…Atherosclerotic lesions generally affect large and medium sized arteries. Pathological features include plaque formation with calcium deposition, medial thinning, destruction of muscular and elastic tissue…

…long term cardiovascular outcomes in CCS. General strategy For most patients, initial therapy consists of a beta blocker and/or a calcium channel blocker (CCB…

…are not directly visualized by calcium scoring. In contrast, coronary CT angiography (CCTA) can characterize both calcified and non calcified plaque and can assess stenosis…

…drugs, beta blockers and calcium channel blockers (inhibitors). The reader will notice that most of these drugs are contraindicated in patients with structural heart disease…

…nitroglycerin, nitroprusside, and nicardipine in hypertensive emergencies. Time to onset of action 2 4 minutes Duration of action 5 15 minutes Delivery IV (infusion). Dose…

…action Nicardipine is a dihydropyridine calcium channel blocker (CCB). Nicardipine inhibits the influx of extracellular calcium in the myocardial and peripheral vascular smooth muscle cell…

…NO) that induces vasodilatation of both arterioles and veins via generation of cyclic GMP, which then activates calcium sensitive potassium channels in the cell membrane…

…in all cardiac cells but its appearance varies depending on cell type. During de and repolarization ions (Na + [sodium], K + [potassium] and Ca 2+ [calcium…

…tamoxifen, lithium, thiazide diuretics, D vitamin and calcium overdose. ECG changes due to hypercalcemia Common ECG changes Shortened QT interval. Lengthened QRS duration. Bradycardia may…

…Definition and staging according to KDIGO Acute kidney injury is present when at least one of the following criteria is met [1]: A rise in…

…or after suturing over a joint. Pain relief and stabilisation for transfer in a suspected fracture. Clinical suspicion of a scaphoid fracture despite a normal…

…0.2 mL/kg Sodium bicarbonate 50 mmol in hyperkalaemia or tricyclic poisoning 1 mmol/kg Reversible causes: hypoxia, hypovolaemia, hypo /hyperkalaemia and metabolic disturbance…

…calcium in the presence of hyperkalaemic ECG changes or arrhythmia. 4. Shift potassium into the cells with insulin and glucose. Add high dose salbutamol in…

…calcium sensitisers and a beta agonist without vascular effect. Catecholamine receptors Alpha 1 adrenergic receptors: expressed in vascular smooth muscle. Activation results in vasoconstriction and…

…haemoglobin and ionised calcium, together with a full blood count, INR, APTT and fibrinogen. 7. Give tranexamic acid where it is indicated. 8. Proceed in…

…Bradycardia in poisoning with a beta blocker, a calcium channel blocker or digitalis, while awaiting the antidote and specific treatment. Bradyasystole during and after cardiac…

…potassium, ionised calcium, creatinine and the relevant toxicology concentration. 3. Correct the hypokalaemia. Aim for a serum potassium in the upper normal range, around 4…

…action Nicardipine is a dihydropyridine calcium channel blocker (CCB). Nicardipine inhibits the influx of extracellular calcium in the myocardial and peripheral vascular smooth muscle cell…

…arterioles and veins) via generation of cyclic GMP, which then activates calcium sensitive potassium channels in the cell membrane. Nitroglycerin is similar in action and…

…L type calcium current (Ica.L) and the pacemaker current (If) in sinus node cells, accompanied by a decrease in Vmax. Consequently, shifts in the…

…acute coronary syndrome (NSTE ACS) in patients with a low to intermediate likelihood of CAD when cardiac troponin and/or the ECG is normal or…

…involvement in the inflammatory process. A broad spectrum of pharmacologic agents can induce bradycardia or conduction disorders. These include beta blockers, non dihydropyridine calcium channel…

…ischaemia, myocardial scar, ventricular function, and, in selected circumstances, myocardial viability. Both techniques rely on intravenous radiopharmaceuticals that are taken up by myocardial tissue. The…

…elevation in right atrial pressure. Levosimendan represents a distinct class of inodilator. It enhances myocardial contractility and induces peripheral vasodilation through cardiac myofilament calcium sensitisation…

…to the CTO is increased when non invasive testing demonstrates significant inducible ischaemia and preserved viability in the myocardial territory supplied by the occluded artery…

…of prescribed drugs in blood or urine. The terms “controlled resistant hypertension,” referring to blood pressure controlled with four or more medications, and “refractory hypertension…

…excessive beta blocker or calcium channel blocker exposure. The incidence of cardiogenic shock complicating STEMI has fallen with prompt reperfusion and reduction of infarct size…

…with inflammation, thrombosis and accelerated atherosclerosis. In CKD, additional mechanisms include vascular stiffness and accelerated medial calcification related to disturbed calcium–phosphate metabolism. Patients with…

…arteries. Epicardial spasm produces a reversible functional occlusion and usually causes transmural ischaemia. The resulting abnormalities in left ventricular function may lead to myocardial infarction…

…associated with the Brugada syndrome. These mutations are located in genes encoding potassium and calcium channels of the outer cell membrane. Clinical presentation of Brugada…

CPR Poisoning and drug toxicity In adolescents and young adults, intoxication events leading to cardiac arrest are notably prevalent, primarily due to the misuse of…

…intracellular calcium levels, which causes a shortening of the action potential. Digoxin shortens the action potential in all cardiac cells, both in the atria and…

…action Nicardipine is a dihydropyridine calcium channel blocker (CCB). Nicardipine inhibits the influx of extracellular calcium in the myocardial and peripheral vascular smooth muscle cell…

…Asystole occurs if an escape rhythm is not established. Yes In AV block II and AV block III, atrial impulses do not reach the ventricles…

…angiography in patients with unknown etiology for acute severe heart failure. A recent echocardiographic examination should be available or performed urgently to evaluate ventricular and…

…medications such as nitrates, beta blockers, or calcium channel blockers Recent acute myocardial infarction (AMI) Pharmacologic agents in perfusion imaging Vasodilators (adenosine, dipyridamole, regadenoson) These…

…ventricular compliance. These factors include age, afterload, myocardial synchronization and intracellular processes ( e.g intracellular calcium signaling, the sodium–potassium pump, mitochondrial function, actin myosin…

…electric current. In electrocardiology, these charged particles are represented by intracellular and extracellular ions, such as sodium (Na+), potassium (K+), and calcium (Ca2+). These ions…

…or high in the absence of thyroid disease; repeat it once the patient has recovered. Pitfalls Haemolysis raises the potassium, LDH and AST and lowers…

…Calcium and vitamin D. A bisphosphonate with longer treatment and risk factors, according to the guideline Hyperglycaemia Glucose measurement, above all in the afternoon and…

…up At an eGFR below 60, or in the presence of albuminuria: check the potassium, calcium, phosphate, PTH, haemoglobin and bicarbonate , review the medication list …

…Pointes severe ziprasidone mesylate ZIPRASIDONE MESYLATE ZIPRASIDONE MESYLATE Arrhythmia wp less change in QTc from baseline mild PENICILLIN G PROCAINE PENICILLIN G PROCAINE PENICILLIN G…

…plaque, thrombus, and implanted stents. The principal modalities used in the catheterization laboratory are intravascular ultrasound (IVUS) and optical coherence tomography (OCT). Unlike coronary angiography…

…portion of its transmembrane pore, ivabradine reduces the slope of diastolic depolarisation and produces a dose dependent reduction in sinus rate. Its principal therapeutic distinction…

…the absolute reduction in LDL C, regardless of the drug used to achieve it. Absolute benefit depends on baseline cardiovascular risk and the magnitude of…

…incorporated. In symptomatic individuals without known CAD, newer clinical prediction algorithms are preferred over older approaches based solely on age, sex and typicality of symptoms…

Cardiology Pharmacology & dosing Definition and pathophysiology Statins inhibit 3 hydroxy 3 methylglutaryl coenzyme A reductase, the rate limiting enzyme in cholesterol synthesis. Reduced hepatic cholesterol…

…and secondary. Primary and secondary ST T changes Primary ST T changes are caused by abnormal repolarization . This is seen in ischemia, electrolyte disorders (calcium…

…lithium, thiazide administration, and over supplementation of calcium and vitamin D. ECG in hypercalcemia Typical ECG changes: Shortened QT interval. Attenuated T wave amplitude. Prolonged…

…al. The effects of calcium and sodium bicarbonate on severe hyperkalaemia during cardiopulmonary resuscitation: a retrospective cohort study of adult in hospital cardiac arrest. Resuscitation…

…al. The effects of calcium and sodium bicarbonate on severe hyperkalaemia during cardiopulmonary resuscitation: a retrospective cohort study of adult in hospital cardiac arrest. Resuscitation…

…al. The effects of calcium and sodium bicarbonate on severe hyperkalaemia during cardiopulmonary resuscitation: a retrospective cohort study of adult in hospital cardiac arrest. Resuscitation…

…ion channel function (alterations in sodium, potassium and calcium currents have been suggested). The altered ion channel function leads to regional dispersion in the refractoriness…

…may also present in individuals without identifiable cardiac disease. Contributing factors include pulmonary disorders, particularly obstructive pulmonary disease, the use of theophylline, and elevated catecholamine…

…Echocardiography is generally performed in order to evaluate ventricular function, since it may affect the choice of device therapy and also suggest whether other interventions…