…Several underlying conditions increase a patient's sensitivity to digitalis related arrhythmias. The clinician must evaluate for the presence of worsening renal function, advanced age…

…quality — a relaxed patient is easier to examine. Indications Symptoms: bleeding outside menstruation, postmenopausal bleeding, discharge, itching, burning, pelvic pain, dyspareunia. Cervical cancer screening according…

Critical care Myocardial ischemia and infarction Definition and Pathophysiology Cardiogenic shock is a state of inadequate tissue and end organ perfusion caused by cardiac insufficiency…

…The sinus of Valsalva diameter (SOVd) is a critical measurement in evaluating aortic root morphology. Age stratified formulas help determine expected normal values based on…

…Glomerular Filtration Rate (eGFR) is: eGFR = 175 × (Scr)^ 1.154 × (Age)^ 0.203 × (0.742 if female) × (1.212 if African American)…

…either within or outside the hospital, prompt communication with an obstetrician and neonatologist is critical. Cardiopulmonary resuscitation (CPR) should generally adhere to the standard adult…

…guidelines as HF with a left ventricular ejection fraction (LVEF) of ≤40% [14, 26, 27] . Recent guideline updates have introduced critical nuances to HF terminology…

… warm ischaemic time is the limiting factor The time critical element The diagnosis and the donor care The time from withdrawal of treatment to circulatory…

…is not uniformly present. The proportion of painless or silent STEMIs is greater in patients with diabetes mellitus and increases with age. STEMI may present…

…deaths in patients without structural heart disease and is the leading cause of SCD in men under the age of 40 in endemic regions [3] …

…pharyngeal swelling, obesity N eck mobility Reduced neck mobility, a cervical collar, rheumatoid arthritis, ankylosing spondylitis MACOCHA is validated for the intensive care patient and…

…RV filling and/or reduced RV output. Recognition of this syndrome is critical because it may precede haemodynamic collapse. Clinical risk scores Validated clinical tools…

…specific segments of the left ventricle that demonstrate abnormalities. These tools compare perfusion data to population based reference databases, often adjusted for sex and age…

…sufficient Severe elevation Acute HMOD Present Absent clinically Symptoms Often present and related to the affected organ May be absent or nonspecific Treatment setting Usually…

…and lateral walls, and the posterior wall if the LCx supplies the posterior descending artery (PDA) in a left dominant circulation (i.e. 10 15…

Cardiology Critical care Pharmacology & dosing Definition and Pathophysiology In the management of acute heart failure and cardiogenic shock, intravenous vasoactive agents are categorised according to…

Arrhythmias and arrhythmology Critical care Definition and pathophysiology Atrial fibrillation (AF) is the most frequent supraventricular arrhythmia in patients with acute coronary syndromes (ACS) and…

Arrhythmias and arrhythmology Critical care Pharmacology & dosing Definition and Pathophysiology Bradycardia and conduction disorders arise from dysfunction within the sinus node, the atrioventricular node (AVN…

CPR Time is the most critical factor for survival in cardiac arrest. Life saving interventions must be initiated momentarily to maximize the probability of survival…

…to Methods and Clinical Relevance The shunt fraction (Qp/Qs) is a critical hemodynamic parameter used to quantify the ratio of pulmonary blood flow (Qp…

…opposite in each case. Equivalent doses Agent Equivalent glucocorticoid dose Mineralocorticoid effect Biological half life : : : : Hydrocortisone (cortisol) 20 mg Marked Short, 8–12 hours Prednisolone…

…leaves no specimen . That makes the choice of lesion the critical point: never freeze anything whose diagnosis you have not established. Indications Lesion Freeze time…

…cannula. Wait a few minutes — the venepuncture itself can cause a stress related rise in cortisol. 3. Take the baseline sample : cortisol and plasma ACTH…

…cycle, encompassing both systole and diastole. It is a critical parameter in cardiovascular physiology, providing insight into the perfusion pressure experienced by organs and tissues…

…and hypoperfusion manifesting as hypotension. The high mortality associated with sepsis underscores the critical importance of timely and appropriate interventions. In patients presenting with concurrent…

…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 bloodless field one works by feel, and by feel nail spicules are left behind — which is the commonest cause of recurrence. Indications Condition Procedure : …

…below the target range, or a PaO2 below 8 kPa on an arterial blood gas. Acute critical illness during initial stabilisation — cardiac arrest, shock, sepsis…

…left atrium is activated passively. The upper boundary of this circuit may be located either anterior or posterior to the superior vena cava. A critical…

…Goldberger et al ECG Wave Maven It is likely that this Dr Goldberger is related to the Dr Goldberger who invented the ECG leads aVR…

…such as amyloidosis or sarcoidosis Other cardiac procedures Chemotherapeutic agents Catheter ablation Critical illness Defibrillator shocks Strenuous exercise Cardiac contusion The diagnosis should therefore distinguish…

…can immediately and safely restore sinus rhythm, obviating slow drug titration and rendering the supraventricular versus ventricular distinction less critical. Performance involves sedation (e.g…

…For cardiologists – particularly interventional cardiologists – this knowledge is of critical importance as they must be able to directly pinpoint where the coronary artery occlusion is…

…providing absolute quantification. The resting myocardium rarely reveals evidence of significant coronary artery stenosis unless the stenosis is severely critical, potentially causing angina during rest…

…in knowledge, with some of the most critical components of current guidelines being based on observational data ( e.g compression rate and depth). With current…

…fail to generate stroke volumes. Consequently, addressing reversible causes of cardiac arrest becomes more critical than performing chest compressions. Hemorrhages, either manifesting externally or concealed…

…asymptomatic, NSVT serves as a critical marker of arrhythmogenic risk, particularly in the setting of ischemic heart disease or reduced left ventricular ejection fraction (LVEF)…

…respiratory arrest. A venous blood gas can give useful information about pH and the trend in carbon dioxide, but in critical illness, marked hypoxaemia, or…

…This corresponds to the so called critical administration threshold and identifies rapid bleeding better than the retrospective definition of at least 10 units of red…

…conversion of angiotensin I to angiotensin II. By abrogating the effects of angiotensin II, ACE inhibitors stabilize left ventricular remodeling, improve patient symptoms, prevent hospitalization…

…bradyarrhythmia Increased myocardial oxygen demand Sustained tachyarrhythmia, severe hypertension, hypertensive crisis, critical aortic stenosis, severe hypertrophic cardiomyopathy, extreme exercise Direct myocardial injury Myocarditis, cardiac co

…V6 [3]. Clinical Implications of Axis Deviation Deviations in the electrical axis serve as critical diagnostic markers for structural and hemodynamic cardiac abnormalities. Right Axis…

…1]. Acute Management and Treatment Alternatives The management of TdP and related malignant ventricular arrhythmias requires a structured approach focusing on rhythm stabilization, relief of…

…tachyarrhythmia, or severe hypertension with or without left ventricular hypertrophy. Among patients with NSTE ACS undergoing angiography, approximately 10% have no critical epicardial stenosis. In…

…remains unknown ( Guildner et al ). Jaw thrust is preferred if there is suspicion of cervical spine injury, in which scenario head tilt chin lift should…

…used routinely to visualize regional myocardial function and mechanics. Loading conditions and heart rate may affect left ventricular function. Transesophageal echocardiography (TEE) is superior to…

…regular wards and rehabilitation facilities. Depending on the cause of the arrest, other units may be critical (e.g. trauma unit). Careful and evidence based…

…The left bundle branch further divides into the anterior and posterior fascicles. The bundle branches and fascicles play a critical role in disseminating the impulse…

…postpones or mitigates cerebral injuries. No flow time and low flow time are critical parameters for determining the probability of survival. No flow longer than…

…Figure 1 . Myocardial ATP concentration after induction of ventricular fibrillation (cardiac arrest). As ATP concentration declines, critical cell functions cease. Membrane potential, action potential, excitability…