…together account for approximately half of patients with symptomatic HF. The distinction is clinically useful but not absolute. Ejection fraction is a continuous variable and…

…of flow) and continuous Doppler (to locate the maximum flow velocities). As Figure 1B illustrates, the mitral inflow yields 3 phases on the spectral curve…

…the continuous wave Doppler cannot determine the location of the maximum velocity recorded, but it allows for the recording of very high velocities along the…

…lead to misclassification. Blood pressure should be measured with a validated and calibrated device using a consistent method for the individual patient. The recommended procedure…

Echocardiography The Bernoulli principle and pressure gradients using Doppler measurements Continuous wave Doppler and pulsed wave Doppler can measure the velocity of erythrocytes as they…

…and occlusion patterns on the ECG Classic ST elevation criteria New ST elevation at the J point in at least two anatomically contiguous leads indicates…

…2]. The single most important practical rule is: Continuous acute dizziness with spontaneous nystagmus: consider HINTS plus, but only if the examiner is trained. Brief…

…heart rate and a continuous ECG. Establish two intravenous cannulae where possible. Use intraosseous access if intravenous access cannot be obtained quickly and parenteral treatment…

…only redefined: continuous core temperature measurement and a target value that must never be exceeded, during the first 72 hours for as long as the…

…is defined by a macroreentrant atrial circuit, which manifests on the electrocardiogram (ECG) as organized, continuous atrial electrical activity. This activity most commonly presents as…

…The valve is attached to the mitral annulus , which is continuous with annulus fibrosus (the fibrous ring). The mitral valve has an anterior leaflet and…

…or raised Other Moderate work of breathing Accessory muscle use Cyanosis, exhaustion, hypotension or collapse The classification is based on a combination of clinical findings…

…be confused with a venous access. Indications Continuous blood pressure monitoring in haemodynamic instability or during ongoing vasoactive treatment. Conditions in which blood pressure must…

…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…

…Remove contaminated clothing and wash the skin after external exposure A low Glasgow Coma Scale is not on its own an absolute indication for intubation…

Infektionssjukdomar Akutsjukvård Lathundar Purpose and scope A quick reference for the doctor on call faced with suspected sepsis in adults: rapid recognition, microbiological sampling, empirical…

…partial rupture into a complete one. Contact the urologist or the surgeon on call for urethrography and suprapubic drainage. Preparation and equipment A sterile catheterisation…

…transgastric aortic valve long axis (AVLAX) view. Method : Use continuous wave Doppler (CWD) across the aortic valve. Trace the Doppler profile to calculate the AV…

…to 15 minutes as necessary. Continuous infusion: Start infusion at 0.1 mg/min and increase in increments of 0.1 mg. Adverse effects Tachycardia…

…Continuous ECG monitoring is mandated during hospital initiation to detect excessive QT prolongation, proarrhythmia, and severe bradycardia. Patients should be monitored for arrhythmias and QT…

…victims have continuous ECG monitoring (telemetry), which allows instantaneous identification of the initial rhythm ( Thorén et al ). The initial rhythm has immense significance for survival…

…threshold may trigger consideration for Extracorporeal Membrane Oxygenation (ECMO) initiation ( Soar et al ). ETCO 2 trends can vary during CPR depending on various factors such…

…useful for detecting valvular regurgitation and defects in the atria or ventricles (Figure 2). In addition, color Doppler can be used to align the continuous…

…and ischemia cannot occur. No changes on resting ECG. Increased myocardial workload (exercise) Oxygen supply increases in parallel with increased oxygen consumption during exercise. Thus…

…Echocardiography in pulmonary regurgitation Echocardiography is the modality of choice for diagnosing pulmonary regurgitation. Continuous Doppler through the pulmonary valve reveals regurgitant blood flow in…

…disease. The stenosis can be fixed or dynamic, depending on the underlying etiology. Pulmonary stenosis can be valvular (i.e stenosis localized in the valve)…

…the PRF only depends on the distance the sound waves must travel. The longer the distance, the more time required for sound waves to travel…

…visually characterized by thickened leaflets, with reduced motion and potentially fused commisures. Continuous Doppler is used to assess the stenosis. Doppler recordings are made during…

…vary; follow the local setting instructions for the device available on the unit. Preparation and equipment A device capable of both CPAP and bilevel ventilation…

…argument for imaging rather than a conventional exercise test. Preparation and equipment Cycle ergometer with a braked, workload controlled resistance; 12 lead ECG with continuous…

…continuous ECG monitoring and early assessment of the need for dialysis ECG changes or serious neuromuscular symptoms mean a high risk even if the plasma…

…blood pressure measurement and continuous monitoring. An arterial line is often appropriate when very rapid or precise control is required, for example in acute aortic…

…patient. Continuous glucose monitoring reflects interstitial glucose and lags behind the blood glucose during rapid changes. Pressure on the sensor, for example during sleep, can…

…in the hospital. Endocrine Society clinical practice guideline on the management of hyperglycaemia in hospitalised adults. The summary of product characteristics for each insulin preparation.

…Screen for delirium every shift BIS (during neuromuscular blockade) 40–60 Targeted light sedation with a daily wake up trial shortens the time on the…

…Take samples for blood grouping and cross matching before transfusion if this can be done without delay. 5. Start active warming and use a blood…

…before it. Preparation and equipment Ultrasound with a sector probe (the same probe as for echocardiography) and a sterile probe cover. Continuous ECG, blood pressure…

…nervous system. Contact your national or regional poison control centre for advice on the treatment threshold and on whether haemodialysis should be considered. Rhabdomyolysis with…

…may produce elevated troponin concentrations. The probability of MI increases continuously as the absolute hs cTn concentration rises. Early absolute changes over 1 hour provide…

…or atheroembolic material, but pharmacological and mechanical strategies directed specifically at reperfusion injury have not generally demonstrated sufficient clinical benefit for routine use. No reflow…

…Continuous blood pressure and rhythm monitoring are mandatory, particularly when utilising dobutamine, to ensure the lowest effective dose is used. When titrating sodium nitroprusside for…

…period of anticipated EMI. The perioperative strategy should also recognize that CRT patients may rely on continuous biventricular pacing for haemodynamic stability. In patients with…

…emergency medical services should be called. Patients who have been prescribed sublingual nitroglycerin should be instructed in its appropriate use, although specific dosing instructions are…

…setting, patients at high risk for malignant arrhythmias should undergo continuous electrocardiogram monitoring throughout the entire peri operative period to assess rhythm stability [10]. References…

…due to syncope, identify the cause, and assess the risk for future episodes and serious harm. This evaluation should include a detailed history, thorough questioning…

…which some of the ultrasound energy is reflected and the remainder continues through the tissues. Depending on the difference in acoustic impedance between the tissues…

ECG Myocardial ischemia and infarction Use of ECG in acute coronary syndromes & chest pain patients An ECG must be performed on all patients seeking medical…

…of ST segment elevations on ECG. Current guideline criteria for ischemic ST segment elevation: New ST segment elevations in at least two anatomically contiguous leads: …

…aorta can be regarded as a cylinder, and the same assumption can be made for the other valves. The area is calculated by measuring the…

…one must consider rescue PCI. For the purpose of assessing ST segment return, one should preferably use continuous ST segment monitoring. If monitoring equipment is…

…Pathological tricuspid regurgitation is more pronounced. Echocardiography is the preferred method for diagnosing tricuspid regurgitation. Causes of tricuspid regurgitation The most common causes of tricuspid…

…resistant to resolution. Known predictors of cardiac arrest The only risk biomarker in genuinely widespread use is left ventricular ejection fraction (LVEF), measured by echocardiography…

Continous medical discussion: the ECG blog ECG Early repolarization pattern: confused J points, notches and slurs I once had the privilige of attending a lecture…

…Seitelberger R, Ross J Jr. Mechanism of beneficial ef fect of beta adrenergic blockade on exercise induced myocardial ischemia in conscious dogs. Circ Res. 1987…

…include all these aspects. Most books lacked clinical management, key aspects of pathophysiology and discussions on differential diagnoses for each condition. Moreover, most books included…

Cardiology Continous medical discussion: the ECG blog Infectious diseases Cardiovascular effects of COVID 19 Coronavirus disease 2019 (COVID 19) has caused a global public health…

Cardiology Continous medical discussion: the ECG blog Coronary artery disease: On LDL cholesterol, dietary fat & statins You are probably aware that ischemic heart disease, also…

Cardiology Continous medical discussion: the ECG blog Endocrinology & metabolism Cardiovascular medicine is currently witnessing a paradigm shift. For decades, the management of type 2 diabetes…

Arrhythmias and arrhythmology Continous medical discussion: the ECG blog Genetic and miscellaneous conditions A novel potentially life threatening cardiac arrhythmia syndrome identified with ECG The…

…on specific electrocardiographic thresholds for ST segment elevation measured at the J point. The diagnostic criteria require new ST elevation in at least two contiguous…