…associated with hypertension, coronary artery disease, arrhythmias, heart failure and alcohol related cardiomyopathy. The cardiovascular implications of lower alcohol intake remain controversial. Epidemiological studies have…

…ischaemia (ALI) is an abrupt reduction in arterial perfusion of an upper or lower limb that causes tissue metabolic requirements to exceed available blood flow…

…its lower edge about 2 cm above the tip of the malleolus. 3. Dorsalis pedis artery — the signal is sought on the dorsum of the…

…and symmetric. Their duration is short; they typically disappear within minutes after a total occlusion in a coronary artery occurs (then of course, the ST…

…coronary syndrome Reinfarction reduced by approximately 30–40%; death reduced by approximately 35–45% Peripheral artery disease Lower risk of progression to chronic limb threat

…zone. Coronary Occlusion and Myocardial Injury STEMI generally results from abrupt reduction in coronary blood flow caused by thrombotic occlusion of a previously atherosclerotic artery…

…and the relative merits of PCI and coronary artery bypass grafting (CABG). Definition and Pathophysiology From balloon angioplasty to coronary stents Balloon angioplasty was initially…

…and (3) modulation of sarcolemmal and mitochondrial potassium ATP channels. Levosimendan alleviates heart failure symptoms, increases cardiac output, and lowers pulmonary artery pressure without increasing…

…onset, prolonged duration of effect, and significant individual variations in its effect. Drug Enalaprilat Brand names Vasotec IV ® Indications Hypertension and hypertensive emergency. Acute…

…coronary artery disease since it does not increase heart rate, and reduces myocardial oxygen consumption. Time to onset of action: 5 minutes. Effects Lowers blood…

…the risk of cardiomyopathy. Pathophysiology Prolonged tachyarrhythmias lead to the following hemodynamic effects: Tachyarrhythmia results in reduced preload, diminished stroke volume, and subsequently lower blood…

…or mechanical prostheses. The former is preferred due to the lower risk of thrombosis and evidence demonstrating long term durability (Filsoufi et al). Percutaneous interventions…

…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…

…the early warning sign. Choice of agent Situation Choice Reason : : : An opioid naive adult with normal renal function Morphine The reference drug, with the greatest…

…onset, prolonged duration of effect, and significant individual variations in its effect. Drug Enalaprilat Brand names Vasotec IV ® Indications Hypertension and hypertensive emergency. Acute…

…onset, prolonged duration of effect, and significant individual variations in its effect. Drug Enalaprilat Brand names Vasotec IV ® Indications Hypertension and hypertensive emergency. Acute…

…to by their lower case letters (q, r, s). Figure 5 shows examples of naming of the QRS complex. Net direction of the QRS complex…

…to the ECG in terms of sensitivity and specificity. Nevertheless, to detect hypertrophy/dilatation using the ECG, a wide range of criteria and algorithms have…

…1 receptor agonists lower systemic blood pressure and increase renal perfusion. Time to onset of action 50 to 10 minutes Duration of action 30 to…

…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…

…become worse. Particularly, the degree of AV block may increase. QRS complex QRS duration becomes prolonged. ST segment ST segment depression may develop. T wave…

…severe angina; an accelerating pattern with increasing frequency, duration, or severity; a lower threshold for symptom provocation; or angina occurring after a recent MI. Myocardial…

…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…

…ms 450 ms 470 ms Table 1 . Reference intervals for QTc duration according to Bazett's formula. Note that a QTc interval 480 is always…

…Prescription Physical activity should be assessed and prescribed using the components of: Frequency Intensity Time or duration Type Progression The prescription should be individualized rather…

…suggested to calculate corrected QT intervals. Some of these formulas follow: Bazett's formula for calculating corrected QT duration (QTc). Bazett Formula: QTc = QT…

…lower, regardless of etiology, if the initial rhythm is asystole or PEA. Most current protocols for ECMO exclude patients presenting with asystole or PEA. Duration…

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

…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…

…light causes rapid bilateral pupillary constriction (a brisk reflex), whereas low light causes dilation. This reflex is highly sensitive to brainstem integrity and cerebral perfusion…

…obstruction) of the left main coronary artery (LAD) or 2 epicardial coronary arteries (Felker et al). Left ventricular dilation entails a markedly elevated risk 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): [ …

…muscle rupture. The risk of rupture is greater for the posteromedial papillary muscle, which only receives blood supply from one coronary artery (Coronary arteries). Chronic…

…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…

…score of ≥2 (excluding sex) is a Class I indication for OAC. Bleeding Risk Assessment: HAS BLED Score Bleeding risk must be quantified using validated…

…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…

…in dilation of vena cava inferior ( 2.1 cm). Severe tricuspid regurgitation may lead to systolic reversal in the hepatic veins. This is visualized using…

…Table 1. Causes of aortic regurgitation Bicuspid aortic valve Rheumatic heart disease Calcified aortic valves Idiopathic aortic dilatation (aneurysm) Hypertension Aortic dissection, proximal Marfan syndrome…

…ventricle, which is counteracted by dilatation of the ventricle. Dilatation of the right ventricle results in reduced intraventricular pressure and thereby reduced myoardial load. Pulmonary…

…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…

…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…

…the dilution step, not in the choice of dose. Paediatric doses are calculated on actual body weight unless otherwise stated. When the weight of a…

…and prognosis of most cardiac diseases, including coronary artery disease, heart failure, arrhythmias, structural heart disease, etc. Over the years, a large number of parameters…

…for calculating corrected QT duration (QTc). QT correction according to Bazett , Fridericia , Framingham and Hodges follow in the calculator below. Open the calculator → Normal…

…is also indicated. Possible shortening of DAPT A duration of 6 months after ACS is generally considered too short for routine use, but it may…

…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 ).

…is also what makes the decision hold afterwards. Organ preserving treatment — treatment given solely for the sake of the donation — may continue for at m

…Reperfusion therapy Management Recommendation Level of evidence Reperfusion is indicated in all patients with symptoms of ischaemia of <12 h duration and persistent ST segment…

…reflection of the electrical potentials generated by the left ventricle. QRS duration QRS duration is the time duration from the start to the end of…

…than the base rate should inhibit the pacemaker. P waves The appearance of the P wave depends on where the atrial lead is fixed. Typically…

…circulatory flow arrest. No flow time : The duration (minutes) from circulatory collapse to initiation of CPR. During no flow there is no cerebral perfusion and…

…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…

…based interventions. Many tachyarrhythmias carry a potential risk of serious morbidity or mortality, underscoring the need for a structured and guideline directed approach. This chapter…

…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…

…measured by using the PR segment as the baseline. Refer to Figure 1 . The QRS complex The QRS complex represents the depolarization (activation) of the…

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…

…The most common serious error is dilating a vessel that turns out to be an artery — everything in the technique is designed to make sure…