…alkalosis due to hyperventilation, rhabdomyolysis (particularly the initial phase), sepsis, malignancies with osteoblastic metastases, diminished calcium absorption and/or enhanced calcium excretion, chronic renal failure…

…s disease, renal failure, tamoxifen, lithium, thiazide diuretics, D vitamin and calcium overdose. ECG changes due to hypercalcemia Common ECG changes Shortened QT interval. Lengthened…

…due to cardiovascular disease ( Myerburg et al ). Sudden unexpected cardiac arrest is the mechanism of death for about half of all individuals with heart failure…

…and a difficult to palpate apex beat [10]. Despite congestive heart failure, a third or fourth heart sound is rarely heard due to restrictive pathophysiology…

…third degree AV block. Note that escape rhythms may arise during bradycardia. Also, note that bradycardia due to dysfunction in the sinoatrial node is referred…

…hospital cardiac arrest. Autopsies are recommended when the underlying cause is unknown, particularly among young individuals. Yet, autopsies are often not performed due to the…

…For example, in cardiac arrest due to pulmonary embolism the initial rhythm is typically PEA, which is explained by the fact that the embolus prevents…

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

…in the heart failure armamentarium. Its use has declined over time due to the advent of more efficacious agents with wider therapeutic to toxic windows…

…is the most common sustained cardiac arrhythmia and a profound driver of global cardiovascular morbidity and mortality, primarily due to its association with ischemic stroke…

…for heart failure and arrhythmias. Family History of Sudden Cardiac Death (FHSCD) : A history of SCD in close relatives suggests a genetic predisposition to arrhythmias…

…used in patients with heart failure, atrial fibrillation, atrial flutter, and in selected cases of paroxysmal supraventricular tachycardia. Due to its profound pro arrhythmic effects…

…stenosis due to risk of hypotension. Clevidipine doses and administration in hypertension. Nicardipine Drug Nicardipine Brand names Cardene ® Indications Hypertension, hypertensive emergency/crisis. Pregnancy…

…Ventricular arrhythmias Cardiac ischemia Hypertension Hypotension Phenylephrine Typically used as emergency bolus to correct acute hypotension. Hypotension (any) Used to increase MAP during hypotension in…

…stenosis due to risk of hypotension. Clevidipine doses and administration in hypertension. Nicardipine Drug Nicardipine Brand names Cardene ® Indications Hypertension, hypertensive emergency/crisis. Pregnancy…

…Ventricular arrhythmias Cardiac ischemia Hypertension Hypotension Phenylephrine Typically used as emergency bolus to correct acute hypotension. Hypotension (any) Used to increase MAP during hypotension in…

…and may arise from non ischaemic cardiac conditions (such as myocarditis) or non cardiac conditions (such as renal failure). To establish a diagnosis of MI…

…This may be due to insufficient stimulus energy, or lead dislodgement/fracture. Functional failure to capture occurs when a stimulus is delivered during the myocardial…

…valves during the cardiac cycle. Doppler recording of mitral valve flow during diastole. (a) = active atrial filling; (b) = increased atrial pressure due to…

…of heart failure. Caution • Used cautiously in patients with acute heart failure. • Clevidipine can cause reflex tachycardia. • Contraindicated in severe aortic stenosis due to risk…

…to varying degrees; this non atherosclerotic condition may occur especially in young women. Non coronary mechanisms that reduce oxygen supply include severe bradyarrhythmia, respiratory failure…

…stroke volumes. Failure to increase cardiac output sufficiently will result in the following compilations: Pulmonary edema develops due to rising LAP and LVEDP. Cardiogenic shock…

…populations, a distinct form of atrial tachycardia may occur due to embryological remnants within the atrial myocardium. These residual tissues, persisting from cardiac embryogenesis, are…

…tricuspid regurgitation. Causes of tricuspid regurgitation The most common causes of tricuspid regurgitation are as follows: Right ventricular dysfunction due to pressure/volume overload. Right…

…due to the risk of circulatory collapse. Decompensated heart failure – due to the risk of circulatory collapse and arrhythmias Pulmonary embolism in acute phase – due…

…ongoing chest pain refractory to medical treatment life threatening arrhythmias or cardiac arrest mechanical complications of acute myocardial infarction. acute heart failure recurrent dynamic ST…

…flow are appropriate. Exercise PH is defined by an mPAP/cardiac output slope greater than 3 mmHg/L/min from rest to exercise. This response…

…due to high vagal tone. These individuals have developed a highly efficient left ventricle, capable of generating sufficient cardiac output at low heart rates. During…

…with other forms of ventricular tachycardia. Mechanisms of ventricular tachycardia Ventricular tachycardia (VT) may emerge due to increased/abnormal automaticity, re entry or triggered activity…

…atrial impulses to the ventricles and thus ventricular fibrillation and cardiac arrest. High degree AV block (second degree Mobitz type 2 AV block, third degree…

…recorded simultaneously. Sex : Female Age : 72 years History : heart failure Medications : digoxin, quinidine ECG 1 . The initial beats are supraventricular beats during sinus rhythm. A…

…Definition and classification Heart failure (HF) is a clinical syndrome in which the heart cannot deliver blood at a rate appropriate to tissue requirements unless…

…25 mmHg during exercise [4] . This hemodynamic criterion underscores that "preserved" ejection fraction does not equate to normal cardiac function, but rather to a state…

Cardiology Key points Levosimendan alleviates heart failure symptoms, increases cardiac output, and lowers pulmonary artery pressure without increasing myocardial oxygen consumption. The inotropic effect of…

…relaxation and filling. Hypertension and diabetes can contribute to the development of heart failure in the preserved and mildly reduced EF ranges, and obesity is…

…and T during acute myocardial infarction As noted above, cardiac troponin I (cTnI) concentrations tend to increase to higher levels than cTnT during acute myocardial…

…diminished cardiac output, falling arterial pressure, and, if untreated, death. The volume required to produce tamponade depends principally on the rate of accumulation and the…

…cancer related disease and cardiac amyloidosis among the relevant clinical settings or comorbidities. HFrEF is distinguished from heart failure with mildly reduced ejection fraction (HFmrEF…

…nuances to HF terminology to reflect the dynamic nature of myocardial remodeling. The designation "Heart Failure with improved Ejection Fraction" (HFimpEF) is now applied to…

…implantation of ICDs [implantable cardioverter defibrillator]). Our inability to predict cardiac arrest is evident in many ways. Some examples follow: Modern ICDs are capable of…

…contribute to sodium and water retention. The interaction between cardiac and renal dysfunction is particularly important. Cardiorenal syndrome may develop during acute decompensated heart failure…

Procedurer In acute circulatory failure it is not the number of cannulae that matters but the flow per unit time . A large bore, short cannula…

…care Victims of out of hospital cardiac arrest (OHCA) who achieve ROSC in the emergency room (ER) are transferred to the intensive care unit (ICU…

…cardiac diseases, including coronary artery disease, heart failure, arrhythmias, structural heart disease, etc. Over the years, a large number of parameters have been introduced to…

…the circulation. ECMO use during cardiac arrest (referred to as ECPR [extracorporeal CPR] ) requires the immediate establishment of veno arterial ECMO (VA ECMO) . A peripheral…

…enhances myocardial contractility and induces peripheral vasodilation through cardiac myofilament calcium sensitisation. This process is achieved via calcium dependent binding to troponin C during systole…

…vital signs contribute to initial triage and that alternative cardiac and thoracic diagnoses must be considered. The immediate clinical categories include: Non cardiac diagnosis Chronic…

…valvular disease or congenital heart disease. Cardiomyopathy leads to impaired cardiac function and heart failure. There are six main types of cardiomyopathy: Hypertrophic cardiomyopathy (HCM…

…Heart Damage ar less Hypertension mild VIVITROL NALTREXONE naltrexone Mixed ar less cardiac failure severe Apretude CABOTEGRAVIR CABOTEGRAVIR SODIUM NA CLINICAL PHARMACOLOGY no QT interval…

…picture Moderate 6.0 to 6.4 mmol/L ECG and cardiac monitoring. Emergency treatment is often warranted, particularly in an acute rise, renal failure…

…injury is separate from MI. It refers to cardiac troponin release that does not fulfil the criteria for ischaemic myocardial infarction. It may be acute…

…increases RV pressure load and may impair RV filling and forward output. The resulting syndrome may progress to systemic congestion, reduced cardiac output, haemodynamic collapse…

…or newly developed during the acute illness The ventricular rate and its relationship to symptoms and haemodynamic status Whether heart failure is present and whether…

…zone and contributes to ventricular failure. Mechanisms of Shock The central consequence of extensive infarction is loss of contractile myocardium, with reduced cardiac output and…

…Non ischaemic myocardial injury may accompany numerous cardiac and systemic disorders, including: Cardiac causes Systemic causes Heart failure Sepsis Myocarditis Chronic kidney disease Cardiomyopathy Stroke…

…accelerated medial calcification related to disturbed calcium–phosphate metabolism. Patients with advanced CKD are particularly vulnerable to structural cardiac abnormalities, HF and sudden cardiac death…

…heart failure management, evaluation for coronary artery disease, etc .) are warranted. Management of AV blocks aims to restore atrioventricular conduction either pharmacologically or by means…

…heart failure and cardiac arrest. In cases with intermittent symptoms, it is important to establish a temporal correlation between symptoms and episodes of bradyarrhythmia on…

…ECG changes Concomitant cardiac disease Oxygen targets Patient Initial target saturation : : Known COPD or another clear risk of hypercapnic respiratory failure 88 to 92 percent…

…Hypercapnic failure in cardiogenic pulmonary oedema that does not improve with CPAP alone. As ceiling therapy where intubation has been judged not to be appropriate…