…Sit the patient up again and observe the eyes for a further period — reversal of the nystagmus is common. 6. Repeat on the left side…

…A central line set with a triple lumen catheter, usually 7 Fr. Catheter length: the right internal jugular vein requires the shortest catheter, while left…

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…

…therapy is a central component of cardiovascular prevention, particularly in patients with established atherosclerotic cardiovascular disease (ASCVD), chronic coronary syndrome (CCS), peripheral artery disease (PAD…

…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…

…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…

…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…

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

…Pathophysiology Coronary artery disease and obstructive stenosis Anatomically significant epicardial CAD is conventionally defined as stenosis of at least 70%, while a left main coronary…

…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…

…Thrombus formation is most commonly related to the left atrial appendage, although competing mechanisms such as large artery atherosclerosis and small vessel disease may also…

…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…

…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…

…failure with reduced ejection fraction (HFrEF) and coronary artery disease (CAD), and after acute coronary syndromes in patients with reduced left ventricular ejection fraction (LVEF)…

…and ascends in a caudocranial direction along the interatrial septum. The left atrium is activated passively. The upper boundary of this circuit may be located…

…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…

…consequent excess risk of premature atherosclerotic cardiovascular disease (ASCVD), particularly coronary artery disease (CAD). FH results from pathogenic variants affecting proteins in the hepatic LDL…

…ventricular relaxation and increased filling pressures The central hemodynamic abnormality in HFpEF is impaired diastolic function. The left ventricle may have apparently preserved global systolic…

…to suspected chronic coronary syndrome, is evaluated by estimating the likelihood of obstructive coronary artery disease (CAD) before diagnostic testing. This pre test probability is…

…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…

…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…

…Right sided filling pressures—including central venous, right atrial, and right ventricular end diastolic pressures—are elevated, whereas left ventricular filling pressure is usually normal…

…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…

…discussed in this article. Metabolic equivalent (MET): measuring oxygen consumption Estimation of oxygen consumption is central to the assessment of exercise capacity. Metabolic equivalents (METs…

…exceptions. Prior to the Doppler era, hemodynamic assessments were performed by means of right heart catheterization (with Swan Ganz catheter [ pulmonary artery catheter ]). However, hemodynamic…

…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…

…increases cardiac output, and lowers pulmonary artery pressure without increasing myocardial oxygen consumption. The inotropic effect of levosimendan is not affected by the concurrent use…

…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…

…radial trace may underestimate central pressure. The dorsalis pedis artery works but often shows more pronounced pulse pressure amplification. The brachial artery should be avoided…

…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…

…small variable large if central, variable if excentric Coaptation defect mild moderate severe CW profile aortic regurgitation weak variable dense Size left atrium normal normal…

…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…

…small variable large if central, variable if excentric Coaptation defect mild moderate severe CW profile aortic regurgitation weak variable dense Size left atrium normal normal…

…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…

…popliteal artery entrapment, trauma, phlegmasia cerulea dolens, ergotism, hypercoagulable states or iatrogenic vascular injury. Acute occlusion may also occur in an artery with established collateral…

…artery perfusing the AV node—before the drug is eliminated. A flush should immediately follow the bolus injection to ensure rapid delivery to the central…

…be biased by the clinical environment. Out of office measurement is consequently central to diagnosis and long term management. Clinical presentation and symptoms The source…

…75 mL/min/1.73 m², the probability of coronary artery disease (CAD) increases in an approximately linear manner. At an eGFR of 15 mL…

…the past century. Initial post mortem observations in the late 19th century first linked thrombotic occlusion of a coronary artery with myocardial necrosis. Although early…

…aorta. Type III: originates in the descending aorta, usually just distal to the left subclavian artery. Type IIIa: remains confined to the descending thoracic aorta…

…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…