…Type B disease may produce rupture, renal, mesenteric or limb malperfusion, spinal cord ischaemia, paraplegia or paraparesis, rapid aortic expansion, refractory pain and hypertension despite…

…or treatment with another adenosine diphosphate (ADP) receptor inhibitor for patients who had coronary syndrome and are at high risk of developing a new event…

…syndrome or symptomatic bradycardia in the absence of a pacemaker. Hypersensitivity to adenosine. Administration Normal route : Peripheral intravenous (IV). Alternative route : Central venous administration of…

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

Myocardial ischemia and infarction ECG Definition and Pathophysiology Acute coronary syndromes (ACS) encompass a spectrum of clinical conditions characterized by a recent change in symptoms…

…Aspiration Chronic obstructive pulmonary disease (COPD) Bronchospasm (asthma) Other : Coma Central hypoventilation syndromes Neuromuscular diseases Anemia The natural course of asphyxia Should ventilation be entirely…

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

…PaO2 Circulation A systolic blood pressure of 100 mmHg or less, a MAP below 65 mmHg, delayed capillary refill, cold or mottled skin Metabolism and…

…be cold, pale, cyanotic or mottled. Capillary refill is delayed, and venous filling may be reduced. Other possible findings include muscle stiffening and loss of…

…repolarization and provoke ventricular tachycardia or ventricular fibrillation. The likelihood of clinically significant EMI is generally low, particularly with bipolar electrocautery performed away from the…

…dialysis catheter, not an ordinary triple lumen catheter). Measurement of central venous pressure and central venous oxygen saturation. Repeated blood sampling during intensive care. Exhausted…

…pathophysiology Congestion is a central expression of the heart failure syndrome and reflects excessive retention of sodium and water, with expansion of both the intravascular…

…and pathophysiology Lipid lowering therapy is a central component of cardiovascular prevention, particularly in patients with established atherosclerotic cardiovascular disease (ASCVD), chronic coronary syndrome (CCS)…

…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…

…20% of atrial size 4 10 cm² or 20 40% of atrial size 10 cm² or 40% of atrial size Jet orientation central variable excentric…

…obstruction of pulmonary blood flow increases RV pressure load and may impair RV filling and forward output. The resulting syndrome may progress to systemic congestion…

…and progression of atherosclerotic disease in patients with established coronary or other atherosclerotic vascular disease. Antiplatelet therapy is a central component because platelet activation and…

…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…

…combined use of aspirin and an oral P2Y12 receptor inhibitor. It is central to the prevention of platelet mediated coronary thrombosis after acute coronary syndrome …

…a more structured form of physical activity undertaken to maintain or improve physical fitness. Regular physical activity is a central component of cardiovascular prevention and…

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

…not apply. Assess gait and truncal stability and investigate for a central cause. Acute vestibular syndrome is often caused by acute unilateral vestibulopathy, commonly called…

…Marked cervical restriction of movement or pain — use the Semont manoeuvre or the side lying variant of the Dix–Hallpike test. Marked obesity or spinal…

…a central venous catheter and an arterial line is necessary to achieve an optimal result. Overview of vasopressors and inotropes Vasoconstriction Vasodilatation Positive inotropy Phenylephrine…

…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…

…hemodynamic monitoring with ECG, central vein catheter and intra arterial catheter (A line) is warranted. Overview of vasopressors and inotropes Inotropes and vasopressors. Table 1…

…= (CO × SVR) + Central Venous Pressure (CVP) This equation illustrates that MAP is determined by the volume of blood the heart pumps and the resistance…

…after acute coronary syndromes in patients with reduced left ventricular ejection fraction (LVEF). They are also recommended in patients within one year of MI and…

…conduction is consistently located in the posterolateral to posteromedial inferior region of the right atrium. This circuit also relies on a central area of block…

…Considerations The central pathophysiological concern in the emergency department is myocardial ischaemia caused by an acute coronary process. Myocardial injury leads to release of cardiac…

…characterized by persistently elevated plasma low density lipoprotein cholesterol (LDL C) from early life and a consequent excess risk of premature atherosclerotic cardiovascular disease (ASCVD)…

…are elevated. The syndrome is therefore defined by symptoms and signs of congestion or impaired cardiac performance rather than by ejection fraction alone. Heart failure…

…or chronic chest pain attributable to suspected chronic coronary syndrome, is evaluated by estimating the likelihood of obstructive coronary artery disease (CAD) before diagnostic testing…

…HELLP syndrome—haemolysis, elevated liver enzymes or transaminases, and thrombocytopenia—is generally regarded as a severe preeclamptic phenotype or variant. Pathophysiology The precise mechanism of…

…before resistant hypertension can be defined. The central physiological contributors include excess salt intake and salt and water retention, particularly when kidney function is impaired…

…pressures are reduced. The central management principle is preservation of adequate right ventricular preload while supporting left ventricular performance and systemic circulation. Improvement in left…

…baseline physical examination of patients prior to sotalol initiation. Diagnostics Electrocardiography (ECG) Electrocardiographic monitoring is central to the safe initiation and maintenance of sotalol therapy…

…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…

…defibrillation capability and expedited reperfusion central to survival. Clinical Presentation and Symptoms The characteristic symptom prompting activation of the STEMI pathway is ischaemic type chest…

…but redistribution of blood volume and increased ventricular contractility occur consistently. Exaggerated activation of a central reflex produces a stereotypic response: an initial increase in…

…rapidity of onset, is of paramount importance. The primary concern in correcting hyponatremia is the prevention of osmotic demyelination syndrome (ODS), previously known as central…

…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…

…principles of exercise test protocols will also be discussed in this article. Metabolic equivalent (MET): measuring oxygen consumption Estimation of oxygen consumption is central to…

…central principle to all hemodynamic calculations is the Doppler effect, which was discussed previously (see Doppler Effect and Doppler Echocardiography). Only a brief summary of…

…hemodynamic monitoring with ECG, central vein catheter and intra arterial catheter (A line) is warranted. Overview of vasopressors and inotropes Inotropes and vasopressors. Table 1…

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

…Biological death usually occurs within minutes thereafter; survival is highly unlikely after 8–10 minutes of no flow (i.e. cardiac arrest without any circulation)…

…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…

…and a warm, well perfused hand carry more weight. Choice of vessel The radial artery is the first choice : superficial, easy to compress, with a…

…why mixed acid base disorders are missed. The blood gas describes the physiology at the moment of sampling, but does not by itself identify the…

…kg over 20–60 min Central access for a longer infusion Metoprolol 5 mg IV, repeated to a maximum of 15 mg 0.1 mg…

…indexed Aortic annulus 20 31 mm 12 14 mm/m2 Sinuses of Valsalva 29 45 mm 15 20 mm/m2 Sinotubular junction 22 36 mm…

…or a very strong clinical suspicion. 3. Give intravenous calcium in the presence of hyperkalaemic ECG changes or arrhythmia. 4. Shift potassium into the cells…

…care 3 Take at least two sets of blood cultures from separate peripheral punctures. Also culture from a central line if one is present 4…

…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…

…2. Marked sinus bradycardia, sinus arrest, sick sinus syndrome with long pauses. Bradycardia in poisoning with a beta blocker, a calcium channel blocker or digitalis…

…early diastolic early diastolic holodiastolic Quantification of regurgitant jet Mild regurgitation Moderate regurgitation Severe regurgitation Jet width / LVOT width < 0,25 0,25 0…

…a central vein, the initial dose should be reduced. Dosage and Dose Escalation To terminate tachycardia, adenosine is rapidly injected intravenously at initial doses of…

…consequently central to diagnosis and long term management. Clinical presentation and symptoms The source material does not describe the typical symptoms or symptom burden of…