…pulmonary pressures that contributes to exertional breathlessness and reduced exercise capacity. Multiorgan and comorbidity driven disease HFpEF is heterogeneous rather than a single pathophysiologic entity…

Echocardiography Echocardiographic assessment of left ventricular diastolic function Methods for evaluating left ventricular diastolic function have evolved considerably in the past two decades. Currently recommended…

…analyzed continuously (Figure 1). This is possible by using two different sets of piezoelectric crystals; one set for sending ultrasound and the other for analyzing…

Cardiology Definition and pathophysiology Blood pressure is a continuous cardiovascular exposure rather than a binary distinction between normotension and hypertension. Its long term relationship with…

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…

…attach continuous rhythm monitoring, secure intravenous access, assess the circulation and the bleeding risk, and exclude dangerous differential diagnoses [1,2]. STEMI and other ECG…

…Acute or subacute onset, continuous dizziness lasting hours to days, often with nausea, nystagmus, motion intolerance and difficulty walking Vestibular neuritis, cerebellar or brainstem infarction…

…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…

…2. Insert the core temperature probe and connect it to the feedback loop of the cooling device. Without continuous measurement the whole treatment is blin

…undergoing pharmacological treatment for AF with class IC drugs or amiodarone. In these instances, the flutter rate may be reduced to less than 200 beats…

…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 reduced air entry Silent or nearly silent chest pCO₂ Low Usually low Normal or raised Other Moderate work of breathing Accessory muscle use Cyanosis…

…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…

…Cerebellar infarction HINTS in continuous vertigo HINTS is not a test for BPPV. It is used in the acute vestibular syndrome — continuous vertigo with spontaneous…

…cases, enhanced elimination. For many poisonings, well delivered supportive treatment matters more than the antidote [1,2]. Telephone your national or regional poison control centre …

…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…

…for accurate measurement of urine output in a critically ill patient. Perioperatively and postoperatively in longer procedures and with epidural anaesthesia. Bladder washout and continuous…

…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…

…it is advised to use ETCO2 trends over time rather than single measurements. ETCO 2 should not be the sole determinant for terminating CPR or…

…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…

…Figure 1. Myocardial cells require a continuous oxygen supply in order to maintain normal metabolism. If oxygen supply is less than oxygen demand, ischemia develops…

…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…

…The maximum and mean pressure gradient is calculated using continuous wave (CW) doppler placed along the pulmonary valve in the parasternal short axis view (PSAX…

…Figure 1. The difference between pulsed wave (PW) and continuous wave (CW) Doppler. PW Doppler sends short pulses of ultrasound and analyzes reflected sound waves…

…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…

…all in diabetes. The severity of the symptoms and the patient's need for help matter more than a single measured value [2]. Level Plasma…

…protocol Avoid tight targets in inpatients. Hypoglycaemia on the ward is more dangerous than moderate hyperglycaemia over a few days. Principles Insulin component Function Who…

…aims in themselves. Almost all of them have proved to work better as ranges to stay within than as figures to strive for. Ventilation In…

…for at least 4 units of red cells within 1 hour. An actual requirement of more than 3 units of red cells during any continuous…

…pulsus paradoxus Contraindications In overt tamponade with shock there are no absolute contraindications other than the conditions in which the procedure is the wrong treatment :…

…differs between units. Poisoning with other weak acids where the poison control centre recommends it, for example certain phenoxy acid herbicides (2,4 D, MCPA)…

…and Pathophysiological Basis High sensitivity cardiac troponin (hs cTn) assays detect circulating troponin released from injured cardiomyocytes at substantially lower concentrations than earlier generation assays…

…specifically at reperfusion injury have not generally demonstrated sufficient clinical benefit for routine use. No reflow may also occur in association with other procedural complications…

…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…

…of symptom onset: reperfusion therapy is recommended for all patients with a working diagnosis of STEMI. More than 12 hours after onset: primary PCI remains…

…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…

…syncope and in patients older than 40 years with recurrent syncope of unknown etiology. This test should be performed under continuous ECG and blood pressure…

…times between dense structures ( i.e structures with high echogenicity). For each reflection, a portion of the sound waves return to the transducer and produce…

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…

…segment elevations in at least two anatomically contiguous leads: • Men age ≥40 years: ≥2 mm in V2 V3 and ≥1 mm in all other 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…

Continous medical discussion: the ECG blog ECG A deep learning ECG biomarker for sudden cardiac death: what the new Nature study shows Low risk (blue…

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…

Continous medical discussion: the ECG blog Myocardial ischemia and infarction Myocardial ischemia The definition of ischemia may appear trivial but it is actually a very…

…Recognizing that many visitors are interested in other books and online resources, we have plowed through more than 30 of the most popular ECG books…

…factors for poor outcomes. The vast majority of infections with COVID 19 result in mild disease, with symptoms similar to seasonal flu (influenza) and other…

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…

…Greater than or equal to 1.5 mm All patients Other leads Greater than or equal to 1 mm These criteria for the other leads…