…state of inadequate tissue and end organ perfusion caused by cardiac insufficiency. Sustained hypoperfusion reduces oxygen and nutrient delivery and, when severe or prolonged, produces…

…deliver blood at a rate appropriate to tissue requirements unless filling pressures are elevated. The syndrome is therefore defined by symptoms and signs of congestion…

…haemorrhage , and state the patient's location and identity, the presumed cause of bleeding, and how the products are to be delivered. 2. Designate a…

…or visceral, adipose tissue is more closely related to insulin resistance and the risk of diabetes and cardiovascular disease than total adiposity alone. The waist…

…the sinus rate. In the AV node, adenosine produces a transient, rate dependent prolongation of the A H interval, frequently manifesting as transient first , second …

…manifestations of preeclampsia and the potential for stroke even at blood pressure levels that might otherwise be considered only moderately elevated. The syndrome can produce…

…cardiac metabolic efficiency, including increased oxygen delivery and beta hydroxybutyrate oxidation Reduced sodium hydrogen exchanger subtype 3 activity Attenuation of oxidative stress, inflammation and fibrosis…

…Can produce severe hypotension. Time to onset of action 30 seconds to 1 minute Duration of action 1 to 10 minutes Delivery IV Dose Infusion…

…wall, usually through formation of an intramural haematoma that compresses the true lumen. The resulting reduction in coronary blood flow may produce myocardial ischaemia, acute…

…poisoning consists of four parallel components: supportive treatment, a targeted antidote, reduced absorption and, in selected cases, enhanced elimination. For many poisonings, well delivered supportive…

…complementary to that of statins. Statins reduce hepatic cholesterol synthesis, whereas ezetimibe limits intestinal cholesterol uptake. Expected LDL C reduction Ezetimibe produces a modest LDL…

…resuscitation (CPR). Prompt delivery of chest compressions, ventilations and defibrillation (when possible) are the strongest determinants of survival in cardiac arrest. All subsequent actions require…

…Key messages Two things set the COPD exacerbation apart from many other causes of acute dyspnoea: oxygen must be titrated cautiously and the blood gas…

Arrhythmias and arrhythmology Procedurer Lathundar Electrical cardioversion is the delivery of a precisely regulated electrical shock to terminate a tachyarrhythmia, and it encompasses both synchronized…

…etc . The purpose of such changes is simply to enable the cardiopulmonary system to increase its delivery of oxygen to skeletal muscle and myocardium. The…

…fibrillation (VF). ECG 6 . Delivery of shock, followed by asystole. ECG 7 . Asystole after shock. ECG 8 . Recurrence of supraventricular rhythm. ECG 9 . Supraventricular rhythm…

…Time to onset of action 50 to 10 minutes Duration of action 30 to 60 minutes Delivery IV Dose Initial infusion dose: 0.1 μ…

…Time to onset of action 1 to 2 minutes Duration of action 10 to 30 minutes Delivery IV Dose Bolus injection : 5 to 15 mg…

…close to delivery (embryopathy and fetal bleeding respectively). Marked liver failure with coagulopathy. Severe uncontrolled hypertension. Recent intracranial haemorrhage without a fresh assessment of benefit…

…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:…

…Time to onset of action 1 minute Duration of action 20 30 minutes Delivery IV Dose Loading dose: 500 μg/kg bolus over 1…

…0 g/kg/day Enteral nutrition Started within 48 h where possible Thromboprophylaxis Low molecular weight heparin unless contraindicated Head of the bed 30–45°…

…Time to onset of action 15 to 30 minutes. Peak effect Within hours. Duration of effect 8 to 24 hours Delivery IV Dose Initial dose…

…reduction of afterload is desired in conditions requiring afterload reduction. Time to onset of action 10 30 minutes. Duration of action <4 hours. Delivery IV…

…Time to onset of action 20 minutes Duration of action 5 to 8 hours Delivery IV Dose 1.25 to 5 mg IV followed by…

…oxygen delivery, high flow oxygen therapy (100% FiO2) should be provided to maintain arterial oxygen saturation levels above 95%. Given the young age of these…

…fibrillation (VF). ECG 4 . Polymorphic VT progresses to ventricular fibrillation (VF). ECG 5 . Ventricular fibrillation (VF). ECG 6 . Delivery of shock during ventricular fibrillation (VF).

…Time to onset of action 5 to 10 minutes Duration of action 2 to 4 hours Delivery IV Dose Can be given as repeated intravenous…

…Time to onset of action 5 to 15 minutes Duration of action 1.5 to 5 hours Delivery IV Dose 5–15 mg/hour IV…

…Premature menopause Premature ovarian insufficiency Hypertensive disorders of pregnancy Preeclampsia Preterm delivery Gestational diabetes Small for gestational age delivery Placental abruption Pregnancy loss Polycystic ovary…

…delivery apply — not the withholding of oxygen. Previous bleomycin treatment — hyperoxia increases the risk of pulmonary toxicity. Keep the saturation in the lower part of…

…Delivery IV, IM, PO, transdermal Dose Injection IV: • 150 μg in 1 ml vial. Dilute with 10 ml of normal saline and give by…

…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:…

…Time to onset of action 2 to 5 minutes Duration of action 5 to 10 minutes Delivery IV Dose Initial infusion dose: 5 μg…

…polymer free drug delivery system, and an antiproliferative agent. Their development has improved procedural safety, reduced repeat revascularization, and broadened the range of lesions amenable…

…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:…

…in increased oxygen demand and dilatation of the right ventricle. Despite the dilation, myocardial ischemia will develop if right ventricular oxygen demand exceeds oxygen delivery…

…myocardium may be excited by external electrical stimuli that drive the cells to threshold. Stimulation threshold is the minimum amount of energy required to reach…

…9 . Delivery of shock (red arrow), with subsequent asystole. ECG 10 . Recurrence of supraventricular complexes (red arrows). ECG 11 . Relapse of VF and new shock…

…9 . Delivery of shock (red arrow), with subsequent asystole. ECG 10 . Recurrence of supraventricular complexes (red arrows). ECG 11 . Relapse of VF and new shock…

…SVR = 80 × (MAP − CVP) / CO PVR = 80 × (mean PA − PCWP) / CO Oxygen delivery (DO₂) = CO × (1.34 × Hb × SaO₂ + 0.003 × PaO₂)…

…which is synonymous with ischemic heart disease, is the most common form of cardiovascular disease. It has been the number one killer in Western and…

…gestational week and recent delivery. Pre eclampsia can present postpartum. Known hypertension and current antihypertensive treatment. Missed doses or abrupt withdrawal of a beta blocker…

…as in LBBB, the left ventricle receives the depolarizing impulse from the right ventricle (where the pacemaker delivers the pulses). The depolarizing wave spreads outside…

…A stimulus delivered during the refractory period should not result in activation because the myocardium is refractory. The most common cause of failure to capture…

ECG Principles of myocardial excitability Myocardium is excitable not only by action potentials originating in the sinus node, but also by external electrical stimuli that…

…endocardium, where they deliver the action potential to contractile cells. The subsequent spread of the action potential occur from one contractile cell to another, starting…

…commonest source of error is confusing them. CPAP delivers a constant pressure that recruits alveoli and unloads the heart, whereas bilevel NIV delivers pressure support…

…which delivers the electrical impulse to the anterior wall of the left ventricle; (2) the posterior (posteroinferior) fascicle , which delivers the electrical impulse to the…

…At the other end, roughly two thirds of ICDs implanted for reduced LVEF never deliver an appropriate shock, so the false positive burden is substantial…

…be delivered by bystanders (laypeople). BLS involves the use of chest compressions, as well as possibly ventilation and automatic external defibrillator (AED). Return of Spontaneous…

…in sync mode no shock at all is then delivered while the patient deteriorates. Indications Emergency, irrespective of duration and anticoagulation status: Tachyarrhythmia with haemodynamic…

…save one. If an intervention has an NNT of 10, then 10 people must be treated to save 1. AED = automatic external defibrillator. ECMO…

…an ectopic focus arises in or near the bundle of His, the impulse may be delivered to both bundle branches and subsequently the entire ventricular…