…flow across the mitral valve. The duration of diastasis is inversely related to heart rate (diastasis is shorter at higher heart rates and vice versa ).

…mm (ascending aorta, aortic arch) All individuals 60 mm (descending aorta) All individuals Risk factors : previous dissection, family history of dissection, severe aortic regurgitation or…

…0.1 mV in 2 or more contiguous leads of the 12 lead ECG, excluding leads V1 to V3. 3. QRS duration is <120 ms…

…of the Pupillary Reflex in Cardiac Arrest The pupillary light reflex is controlled by a simple neural circuit: light signals travel from the retina via…

…DCM) Dilated cardiomyopathy (DCM) is defined as dilation of one or both ventricles. Dilation of the left ventricle is virtually always accompanied by impaired left…

…syndrome), osteogenesis imperfecta typically causes prolapse of P2 (Figure 1). Myocardial ischemia affecting the papillary muscles or the connected myocardium may cause mitral prolapse, and…

…ventricular tachyarrhythmias (including recurrent episodes of ventricular tachycardia) can also cause this cardiomyopathy. The duration of the tachyarrhythmia appears to be a stronger risk factor…

…Tetralogy of Fallot Marfan syndrome Takayasu's arteritis Iatrogenic (e.g complication of catheterization) Congenital dysplasia/aplasia of the pulmonary valve Idiopathic pulmonary artery dilation…

…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…

…of both thromboembolic and hemorrhagic risks. The diagnostic prerequisite for clinical AF remains the documentation of the arrhythmia via a standard 12 lead ECG or…

…and P3 (posterior or lateral scallop). Figure 1. Anatomy of the mitral valve The leaflets are connected to the papillary muscles via chordae tendineae (Figure…

…back to the right atrium and venous system, resulting in dilation of vena cava inferior ( 2.1 cm). Severe tricuspid regurgitation may lead to systolic…

…prevent, or alleviate, the pressure increase in the left ventricle and left atrium. Chronic aortic regurgitation leads to dilatation and hypertrophy of the left ventricle…

…deep veins of the legs or pelvis. Thrombi formed in the deep veins in the legs or pelvis can detach and flow via inferior vena…

…inhibitors Enalaprilat Enalaprilat is rarely used in hypertensive crisis due to its slow onset, prolonged duration of effect, and significant individual variations in its effect…

…inhibitors Enalaprilat Enalaprilat is rarely used in hypertensive crisis due to its slow onset, prolonged duration of effect, and significant individual variations in its effect…

…fluid ounces of 40% distilled spirits. Habitual heavy consumption is defined in the source material as at least eight drinks weekly in females or at…

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

…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…

…days duration. Vernakalant does not convert atrial flutter to sinus rhythm. Vernakalant is only administered in a monitored clinical setting appropriate for cardioversion. Administration of…

…10 mL of 100 mg/mL in hyperkalaemia, hypocalcaemia, calcium channel blocker poisoning 0.2 mL/kg Sodium bicarbonate 50 mmol in hyperkalaemia or tricyclic…

…For better or worse, ejection fraction has become virtually synonymous with left ventricular function. An obvious drawback with the use of the ejection fraction is…

…reference to the intravenous antihypertensive drugs used in a hypertensive emergency. It summarises the mechanism of action, the onset, the duration of effect, the dosing…

…of titration is abandoned — when a fixed dose is given without assessment, when a modified release preparation is started in an opioid naive patient, or…

…classified as net positive or net negative, referring to its net direction. The QRS complex is net positive if the sum of the positive areas…

…Hypertrophy and dilatation may coexist. Moreover, the ECG cannot distinguish whether large QRS amplitudes are due to dilatation or hypertrophy. Because the majority of the…

…to measure the QT interval Measurement of the QT interval may be difficult due to T wave changes. Causes of prolonged QTc duration Antiarrhythmics (procainamide…

…The duration of therapy requires an individualized balance between: Ischaemic risk, including recurrent myocardial infarction and stent thrombosis. Bleeding risk, particularly major or life threatening…

…deceased — in the donation register, on a donor card, or through statements made to the next of kin. Active malignancy with a risk of transmission …

…is 12 h, a primary PCI strategy is indicated in the presence of ongoing ischemic symptoms, haemodynamic instability, or life threatening arrhythmias. I C A…

…of the QRS complex is called the PR segment. The PR segment is the baseline (also referred to as reference line or isoelectric line ) of…

…of the P wave depends on where the atrial lead is fixed. Typically, the atrial lead is fixed next to the right atrial appendage, or…

…duration (minutes) from start of CPR to ROSC or end of resuscitation attempts. Efficient CPR generates approximately 25% of normal cardiac output, which postpones or…

…VT]). The VF waveform is initially coarse ( i.e fibrillatory waves have large amplitudes) but as the duration of VF is prolonged, the amplitude gradually…

…the QRS duration is prolonged (≥0.12 seconds), the arrhythmia is a wide complex tachycardia (WCT) . This initial distinction will guide the rest of the…

…and aVF (with QRS duration <0.12 seconds), provided that other causes of right axis deviation have been excluded. Causes of left axis deviation Left…

…and aVF (with QRS duration <0.12 seconds), provided that other causes of right axis deviation have been excluded. Causes of left axis deviation Left…

…this chapter, you will learn the physiological basis of all ECG waves and how to determine whether the ECG is normal or abnormal. Although heart…

ECG Hypertrophy and dilatation Biventricular hypertrophy Simultaneous hypertrophy of the left and right ventricle is rather common. The ECG has low sensitivity with respect to…

…a common cause (Figure 1). The duration of the P wave will exceed 120 milliseconds in lead II. Biatrial abnormality/enlargement Biatrial abnormality implies that…

…low risk of pneumothorax Uncomfortable for an awake patient, harder to keep the dressing clean with a tracheostomy or copious secretions Subclavian vein Most comfortable…

…right ventricular hypertrophy. Next chapter Biventricular Hypertrophy Related chapters Overview of Hypertrophy and Dilatation Left Ventricular Hypertrophy Atrial Hypertrophy and Dilatation (P mitrale, P pulmonale…

Enalaprilat Enalaprilat is rarely used in hypertensive crisis due to its slow onset, prolonged duration of effect, and significant individual variations in its effect. Drug…

…lead V1 and qRS pattern in V6 with QRS duration <120 ms) D: Profound sinus bradycardia (<30 beats/min or sinus pauses ≥3 s) Explanation:…

…35 mm or R aVL 11 mm Sokolow Lyon's index is the most used index, despite having the lowest sensitivity (20%) of all indexes…

…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…

…the ventricle is empty or nearly empty). In patients with an initial shockable rhythm, compressions and ventilation can extend the duration of the shockable rhythm…

…usually visible on plain films. Irrigation fluid: a copious volume of drinking quality tap water or sodium chloride 9 mg/mL. The volume matters more…

…of Cardiology (ESC) guidelines advocate for ICD implantation in high risk LQTS patients, emphasizing a comprehensive risk assessment that includes genetic factors and QTc duration…

…bpm (cycle length: <600 ms). Classification according to duration: Sustained VT : VT 30 seconds, or VT <30 seconds terminated by therapy. Non sustained VT (NSVT)…

…bpm (cycle length: <600 ms). Classification according to duration: Sustained VT : VT 30 seconds, or VT <30 seconds terminated by therapy. Non sustained VT (NSVT)…

…from dilating adequately during diastole. This leads to increased and equivalent diastolic pressure in all rooms. Because pressure is high in the atria, filling of…

…block, bundle branch block or fascicular block may become worse. Particularly, the degree of AV block may increase. QRS complex QRS duration becomes prolonged. ST…

…needed. Intubate for a threatened airway, a marked risk of aspiration, or failure that is not rapidly reversed by an antidote B Respiratory rate, saturation…

…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:…

…to reduce myocardial ischemia in the CCU or ICU. Time to onset of action 1 minute Duration of action 20 30 minutes Delivery IV Dose…

…Before compression treatment of a leg ulcer — compression in arterial insufficiency can cause necrosis. Screening in diabetes of 10 years' duration, or in diabetes with…

…Respiratory tract Diagnosis Agent Dose Duration : : : : Pneumonia, non severe (DS CRB65 0–1) phenoxymethylpenicillin 1 g × 3 PO 5–7 days or benzylpenicillin 3 g …

…and where no liver, lung or vessel lies in the path of the needle. Access Puncture site Direction Comment : : : : Subxiphoid 1–2 cm below and…