…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…

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

…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…

…with 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 site, duration and completeness of occlusion and on the adequacy of collateral blood flow. Ischaemia initially produces pain and sensory disturbance. With progression, motor…

…cessation lowers the risk of peripheral artery disease, myocardial infarction, premature death, recurrent infarction and limb threatening complications. Among patients with established peripheral artery disease…

…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…

…introduced the risk of thrombosis related to the intravascular foreign body. First generation DES, particularly sirolimus and paclitaxel eluting devices, were associated with increased late…

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

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

…stroke volume, and subsequently lower blood pressure and reduced organ perfusion. Left ventricular dilation occurs with ensuing decline inleft ventricular ejection fraction (LVEF). This is…

…Valve replacement can be performed with biological or mechanical prostheses. The former is preferred due to the lower risk of thrombosis and evidence demonstrating long…

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

…Choice of agent Situation Choice Reason : : : An opioid naive adult with normal renal function Morphine The reference drug, with the greatest experience eGFR 30–60…

…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…

…From a hemodynamic standpoint, there are two types of enlargement, namely hypertrophy and dilatation. Both hypertrophy and enlargement may reduce atrial and ventricular function as…

…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…

…as patients with reduced left ventricular function. This is because these patients are at particularly high risk of developing life threatening arrhythmias. Antiarrhythmic drugs Disopyramide…

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

…QRS duration exceeding 140 msec in males and 130 msec in females , along with slurring or notching of the mid QRS in at least two…

…intervals for QTc duration according to Bazett's formula. Note that a QTc interval 480 is always considered pathological. For patients with bundle branch blocks…

…central component of cardiovascular prevention and treatment. It is associated with lower cardiovascular and all cause mortality and with reduced incidence or burden of hypertension…

…intervals for QTc duration according to Bazett's formula. Note that a QTc interval 480 is always considered pathological. For patients with bundle branch blocks…

…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…

…that the test failed to identify 27.8% of individuals with poor neurological recovery. The specificity of absent pupillary reflex for predicting a poor neurological…

…lead to ventricular dilation. However, the term dilated cardiomyopathy (DCM) refers to idiopathic or genetic dilation of the left ventricle . Patients with DCM typically develop…

…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): [ …

…prolapse of P2 (Figure 1). Myocardial ischemia affecting the papillary muscles or the connected myocardium may cause mitral prolapse, and thus regurgitation. Ischemia manifests with…

…proximal portion of the pulmonary artery may also be dilated in patients with pulmonary hypertension. Echocardiography in pulmonary regurgitation Echocardiography is the modality of choice…

…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…

…Elderly age ( 65), and Drugs/alcohol. A crucial clinical pitfall is the misapplication of this score. A high HAS BLED score (≥3) indicates a need…

…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…

…heart disease. Endocarditis (common in intravenous drug addicts). Myxomatous degeneration. Rheumatic heart disease. Dilatation of the right ventricle. Dilatation of the right atrium. Pulmonary hypertension…

…because cardiac output diminishes in parallel with increasing myocardial load (and hence oxygen demand). The most common causes of acute aortic regurgitation are aortic dissection…

…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…

…the reason for which remains elusive. Gene mutations can be confirmed in roughly 60% of individuals with ARVC. Mutations in the desmosomal gene PKP2 is…

…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…

…a fuller account of two of the commonest acute drug problems, see Warfarin therapy and Opioid therapy in severe pain. Cardiac arrest Drug Adult Child…

…and of ventricular end diastolic and residual volumes. Experimental and clinical observations with a precordial dilution technic. Circulation. Redfield et al: Heart Failure with Preserved…

…separate chapter discusses Long QT syndrome (LQTS). A complete list of drugs causing QT prolongation can be found here. Corrected QT intervals (QTc) can be…

…A duration of 6 months after ACS is generally considered too short for routine use, but it may be considered in selected patients with a…

…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 ).

…with time, clarity and respect is also what makes the decision hold afterwards. Organ preserving treatment — treatment given solely for the sake of the donation…

…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…

…interpretation requires knowledge of these waves and intervals. The P wave, PR interval and PR segment ECG interpretation starts with assessment of the P wave…

…system (His Purkinje network), which results in rapid impulse transmission and thus shorter QRS duration (as compared with apical pacing). Because ventricular pacing results in…

…of synchronized electric shock (i.e. a shock synchronized to the QRS complex). Typically used to treat atrial fibrillation, ventricular tachycardia, and other tachyarrhythmias with…

…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…

…of serious morbidity or mortality, underscoring the need for a structured and guideline directed approach. This chapter focuses on practical diagnostic and therapeutic considerations, with…

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

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

…requires knowledge of these waves and intervals. The P wave, PR interval and PR segment ECG interpretation traditionally starts with an assessment of the P…

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…