…ventricle. Dilatation of the right atrium. Pulmonary hypertension. Left to right shunt. Right ventricular dysfunction due to pressure/volume overload is the most common cause…

…availability; check what applies where you work. They assume normal renal and hepatic function, a non pregnant adult of normal weight, and individual assessment. See…

…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…

…of heart failure, ventricular arrhythmias or sudden cardiac arrest is common. The following cardiomyopathies lead to dilation of the ventricle: Dilated cardiomyopathy (DCM) Idiopathic or…

…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…

…ventricle during diastole. The most common cause of abnormal pulmonary regurgitation is pulmonary hypertension. Table 1 presents the causes of pulmonary regurgitation. Mild pulmonary regurgitation…

…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…

…by aortic or mitral disease (most commonly mitral stenosis). Simultaneous tricuspid regurgitation is also common. Echocardiography Echocardiography has replaced catheterization for the assessment of tricuspid…

…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…

…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…

…functionally and morphologically normal on echocardiography and cardiac MRI during the first two decades of life. The most common initial presentation is palpitations or syncope…

…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…

…in a special type of heart failure, referred to as heart failure with preserved ejection fraction (HFPEF). HFPEF may be more common than heart failure…

…and this leads to dilatation. The most common cause is valvular regurgitation (insufficiency). For example, aortic regurgitation causes the flow of blood from the aorta…

…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…

…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…

…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…

…most common arrhythmia). Any impulses generated in the ventricles will result in wide QRS complexes because the impulse will spread entirely or partly outside of…

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…

…choice of site, the use of ultrasound throughout the puncture, and maintaining maximal barrier precautions without shortcuts. The most common serious error is dilating a…

…is very common. Figure 2. Two ECGs showing left and right ventricular hypertrophy. Next chapter Biventricular Hypertrophy Related chapters Overview of Hypertrophy and Dilatation Left…

…mitrale, because mitral valve disease is a common cause (Figure 1). The duration of the P wave will exceed 120 milliseconds in lead II. Biatrial…

…causes of pericarditis can result in constrictive pericarditis. In high income countries, idiopathic pericarditis, radiation to the pericardium and surgical interventions are the most common…

…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…

…common are cysts and tumors of the pericardium, as well as congenital malformations leading to an incomplete or absent pericardium. In case of suspicion of…

…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:…

…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…

…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)…

…particularly inverted T waves. Below follows a discussion which aims to clarify some of the common misunderstandings. All T waves are illustrated in Figure 18…

…These require a QRS duration exceeding 140 msec in males and 130 msec in females , along with slurring or notching of the mid QRS in…

…and less common causes such as severe pre existing valvular disease or excessive beta blocker or calcium channel blocker exposure. The incidence of cardiogenic shock…

…via generation of cyclic GMP, which then activates calcium sensitive potassium channels in the cell membrane. Time to onset of action : 1 minute. Duration of…

…function is depressed or preserved Whether hypotension is present Whether an accessory pathway is suspected, particularly before administration of digoxin The duration of the AF…

…and duration of exposure to cardiovascular risk factors. Primary prevention Primary prevention targets people without clinical CVD who nevertheless have established risk factors or an…

…higher the troponin level and the longer the duration of elevated troponin levels. Differences in absolute concentrations of troponin I and T during acute myocardial…

…of phosphate substitution, use of foscarnet. ECG changes due to hypocalcemia Common ECG changes Lengthened QT interval (torsade de pointes is uncommon) Shortened QRS duration…

…circulatory compromise or collapse. Causes of tachycardia (tachyarrhythmia) with wide QRS complexes (QRS duration ≥0,12 s) : ventricular tachycardia is the most common cause and…

…proceeds normally via the His Purkinje system, and in most cases, there is no significant hemodynamic compromise. However, in cases of rapid AVNRT or in…

…concurrent use of beta blockers. The vasodilating effect reduces preload and afterload, further reducing myocardial workload. Levosimendan is used in severe acute or chronic heart…

…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…

…Hyponatremia of unknown duration : These cases are managed as chronic hyponatremia. Degree of hyponatremia P/S Na + Common effects Mild 130 125 mmol/l Cognitive…

…aVF : positive T wave, but occasionally flat. Lead V1 : Inverted or flat T wave is rather common, particularly in women. The T wave inversion is…

…delivers the electrical impulse to the posterior and inferior walls of the left ventricle. Anatomical or functional block in the anterior fascicle leads to left…

…circulatory compromise or collapse. Causes of tachycardia (tachyarrhythmia) with wide QRS complexes (QRS duration ≥0,12 s) : ventricular tachycardia is the most common cause and…

…equals 200 ms). The hallmark of both RBBB and LBBB is the QRS duration which is by definition 120 ms or longer. ECG criteria for…

…the progressive loss of myocytes following the occlusion of a coronary artery. The size, location, and duration of the occlusion are of prime importance but…

…left atrial enlargement, and abnormalities of diastolic filling. Mitral regurgitation may develop through papillary muscle displacement, annular dilatation, or both; progressive ventricular remodeling may also…

…inverted). Early repolarization pattern Early repolarization occurs in 5% to 10% of all males. It is less common among women (prevalence 2% to 4%). The…

…and the most common cause of sinus arrest/pause. It commonly affects younger individuals who endure intense emotional stress, acute pain or other stimuli that…

…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…

…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): [ …

…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…

…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…

…or at least four drinks for women or five for men on one occasion. Pharmacokinetics and pathophysiology Approximately 95% of ingested ethanol undergoes hepatic metabolism…

…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…

…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…