Myocardial ischemia and infarction Pharmacology & dosing Definition and pathophysiology Dual antiplatelet therapy (DAPT) is the combined use of aspirin and an oral P2Y12 receptor inhibitor…

…Postoperative hypertension. Mechanism of action Combined beta adrenergic and alpha adrenergic blocker with rapid onset of action. Labetalol has less antihypertensive efficacy as compared with…

…with inotropic and vasopressor effects, and they often need to be combined in order to optimise or correct the haemodynamics. Most agents exert both vasopressor…

…cardiac contractile force (contractility). Several endogenous and synthetic agents exist and are frequently combined to achieve the desired hemodynamic outcome. Most agents exhibit both vasopressor…

…intrinsic sympathomimetic activity that also prolongs cardiac repolarization, thereby exerting combined class II and class III antiarrhythmic effects. The drug comprises both d and l…

…ventricular systolic function. These methods elucidate slightly different aspects of systolic function and their combined use allows for careful mapping of systolic function. It is…

…cardiac contractile force (contractility). Several endogenous and synthetic agents exist and are frequently combined to achieve the desired hemodynamic outcome. Most agents exhibit both vasopressor…

…haemothorax, a symptomatic or large pneumothorax, recurrent malignant effusion (often combined with pleurodesis), and in chest trauma and postoperatively. Emergency needle decompression: a clinical suspicion…

…heart failure, kidney or liver disease, especially when combined with diuretics (risk of fluid retention and impaired kidney function). Patients with bronchial asthma, chronic obstructive…

…optimal initial combination strategy remains uncertain. A beta blocker combined with a dihydropyridine CCB is appropriate for many patients. Long acting nitrates or ranolazine may…

…many cases, the renal injury probably represents acute tubular necrosis arising from the combined effects of contrast exposure and other ischaemic or nephrotoxic stresses. The…

…acids and other bioactive compounds from nuts; and antioxidant and antithrombotic constituents from whole grains. These combined effects may improve inflammation, insulin resistance, glucose metabolism…

…blood flow and myocardial flow reserve with PET. Evaluate myocardial viability, particularly when combined with metabolic imaging. Contribute to assessment of cardiac inflammation, infective endocarditis…

…units Isolated postcapillary PH (IpcPH) 20 mmHg 15 mmHg ≤2 Wood units Combined pre and postcapillary PH (CpcPH) 20 mmHg 15 mmHg 2 Wood units…

…CKD), which itself promotes cardiovascular disease and amplifies cardiovascular and all cause mortality. The excess risk is mediated by the combined effects of hyperglycaemia, hypertension…

…calcium and magnesium. Note that some patients may exhibit combined electrolyte imbalance. The ECG may be used to estimate the severity of electrolyte imbalances and…

…transducer, frequently making it difficult to obtain representative sections of structures of interest. M mode can be combined with Doppler techniques (Color Doppler, Tissue Doppler)…

…can be given as steroid cover during the test Oestrogen and the combined oral contraceptive These raise cortisol binding globulin and can give falsely normal…

…airway equipment. Analgesia and sedation: an opioid (morphine or fentanyl) combined with a benzodiazepine (midazolam or diazepam) is the commonest combination; propofol is used in…

…and harms In secondary prevention trials involving patients with previous vascular disease, aspirin reduced the combined incidence of non fatal MI, non fatal ischaemic stroke…

…scanning is associated with a particularly low dose, approximately 1–2 mSv, while contemporary combined coronary, pulmonary, and aortic angiography can achieve less than 5…

…pressure derived index of the functional effect of an epicardial stenosis. CFR reflects the combined influence of epicardial stenosis, resting flow and microvascular vasodilator capacity…

…beats/min. The reduction in the combined outcome of cardiovascular death or heart failure hospitalisation was related to the magnitude of heart rate reduction. Ivabradine…

…or metabolic syndrome Elevated triglycerides Low or apparently well controlled LDL C with suspected residual atherogenic particle burden In patients with diabetes and combined dyslipidaemia…

…angina pectoris. The location of the pain beneath the xiphoid and epigastrium, combined with patient denial, often leads to a mistaken impression of indigestion. STEMI…

…ciclosporin, warfarin and grapefruit juice. Gemfibrozil should not be combined with statins because it alters statin absorption, hepatic uptake and disposition. Clinical presentation and symptoms…

…in reperfusion therapy. Advanced ECG interpretation, combined with clinical assessment and imaging modalities, has been shown to improve the identification of these patients. Although current…

…Reserve (CFR) & Index of Microcirculatory Resistance (IMR) CFR: ratio of hyperemic to resting coronary flow/velocity (Doppler or thermodilution wire) — reflects combined epicardial + microvascular resistance…

…Coronary angiography remains primarily an anatomical examination, whereas contemporary decision making increasingly combines anatomical imaging with functional assessment. A central practical principle is that the…

…stents (BMS) in response to restenosis caused principally by neointimal hyperplasia. Contemporary DES combine a metallic scaffold, a polymeric or polymer free drug delivery system…

…the systematic assessment of relatives and other individuals who may carry an inherited predisposition to cardiovascular disease. It combines a structured family history, clinical evaluation…

…coronary artery disease (CAD). It combines echocardiographic assessment of left ventricular (LV) structure and function with exercise or pharmacological stress. The physiological basis is an…

…inotropic support Persistent congestion despite initial therapy Increase diuretic dose and/or combine diuretic classes Diuretic resistance or end stage renal failure Consider renal replacement…

…Diagnostic Framework The diagnostic pathway combines three principal domains: Clinical presentation and vital signs The 12 lead ECG The hs cTn concentration at presentation and…

…risk factors or an elevated estimated risk. It combines lifestyle intervention with treatment of risk factors when indicated. Risk estimation is particularly important when deciding…

…perform systematic interpretation may actually be detrimental. We have therefore compiled a pocket guide with a universal interpretation algorithm. These 22 pages includes all you…

…actually a very complicated topic. The term ischemia was coined in 1858 by Virchow (the same Virchow who unraveled thrombosis). He used te term to…

…common in patients with inferoposterior left ventricular infarction, while infarction confined predominantly to the right ventricle is rare. The clinical spectrum extends from limited right…

…form of typical atrial flutter, the reentrant circuit is confined to the right atrium and travels in a counterclockwise direction. The activation wavefront propagates in…

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

…high risk plaques may exist throughout the coronary tree, while inflammation and thrombotic susceptibility are often systemic rather than confined to a single lesion. Consequently…

…disease is less pronounced in the left ventricle. Rarely the condition is confined to the left ventricle. ARVC causes ventricular tachycardia and sudden cardiac arrest…

…believed that early repolarization was a benign condition, which is why the term benign early repolarization was coined. This notion was overturned in 2008 when…

…Presently, this treatment is confined to well equipped centers and is generally reserved for meticulously selected cases. Extracorporeal Life Support (ECLS) encompasses several extracorporeal systems…

…risk plaques may coexist within one coronary tree, and inflammatory activity may be widespread rather than confined to a single lesion. Plaque composition is heterogeneous…

…abnormal repolarization response to exercise induced myocardial oxygen supply–demand imbalance. The exercise response is not confined to the ECG. Ischaemia may also produce angina…

…profession. Read Dr Rawshani's book Below follows a review, compiled by Dr Araz Rawshani, of the most widely used books in ECG education. Review…