…and nicardipine in hypertensive emergencies. Time to onset of action 2 4 minutes Duration of action 5 15 minutes Delivery IV (infusion). Dose Initial dose:…

…and nicardipine in hypertensive emergencies. Time to onset of action 2 4 minutes Duration of action 5 15 minutes Delivery IV (infusion). Dose Initial dose:…

…as the reference line or isoelectric line ) of the ECG curve. The amplitude of any deflection/wave is measured by using the PR segment as…

…are also estimated using continuous Doppler. A dense regurgitant jet with rapid deceleration (short PHT) is suggestive of severe regurgitation; the leakage usually ends early…

…in the same order every time, reduces the risk of missing abnormalities. The eight steps below go through the rhythm and then the waveforms one…

…appearance in short axis views. The increased pressure may also propagate back to the right atrium and venous system, resulting in dilation of vena cava…

…short PR interval (PR interval <0.12 seconds). This condition is referred to as pre excitation (the ventricles are excited prematurely; refer to Figure 4…

…the left ventricle during diastole. The hemodynamic consequences of aortic regurgitation depend on whether the condition develops acutely or gradually. Acute aortic regurgitation Acute aortic…

…CABG) Types 4b and 4c fulfil the criteria for type 1 MI because they represent coronary atherothrombotic events in the setting of a stent thrombosis…

…likelihood of successful defibrillation is high in coarse VF (the early phase), but diminishes rapidly as the waveform becomes finer (Figures 2, 3 and 4…

…Circulatory phase 4 to 10 minutes Compressions and ventilation, followed by defibrillation Metabolic phase 10 minutes Unknown Table 1 . The 3 phase model of sudden…

…The hypotensive effect of enalaprilat depends on plasma volume and plasma renin activity. Volume depletion and high plasma renin activity increase the effect of enalaprilat…

…ongoing symptoms suggestive of ischaemia; haemodynamic instability; or life threatening arrhythmias. A routine PPCI strategy should be considered for presentation 12–48 hours after symptom…

…R Given that voltage (V) is constant and battery depletion must be minimized, most pacemakers use lead tips with high resistance (400 to 1200 Ω)…

…filtration rate Reported estimates include a rate of approximately 0–2% in patients with an eGFR of 30–44 mL/min/1.73 m2 and…

…pauses. In an ICD patient, EMI may be interpreted as ventricular tachyarrhythmia and trigger inappropriate antitachycardia treatment unless detection and therapy are disabled. Conversely, asynchronous…

…pupils are indicative of cerebral anoxia or brain death and constitute an adverse prognostic sign. Notably, the presence of dilated, nonreactive pupils 48 hours post…

…complex: Naming of the waves in the QRS complex is easy but frequently misunderstood. The following rules apply when naming the waves: A deflection is…

…is comprised of one negative deflection. The following figure shows pathological Q waves in two patients with acute STEMI. Figure 2. Examples of STE ACS…

…ventricular dilation secondary to non compaction cardiomyopathy, which confers only slightly elevated risk of ventricular arrhythmias (Almeida et al). Genes and DCM Approximately 40% of…

…help determine expected normal values based on body surface area (BSA), aiding in the diagnosis of aortic root dilation. Key Formulas BSA Calculation (Mosteller formula): [ …

…LAP rise slowly. This leads to compensatory dilatation of chambers. The mechanism underlying ventricular and atrial dilation proceeds from Laplace's law, which states that…

…misestimations. Clinical implications While the MDRD eGFR calculator has significantly advanced the detection and management of CKD, clinicians should be aware of its limitations. In…

…left ventricular dilation. This type of cardiomyopathy, referred to as tachycardia induced cardiomyopathy , can be caused by any tachyarrhythmia leading to prolonged periods of rapid…

…and it provides adequate opportunities for rhythm diagnostics, as well as detection of T waves and R waves. It is essential that T waves and…

…meaning that the greater portion of the P wave is positive but the terminal portion is slightly negative (the vector generated by left atrial activation…

…a precaution. Dosage of vernakalant Vernakalant is dosed by body weight, with the maximum dose based upon 113 kg. Normal dilution: 4 mg/ml. Recommended…

…shown to reduce stroke risk, and detection may lead to inappropriate anxiety and invasive procedures. Symptomatic disease Symptoms of carotid disease include: TIA; ischaemic stroke…

…the contraction of smooth muscle cells. As compared with nitroprusside, nicardipine induces relatively greater venodilation than arteriolar dilation. Effects Nicardipine causes dilation of the coronary…

…otherwise stated. When the weight of a child aged 1–10 years is unknown: estimate it as (age in years + 4) × 2 kg , but use…

…and the arrhythmia itself. This remodeling manifests as interstitial fibrosis, atrial dilation, and endocardial denudation, which collectively promote local inflammation and create a highly prothrombotic…

…of fraction of left ventricular volume ejected per beat and of ventricular end diastolic and residual volumes. Experimental and clinical observations with a precordial dilution…

…Intervention Included in BLS NNT to save 1 person Reference Early detection of cardiac arrest Yes 11 Berdowski et al Bystander CPR Yes 15 Hasselqvist…

…Investigation of cardiac masses Detection of cardiac masses with echocardiography most often entails additional investigation, which is aimed at clarifying the genesis of the mass…

…ECG Aortic dissection – due to risk of progression and rupture. Acute myocardial infarction (AMI) within 48 hours – due to the risk of aggravating the infarction…

…negative deflection in V1 becomes deeper. This is called P mitrale, because mitral valve disease is a common cause (Figure 1). The duration of the…

…right heart hypertrophy, dilation and ultimately right heart failure. Echocardiography in mitral stenosis Echocardiographic assessment of mitral stenosis includes visual and 2D imaging, as well…

…have increased the detection of pulmonary embolism. Currently, the lifetime risk of developing venous thromboembolism is 8% for individuals 45 years of age ( Raskob et…

…tolerance Reproduction and characterization of symptoms Heart rate and blood pressure responses to exercise Detection of exercise induced arrhythmias Identification of exercise related ST segment…

…Where resources permit, objective assessment may include directly observed treatment or detection of prescribed medications in blood or urine samples. In patients with an estimated…

…distinction between UA and NSTEMI has become increasingly dependent on the use of highly sensitive cardiac troponin assays. As detection of myocardial necrosis has improved…

…Intervention BLS or ACLS NNT to save 1 person Reference Early detection of cardiac arrest BLS 11 Berdowski et al Bystander CPR BLS 15 Hasselqvist…

…the concentration, the dilution instructions and the local protocol before prescribing. Basic principles of treatment The patient should be managed in an emergency department, an…

…titration. Half of all opioid dosing errors arise at the dilution step, and an undiluted syringe of 10 mg/mL makes small adjustments impossible. Procedure…

…approximately 5% alcohol, 5 fluid ounces of wine containing approximately 12% alcohol, or 1.5 fluid ounces of 40% distilled spirits. Habitual heavy consumption is…

…Reliance on hypokalaemia alone therefore misses a substantial proportion of cases. The cardiorenal and cerebrovascular consequences of unrecognized PA make early case detection clinically important…

…other ECG changes (see below) should lead to a suspicion of ARVC. The gradual loss of myocardium leads to ventricular dilation and right heart failure…

…QRS complex; (3) the P wave is positive in lead II and (4) the PR interval is constant. Causes of bradycardia : sinus bradycardia, sinoatrial block…

…pressure, which subsequently causes right atrial dilation. Vena cava inferior may also dilate secondarily. Principles of management Medical therapies do not alter disease progression. Diuretics…

…of the general population for cardiovascular risk factors has not been shown to improve cardiovascular outcomes, although opportunistic assessment during clinical encounters improves detection of…

…excluded with out of office measurements. Objective assessment of adherence may be undertaken where resources permit, using directly observed treatment or detection of prescribed drugs…

…QRS complex; (3) the P wave is positive in lead II and (4) the PR interval is constant. Causes of bradycardia : sinus bradycardia, sinoatrial block…