…is that an arterial line must never be confused with a venous access. Indications Continuous blood pressure monitoring in haemodynamic instability or during ongoing vasoactive…

…simple: two attempts or 90 seconds — then go intraosseous. Indications Peripheral venous cannula: Intravenous drug treatment, fluid or blood products. Contrast medium for CT (this…

…paracentesis set or a catheter over needle, 16–18 G, connected to tubing and a collection container. Sample tubes: an EDTA tube for the cell…

…a gradient or PaO₂/FiO₂ Arterial blood gas COHb or MetHb Arterial or venous sample with co oximetry Follow up of pH in, for example…

…lower than for office measurement. Classification of office blood pressure Category Systolic Diastolic : : : : : Optimal < 120 and < 80 Normal 120–129 and/or 80…

…significant blood loss. Massive haemorrhage meeting the criteria for activation of the massive transfusion protocol. Plasma and platelets: in ongoing bleeding with coagulopathy, or as…

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…

…oscillometric measurement becomes unreliable), lymphoedema or a dialysis fistula in both arms, an arm circumference too large for the available cuffs, and in a patient…

…a peripheral venous cannula. 4. Measure the blood pressure in both arms at the first assessment, particularly in chest pain, back pain or suspected acute…

…rate response Blood pressure reaction ECG reaction: ST changes, T wave changes, arrhythmias, conduction defects Cause of termination This article will discuss each of these…

…regions with reduced blood flow. Radiotracers for SPECT Technetium 99m (Sestamibi or Tetrofosmin): With a six hour half life allowing high doses for better image…

…regadenoson create blood flow disparities between healthy and diseased coronary arteries, allowing ischemia to be detected during imaging. Exercise is the preferred method for inducing…

…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…

…or other vascular beds. Malignant hypertension represents an extreme form in which acute microvascular injury occurs, classically involving fibrinoid necrosis of small arteries in the…

…on four or more drugs or “refractory hypertension” for blood pressure above target despite five or more drugs. Screening for primary aldosteronism Screening for primary…

…when related to one another. A low blood pressure may be due to low flow, low vascular tone or both, and the appropriate action differs…

…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…

…DW, Wickman LL, Swart GL. The hemodynamic and arterial blood gas response to asphyxiation: a canine model of pulseless electrical activity. Resuscitation 1995;30:16975…

…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…

…with a braked, workload controlled resistance; 12 lead ECG with continuous recording; automated or manual blood pressure measurement. Resuscitation trolley with defibrillator, oxygen, suction and…

…1,2]. Telephone your national or regional poison control centre , which in most countries is staffed around the clock for health care professionals. Contact the…

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

…perfusion. • Dose dependent elevation of intracranial pressure (ICP) and reduction in cerebral blood flow. Caution • Used cautiously in patients with high intracranial pressure or azotemia…

…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…

…clinical syndrome in which the heart cannot provide blood flow commensurate with the body’s requirements, or can do so only at the expense of…

…left atrial enlargement or left ventricular hypertrophy, or echocardiographic evidence of impaired filling, make the diagnosis more likely. HFpEF and HFmrEF together account for approximately…

…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…

…should be reserved for patients in whom the diagnosis has been carefully confirmed. Apparent resistant hypertension may result from: Inaccurate or inconsistent blood pressure measurement…

…In some of these patients, microvascular obstruction or epicardial spasm may account for the ischaemia. STEMI usually results from rapid thrombotic occlusion of a previously…

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…

…assessed. 3. Take an arterial blood gas in respiratory compromise, low saturation, suspected carbon dioxide retention, reduced consciousness, or when NIV is being considered. 4…

…for example aphasia, hemianopia or hand paresis in a person of working age Blood pressure Measure initially in both arms if this does not delay…

…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…

…Agent Standard dose in atrial fibrillation Criteria for dose reduction according to FASS : : : Apixaban 5 mg × 2 2.5 mg × 2 if at least two…

…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…

…do not delay transfusion or control of the bleeding in order to obtain a central venous catheter. 4. Take samples for blood grouping and cross…

…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…

…pulmonary blood flow (Qp) to systemic blood flow (Qs). This measurement is pivotal in diagnosing and managing congenital or acquired cardiac shunts, such as atrial…

…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…

…is highly selective for vascular smooth muscle cells and has little or no effect on myocardial contractility or conduction. Clevidipine reduces mean arterial blood pressure …

…readings compared to invasive arterial catheterization, particularly in patients with irregular heart rhythms or low blood pressure. Additionally, individual variations in arterial compliance and pulse…

…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…

…Tachycardia Low systolic blood pressure Respiratory insufficiency, manifested by tachypnoea and/or low arterial oxygen saturation Syncope These findings may occur singly or in combination…

…for many patients. Long acting nitrates or ranolazine may be added when symptoms persist or when heart rate, blood pressure, left ventricular dysfunction, contraindications, or…

…accumulation of pericardial fluid, blood, or, less commonly, a mass. Tamponade occurs when intrapericardial pressure equals or exceeds right atrial pressure. The haemodynamic consequences are…

…involving the epicardial coronary arteries and/or the coronary microcirculation. These abnormalities may produce a transient mismatch between myocardial oxygen demand and coronary blood supply…

…elimination of LDL cholesterol from the blood. Individuals with familial hypercholesterolemia may have either one defect gene copy (heterozygous FH) or two defect gene copies …

…this setting, venous congestion is generally treated initially with diuretics, whereas norepinephrine and/or inotropes are reserved for low output and hemodynamic instability. Evaluation and…

…workload or metabolic equivalents, is among the strongest predictors of mortality in patients with cardiovascular disease after accounting for age. Chronotropic response, blood pressure behaviour…

…or very old or frail patients who may not tolerate rapid blood pressure reduction. Initial Combination Therapy General Strategy For most adults with confirmed hypertension…

…media. Blood then propagates along the wall, creating a true lumen and a false lumen separated by an intimal flap. Propagation may be antegrade or…

…For decades, the management of type 2 diabetes mellitus (T2DM) and obesity was siloed, with clinicians focusing primarily on hemoglobin A1c (HbA1c) reduction, blood pressure…

…review on this topic [1]. References [1] G Heusch. Myocardial Ischemia: Lack of Coronary Blood Flow or Myocardial Oxygen Supply/Demand Imbalance? Circ Res. 2016…

…imaging (MPI) with single photon emission computed tomography (SPECT) or positron emission tomography (PET) is a radionuclide based method for assessing regional myocardial blood flow…

…Angiographic appearance Diagnostic considerations Type 1 Contrast staining of the arterial wall with multiple lumens or radiolucent channels The classic appearance and usually readily recognized…

…uncertain, cardiogenic shock is present, or symptoms have been present for more than 2–3 hours. Patients with a working diagnosis of STEMI should, whenever…