…hour half life, entering cardiomyocytes via the Na + /K + ATPase pump. It undergoes redistribution, making it suitable for assessing viability and hibernating myocardium, at the…

…with expected blood loss or large volume shifts. Patients in whom non invasive measurement is unreliable: marked obesity, pronounced vasoconstriction, arrhythmia, intra aortic balloon pump…

…hemodynamics without increasing heart rate or decreasing blood pressure, making it a consideration for patients with low blood pressure secondary to a low cardiac output…

…of ischaemic symptoms. The immediate pathophysiological objective is restoration of blood flow to the infarct related myocardial territory and limitation of infarct size. The extent…

…by means of an extracorporeal pump and oxygenator. ECMO (Extracorporeal Membrane Oxygenation) , a type of ECLS, operates by drawing venous blood from the patient to…

…there is increased resistance across the aortic valve, making it more challenging to pump blood into the aorta. The most common causes are hypertension (in…

…pulmonary artery pressure etc . The right atrium must then enlarge (hypertrophy) in order to manage to pump blood into the right ventricle. Right atrial enlargement …

…Afterload : Afterload is the resistance that the the ventricle must overcome to pump blood out into the pulmonary artery. Resistance may increase in, for example…

…cannula: Intravenous drug treatment, fluid or blood products. Contrast medium for CT (this requires a large bore cannula in a suitable vein). Standby access in…

…Pressure (CVP) This equation illustrates that MAP is determined by the volume of blood the heart pumps and the resistance encountered in the systemic circulation…

…the aortic valve opens and blood is ejected into the aorta. Left ventricular volume decreases as the ventricle contracts and pumps blood into the aorta…

…increases the venous return to the heart. Contracting muscles function as a pump that propels blood back to the heart. The respiratory depth (volume) increases…

…sodium–potassium pump, mitochondrial function, actin myosin interactions, etc. ). Afterload Afterload is the resistance that the left ventricle must overcome to eject blood into the…

…pulmonary artery pressure etc . The right atrium must then enlarge (hypertrophy) in order to manage to pump blood into the right ventricle. Right atrial enlargement …

…larger than the left ventricle. This is explained by the fact that the right ventricle pumps blood against greater resistance, as compared with the left…

…larger than the left ventricle. This is explained by the fact that the right ventricle pumps blood against greater resistance, as compared with the left…

…failure. A peripheral venous blood gas is easier to obtain and can often be used for an initial assessment of pH and the metabolic component…

…by home measurement or 24 hour recording — the thresholds for which are lower than for office measurement. Classification of office blood pressure Category Systolic Diastolic : : :…

…in acute haemorrhage and a normal value does not exclude significant blood loss. Massive haemorrhage meeting the criteria for activation of the massive transfusion protocol…

Cardiology Clinical medicine Definition and Clinical Context Blood pressure management in older adults must account for chronological age, biological age, frailty, multimorbidity, cognitive status, functional…

…the circumference, do not guess. Measure the blood pressure in both arms when fitting the device. Use the arm with the higher pressure, or the…

…Conversely, a rapid rise in blood pressure from a previously low level can cause organ damage at lower values, for example in pregnancy, acute glomerular…

…Exercise performance (functional capacity, exercise capacity) Heart rate: maximal heart rate, heart rate response Blood pressure reaction ECG reaction: ST changes, T wave changes, arrhythmias…

…Reference values for coronary blood flow Normal coronary blood flow at rest: 0.6 to 1.3 mL/min/g of myocardial tissue During hyperemia…

…immediate blood pressure lowering treatment is required. Patients with suggestive symptoms, signs or a medical history indicating possible secondary hypertension should undergo appropriate screening for…

Cardiology Emergency medicine Definition and Pathophysiology A hypertensive emergency is severe blood pressure elevation accompanied by acute hypertension mediated target organ damage (HMOD). The European…

…because it can increase blood pressure and may affect interpretation of the clinical picture. A 24 hour urine collection for electrolytes can be used to…

…Haemodynamic measurements become interpretable only when related to one another. A low blood pressure may be due to low flow, low vascular tone or both…

…that the aortic valve leaks during diastole, such that blood regurgitates back from the aorta into the left ventricle. This results in volume overload in…

CPR Hypoxia and asphyxiation Hypoxia refers to a reduced partial pressure of oxygen in the blood. Asphyxia is characterized by insufficient ventilation, leading to hypoxia…

…volumes, and pressure conditions in the heart. These techniques allow for the calculation of all clinically relevant hemodynamic parameters, with few exceptions. Prior to the…

…cardiomyopathy with outflow tract obstruction Caution Tachyarrhythmia or bradyarrhythmia Rate control first Blood pressure 200/110 mmHg at rest Treat first Electrolyte disturbance Correct Second…

…Where serious poisoning is suspected, blood and urine can be saved early for later targeted analysis. Initial monitoring and investigations Investigation Comment : : Plasma glucose Taken…

…nitroglycerin regularly may have developed tolerance and require higher doses, alternatively nitroprusside to achieve desirable blood pressure lowring effect. Drug Nitroglycerin Brand names Gonitro ®…

…Pulmonary hypertension. Blood pressure control. Mechanism of action Nitroprusside provides nitric oxide (NO) that induces vasodilatation of both arterioles and veins via generation of cyclic…

…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…

…Pharmacology & dosing Definition and pathophysiology Heart failure is a clinical syndrome in which the heart cannot provide blood flow commensurate with the body’s requirements…

…failure (HF) is a clinical syndrome in which the heart cannot deliver blood at a rate appropriate to tissue requirements unless filling pressures are elevated…

…insulin resistance, dyslipidaemia, elevated blood pressure and impaired glucose regulation. Diagnosis is based on the coexistence of defined clinical and laboratory components; the diagnostic criteria…

…a distinct disease. It identifies patients whose blood pressure remains uncontrolled despite intensive antihypertensive treatment and who therefore require assessment for pseudo resistance, secondary hypertension…

…and infarction Definition and conceptual framework Acute coronary occlusion is the abrupt or progressive reduction of coronary blood flow sufficient to produce myocardial ischaemia and…

Echocardiography Tissue Doppler (Tissue Velocity Imaging) Previous chapters on Doppler imaging have all focused on measurements of blood flow. However, the Doppler effect can also…

…risk of hypercapnia and a normal blood gas Usually 94 to 98 percent An individually documented target prescription, for example in chronic hypercapnia Follow the…

…dose, time of the bolus and the blood pressure before administration. 12. Prepare for the monitoring and management of intracranial haemorrhage and angioedema. First of…

…criteria for intermediate care or intensive care. Time course after the last intake The times given are approximate. Symptoms can begin before the blood alcohol…

…without delay, in any of the following: A systolic blood pressure < 90 mmHg caused by the arrhythmia. Ongoing myocardial ischaemia with chest pain and…

…allows frequent blood pressure measurement and continuous monitoring. An arterial line is often appropriate when very rapid or precise control is required, for example in…

…systolic blood pressure below 90 mmHg, a narrow pulse pressure, peripheral vasoconstriction, impaired consciousness, a rising lactate or a worsening acidosis. An assessed need for…

…septic shock, or a need for high dependency or intensive care 3 Take at least two sets of blood cultures from separate peripheral punctures. Also…

…across the aortic valve. Trace the Doppler profile to calculate the AV VTI, representing the distance blood travels during systole. 3. Right Ventricular Outflow Tract…

…required to up to 900 μg/day. Transdermal (one patch lasts for a week): • Catapress TTS 1 (0.1 mg/24hrs). • Catapress TTS 2 …

…an angiotensin converting enzyme (ACE) inhibitor. Enalaprilat lowers blood pressure by inhibiting ACE. Effects • The hypotensive effect of enalaprilat depends on plasma volume and plasma…

…beta adrenergic receptor blocker. • Esmolol lowers blood pressure immediately (within 1 minute) • Esmolol may also be used to control supraventricular tachycardia (rate control). • Esmolol may…

…receptor agonist. • Lowers blood pressure while maintaining or increasing kidney perfusion. Effects Dopamine 1 receptor agonists lower systemic blood pressure and increase renal perfusion. Time…

…provided for use in patients with hypertensive emergency (also referred to as hypertensive crisis or malignant hypertension ). Hypertensive emergency is defined as significantly elevated blood…

…blocker. Effects Lowers blood pressure, reduces heart rate, myocardial oxygen consumption and myocardial contractility. Less pronounced blood pressure lowering effect than esmolol and labetalol. Time…

…ischaemia (ALI) is an abrupt reduction in arterial perfusion of an upper or lower limb that causes tissue metabolic requirements to exceed available blood flow…

…In acute PE, obstruction of pulmonary blood flow increases RV pressure load and may impair RV filling and forward output. The resulting syndrome may progress…

…a dihydropyridine CCB is appropriate for many patients. Long acting nitrates or ranolazine may be added when symptoms persist or when heart rate, blood pressure…

…syndrome in which increased intrapericardial pressure compresses the heart and impairs ventricular filling. It generally results from accumulation of pericardial fluid, blood, or, less commonly…