…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…

…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…

…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…

…or treatment with sodium nitroprusside. In most hypertensive emergencies the following is aimed for: 1. Lower the mean arterial pressure by no more than about…

…10 mL with sodium chloride) before intravenous titration. Half of all opioid dosing errors arise at the dilution step, and an undiluted syringe of 10…

…pressure ≥180 mmHg and/or diastolic pressure ≥120 mmHg) with concurrent signs of acute organ damage or failure. Any of the drugs listed below may…

…pressure ≥180 mmHg and/or diastolic pressure ≥120 mmHg) with concurrent signs of acute organ damage or failure. Any of the drugs listed below may…

…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…

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

…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…

…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…

…Conventional thoracic X ray sometimes reveals calcification of the pericardium. With MRI or CT, the thickness of the pericardium can be measured and in most…

…therapies have failed. Patients with structural heart disease or reduced left ventricular function are not eligible. Effects of propafenone and flecainide on ECG, heart rhythm…

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

… However, T wave inversions that are accompanied by ST segment deviation (either depression or elevation) is representative of ischemia (but in that scenario, it is…

…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…

…adverse environmental exposures are associated with continued or resumed smoking after the acute event and warrant particular attention. Cardiovascular benefits of cessation The principal benefits…

…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…

…requires urgent surgical or transcatheter intervention, with temporary mechanical circulatory support (MCS) considered as a bridge. Clinical Presentation and Symptoms Symptoms of STEMI The usual…

…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…

…to maintain or improve physical fitness. Regular physical activity is a central component of cardiovascular prevention and treatment. It is associated with lower cardiovascular and…

…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…

…those with high bleeding risk, or those considered unlikely to adhere to medication. However, contemporary data support the use of DES in most PCI procedures…

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…

…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…

…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…

…transient ischemic attack or stroke, and initiation of renal replacement therapy. The study found no significant differences between the two treatment groups with respect to…

…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…

…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…

…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): [ …

…with connective tissue disorders (Marfan syndrome, Ehlers Danlos syndrome), osteogenesis imperfecta typically causes prolapse of P2 (Figure 1). Myocardial ischemia affecting the papillary muscles or…

…are also estimated using continuous Doppler. A dense regurgitant jet with rapid deceleration (short PHT) is suggestive of severe regurgitation; the leakage usually ends early…

…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…

…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…

…of patients with pulmonary embolism or deep vein thrombosis experience a second thrombotic event within 10 years ( Goldhaber et al, Kearon et al ). Epidemiology of…

…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…

…if hypotension or bradycardia occurs. A defibrillator should be immediately available as a precaution. Dosage of vernakalant Vernakalant is dosed by body weight, with the…

…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…

…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…

…QT dispersion. Increased QT dispersion is associated with increased morbidity and mortality. This is presumably explained by a higher incidence of malignant ventricular arrhythmias. It…

…with PCI or without revascularization, although the exact antithrombotic strategy may differ when long term OAC is also indicated. Possible shortening of DAPT A duration…

…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 ).

…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 …

…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…

…pacing with normal conduction to the ventricles via the AV system. The ventricles are depolarized via the His Purkinje network, resulting in normal QRS duration…

…collapse : Sudden cessation of tissue perfusion as a result of cardiac or vascular condition. May reverse spontaneously (e.g., vasovagal syncope) or with treatment (e…

…of increasing coronary blood flow. In circumstances with non shockable rhythm or with prolonged periods of VF (fine VF resistant to defibrillations), the purpose of…

…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…

…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…