulants (apixaban) Andexanet alpha Benzodiazepines Flumazenil The Black Widow, Spider Bett Lactrodectus…

…compression of the ventricles during diastole; cardiac tamponade occurs if excess pericardial fluid causes hemodynamic effects. Electrical alternans – i.e the beat to beat variation…

…that the zoom encloses a specific region of the image, whereas shifting focus simply adjusts the location (along the ultrasound beam) with the best resolution…

Echocardiography Principles of echocardiographic examinations In small children, it is possible to perform the entire transthoracic echocardiography (TTE) with the child in the supine position…

…a premature ventricular contraction. Classification of premature ventricular contractions When every other beat on the ECG is a premature ventricular complex (PVC), the rhythm is…

…the ECG, this is observed as a gradual prolongation of the PR interval with each successive beat until a P wave fails to conduct, resulting…

…to obtain the best possible image quality. Image optimization and requires experience, patience, and correct instrumentation settings. Technical aspects of optimization of image quality have…

…minute At least 110 per minute Bradycardia or arrhythmia PEF Over 50 percent of personal best or predicted 33 to 50 percent Under 33 percent…

…good absorption and are best given orally when gut function is intact. Oral vancomycin (only for C. difficile) is likewise dosed independently of renal function…

…and a warm, well perfused hand carry more weight. Choice of vessel The radial artery is the first choice : superficial, easy to compress, with a…

…block, Mobitz I (Wenckebach): repeated episodes with progressive lengthening of the PR interval until an atrial beat is blocked (the QRS complex fails to appear)…

…indexed Aortic annulus 20 31 mm 12 14 mm/m2 Sinuses of Valsalva 29 45 mm 15 20 mm/m2 Sinotubular junction 22 36 mm…

…the visual acuity before anything else is done. The second most important is to look for signs of perforation — Seidel's sign, an irregular pupil…

…insufficient randomised evidence to determine which agent is best. The choice is therefore governed chiefly by the target organ damage, the pharmacology of the drug…

…has a protective function, and the commonest complication of ear syringing is that someone syringes an ear that did not need syringing. The second commonest…

…pressure Marked respiratory variation in mitral and tricuspid inflow The echocardiographic counterpart of pulsus paradoxus Contraindications In overt tamponade with shock there are no absolute…

…a gradual alteration in the QRS amplitude, often with twisting of the QRS complex around the isoelectric line. Most patients display QTc 500 ms during…

…early diastolic early diastolic holodiastolic Quantification of regurgitant jet Mild regurgitation Moderate regurgitation Severe regurgitation Jet width / LVOT width < 0,25 0,25 0…

…are rarely useful, as myocardial concentration—which correlates best with total cumulative dose—may be a better predictor of long term tolerability. Hemodynamic Effects Amiodarone…

…ischemia and infarction Definition and pathophysiology Post infarction pericarditis encompasses two temporally and clinically distinct complications of acute myocardial infarction (AMI): Early infarct associated pericarditis …

…a gradual alteration in the QRS amplitude, often with twisting of the QRS complex around the isoelectric line. Most patients display QTc 500 ms during…

…Flutter waves are typically best seen in leads II, III aVF, V1, V2 and V3. The exact appearance of the flutter waves will depend on…

…clinical relevance and it may lead to misunderstanding. Use of the term PSVT is therefore not recommended. Synonyms for AVNRT Atrioventricular nodal reentrant tachycardia Atrioventricular…

…LVH) and right ventricular hypertrophy (RVH). The electrical vector of the left ventricle is enhanced in LVH, which results in large R waves in left…

…single best predictors of risk for future adverse events in virtually all patient populations, including apparently healthy individuals. Exercise stress testing in the age of…

…at best, suboptimal. Clinical judgment remains a more reliable tool for evaluating ischemia in these cases, a point emphasized in recent guidelines. Implications of left…

…cause of death in stable outpatients with heart failure. JACC. Braunwald et al: Determination of fraction of left ventricular volume ejected per beat and of…

…constituting 35% of myocardial mass and 5 apical segments, constituting 30% of myocardial mass. The 17 segment model provides the best agreement with anatomic data…

…ECG, clinical characteristics and management Pre excitation The atrioventricular node and bundle of His are normally the only communication between the atria and the ventricles…

…echocardiography should receive information regarding the conduction of the examination. Some patient engagement is required to obtain all views and the best possible image quality…

…in the management of valvular conditions, such as aortic stenosis, aortic regurgitation, mitral valve stenosis, mitral valve regurgitation, etc. The radius of PISA is measured…

…PMVT): Characterized by a continuously changing QRS morphology and axis, indicating a dynamic sequence of ventricular activation. PMVT is frequently associated with acute myocardial ischemia…