…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…

…of the annular circumference. The posterior leaflet generally has two distinct indentations which divide it into three scallops, P1 (anterior or medial scallop), P2 (middle…

…the vast majority of cardiac arrest patients—can induce such pupillary responses. In a comprehensive study by Javaudin et al., involving more than 11,000…

…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 left ventricular dilation. This type of cardiomyopathy, referred to as tachycardia induced cardiomyopathy , can be caused by any tachyarrhythmia leading to prolonged periods of…

…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…

…with more severe neurological deficits, and carry higher rates of mortality and long term disability compared to non cardioembolic ischemic strokes. Consequently, the cornerstone of…

…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…

…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…

…size and form of the thrombus, it will occlude the main pulmonary artery or its branches. The larger the thrombus, the more proximal the occlusion…

…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…

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

…al). ARVC is more malignant in men, the reason for which remains elusive. Gene mutations can be confirmed in roughly 60% of individuals with ARVC…

…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…

…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…

…thrombosis (coronary or pulmonary), tension pneumothorax. No drug has been shown to improve the neurological outcome in cardiac arrest. High quality compressions with minimal interruptions…

…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…

…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…

…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…

…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…

…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…

…T wave. The U wave is most often seen in leads V2, V3 and V4. Individuals with prominent T waves display U waves more often

…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…

…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…

…technically more difficult with ultrasound Femoral vein Fastest, and does not interfere with ongoing CPR or airway management, no risk of pneumothorax Highest risk of…

…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…

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

…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…

…heal with good function or cosmesis without apposition. A wound that bleeds because the edges are held apart. A wound through the full thickness of…

…such as those with a history of cardiac arrest, recurrent syncope despite beta blocker therapy, or markedly prolonged QT intervals—the implantation of an implantable…

…with very irregular waveforms (no visible QRS waveforms) VT/VF storm (electrical storm) ≥3 episodes of sustained VT, VF, or appropriate shocks from an ICD…

…with very irregular waveforms (no visible QRS waveforms) VT/VF storm (electrical storm) ≥3 episodes of sustained VT, VF, or appropriate shocks from an ICD…

…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…

…the expected course and the possibility of rapid reversal with an antidote. Intubation is recommended for neurological, respiratory or haemodynamic failure that cannot be corrected…

…• Clevidipine is more effective than nitroglycerin, nitroprusside, and nicardipine in hypertensive emergencies. Time to onset of action 2 4 minutes Duration of action 5 15…

…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…

…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…

…4 g × 4 IV Exacerbation of COPD with an indication for antibiotics amoxicillin 750 mg × 3 PO 5–7 days or doxycycline 200 mg × 1…

…or the needle from a pericardiocentesis set), 10 mL and 20 mL syringes, a three way tap. A Seldinger set with a guidewire, a dilator…

Calculators For details, refer to the chapter QT Duration and Corrected QT Interval. QTc Calculator Heart Rate QT Interval (in msec) Calculate QTc Values $…