Cardiology Pharmacology & dosing Definition and pathophysiology Lipid lowering therapy is a central component of cardiovascular prevention, particularly in patients with established atherosclerotic cardiovascular disease (ASCVD…

…The reference values below are taken from the consensus documents of the American Society of Echocardiography (ASE) and the European Association of Cardiovascular Imaging (EACVI)…

…and excess cardiovascular risk. The European definition requires failure to reduce office systolic and diastolic blood pressure to below 140 mmHg and 90 mmHg, respectively…

…of atrial size 10 cm² or 40% of atrial size Jet orientation central variable excentric Pulmonary vein flow S dominant reduced S wave systolic flow…

…thresholds. The 2024 European guideline defines hypertension as an office systolic blood pressure (SBP) of ≥140 mmHg or diastolic blood pressure (DBP) of ≥90 mmHg…

…for epidemiological purposes. With the advent of highly sensitive cardiac biomarkers, the European Society of Cardiology (ESC), American College of Cardiology (ACC), American Heart Association…

…The pre test probability is central because the clinical value of any diagnostic test depends not only on its sensitivity and specificity but also on…

…therapy, with or without other lipid lowering treatment. The durability of the response is central to its clinical use. After the initial treatment phase, administration…

…cycle ergometer (bicycle) are the most frequently used test methods. Cycle ergometer is preferred in Europe, while treadmill testing is predominant in the United States…

Procedurer What determines the outcome of a central venous catheter insertion is decided before the needle goes in: the choice of site, the use of…

Cardiology Pharmacology & dosing Definition and pathophysiology Congestion is a central expression of the heart failure syndrome and reflects excessive retention of sodium and water, with…

…Exercise stress test Evaluation of the exercise stress test (exercise ECG) The ECG reaction has always been a central component of the exercise stress test…

…clinical severity, evidence of right ventricular (RV) dysfunction, and myocardial injury. This classification is central to determining the intensity of monitoring, supportive treatment, anticoagulation, and…

…or other atherosclerotic vascular disease. Antiplatelet therapy is a central component because platelet activation and aggregation contribute importantly to arterial thrombus formation, recurrent coronary occlusion…

…with functional assessment. A central practical principle is that the visual severity of a stenosis does not reliably establish its haemodynamic importance. A lesion that…

…receptor inhibitor. It is central to the prevention of platelet mediated coronary thrombosis after acute coronary syndrome (ACS) and percutaneous coronary intervention (PCI). Aspirin irreversibly…

…undertaken to maintain or improve physical fitness. Regular physical activity is a central component of cardiovascular prevention and treatment. It is associated with lower cardiovascular…

…and is not determined solely by the apparent frequency or duration of documented episodes. The central therapeutic objective is prevention of thromboembolic complications, particularly stroke…

…resulting in obstruction. Central nervous system (CNS) injuries might cause apnea or hypoventilation. Respiratory conditions : Tension pneumothorax Drowning Airway obstruction Hanging Pneumonia High altitude sickness…

…disturbance without nystagmus: HINTS does not apply. Assess gait and truncal stability and investigate for a central cause. Acute vestibular syndrome is often caused by…

…Vestibular neuritis, central cause Marked imbalance that makes walking impossible Cerebellar infarction HINTS in continuous vertigo HINTS is not a test for BPPV. It is…

…and haemodynamic monitoring with ECG, a central venous catheter and an arterial line is necessary to achieve an optimal result. Overview of vasopressors and inotropes…

…bore access, or rapid central access, but do not delay transfusion or control of the bleeding in order to obtain a central venous catheter. 4…

…serum concentration. Alkalinisation increases renal elimination several fold and at the same time reduces the passage of salicylate into the central nervous system. Contact your…

…Careful electrocardiographic and hemodynamic monitoring with ECG, central vein catheter and intra arterial catheter (A line) is warranted. Overview of vasopressors and inotropes Inotropes and…

…as described by the relationship: MAP = (CO × SVR) + Central Venous Pressure (CVP) This equation illustrates that MAP is determined by the volume of blood…

…and combinations are frequently required. The central therapeutic aim is symptom control rather than modification of long term cardiovascular outcomes. With the important exception of…

…to posteromedial inferior region of the right atrium. This circuit also relies on a central area of block, which encompasses both an anatomical barrier (the…

…had an infarction. Pathophysiological Considerations The central pathophysiological concern in the emergency department is myocardial ischaemia caused by an acute coronary process. Myocardial injury leads…

…affecting approximately 1 in 250,000–350,000 individuals. The lifelong exposure to high LDL C is central to the disease burden. In untreated HeFH…

…patients with reduced EF. Pathophysiology Abnormal ventricular relaxation and increased filling pressures The central hemodynamic abnormality in HFpEF is impaired diastolic function. The left ventricle…

…and disturbed angiogenic signalling. A central biochemical feature is an imbalance between antiangiogenic and angiogenic factors. Placental production of soluble fms like tyrosine kinase 1…

…Consequently, left ventricular filling falls and cardiac output may become markedly depressed. Right sided filling pressures—including central venous, right atrial, and right ventricular end…

…patients prior to sotalol initiation. Diagnostics Electrocardiography (ECG) Electrocardiographic monitoring is central to the safe initiation and maintenance of sotalol therapy. The drug prolongs the…

…for the selected treatment to restore flow. Early reperfusion is therefore the central priority of STEMI systems of care. Fibrinolysis promotes thrombus dissolution by converting…

…making rapid recognition, defibrillation capability and expedited reperfusion central to survival. Clinical Presentation and Symptoms The characteristic symptom prompting activation of the STEMI pathway is…

…increased ventricular contractility occur consistently. Exaggerated activation of a central reflex produces a stereotypic response: an initial increase in heart rate, followed by a drop…

…hyponatremia is the prevention of osmotic demyelination syndrome (ODS), previously known as central pontine myelinolysis. Excessively rapid correction of sodium can result in catastrophic demyelination…

…episodes Iatrogenic events (e.g., during central venous catheter insertion) Underlying lung pathologies In cases of benign pneumothorax, positive pressure ventilation can precipitate a tension…

…uses to calculate various hemodynamic parameters. The Doppler effect The central principle to all hemodynamic calculations is the Doppler effect, which was discussed previously (see…

…Careful electrocardiographic and hemodynamic monitoring with ECG, central vein catheter and intra arterial catheter (A line) is warranted. Overview of vasopressors and inotropes Inotropes and…

…arterial line, PiCCO, central venous catheter). The hemodynamic effects persist for 7–10 days after the end of infusion. Refer to Table 2 for a…

…In stroke, neuronal cell death begins in the central ischemic zone, where the ischemia is most pronounced and extends towards the penumbra zone (the outermost…

…withdrawal. Benzodiazepines enhance the function of the GABA A receptor and are cross tolerant with alcohol. They therefore treat the central mechanism underlying withdrawal, unlike…

…in marked shock or during high dose vasopressor treatment, when the radial trace may underestimate central pressure. The dorsalis pedis artery works but often shows…

…sometimes supplemented with a central venous sample Common approximate arterial reference ranges in adults are: pH 7.35 to 7.45 pCO₂ 4.7 to…

…drugs, poisoning, withdrawal or several factors Inattention is central. A simple check is to ask the patient to recite the months of the year backwards…

…60 min, then 900 mg/24 h 5 mg/kg over 20–60 min Central access for a longer infusion Metoprolol 5 mg IV, repeated…

…a need for repeated calcium treatment. Urgent investigations As a rule, take: Plasma potassium as a central laboratory sample. A blood gas with pH, bicarbonate…

…cultures from separate peripheral punctures. Also culture from a central line if one is present 4 Take a full blood count with a differential, CRP…

…salicylate poisoning, intubation with an inadequate minute ventilation can rapidly worsen the acidaemia and increase the entry of salicylate into the central nervous system. Discuss…

…MAP remains below 65 mmHg or the hypotension is marked. Do not wait for a central venous catheter Continuously Reassess the mental state, capillary refill…

…fan, paracetamol, cold infusions. A ventilator, an arterial line, a central venous catheter, ECG monitoring, blood gases. Drugs for sedation, analgesia and control of shivering…

…where the pads would go. Transvenous pacing: the relative contraindications are the same as for a central venous catheter — coagulopathy, infection at the puncture site…

…area < 0,05 0,05 0,59 0,59 Qualitative parameters Mild regurgitation Moderate regurgitation Severe regurgitation Jet area small variable large if central…

…to 12 months. Use with caution in patients at risk for bradycardia (slow heart rate). Central sleep apnea, including Cheyne Stokes respiration, has been reported…

…distal to the suspected obstruction Arterial and venous Doppler signals Evidence of systemic disease or a potential embolic source Neurological assessment is central to triage…

…A flush should immediately follow the bolus injection to ensure rapid delivery to the central circulation. If the drug is injected into a central vein…

…may produce cardiorenal syndrome. Worsening renal function in the presence of persistent congestion is particularly associated with elevated central venous pressure, which is transmitted to…

…15–90 days. Chronic: more than 90 days. The central clinical danger is progressive aortic wall disruption, rupture and compromise of branch vessels. Type A…