…of Fallot Marfan syndrome Takayasu's arteritis Iatrogenic (e.g complication of catheterization) Congenital dysplasia/aplasia of the pulmonary valve Idiopathic pulmonary artery dilation Pulmonary…

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

…to dilation of the mitral annulus and papillary muscle displacement (i.e the distance between the papillary muscle and the mitral annulus increases), both of…

…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…

…Myxomatous degeneration. Rheumatic heart disease. Dilatation of the right ventricle. Dilatation of the right atrium. Pulmonary hypertension. Left to right shunt. Right ventricular dysfunction due…

…results in pulmonary hypertension and pulmonary edema. Table 1. Causes of aortic regurgitation Bicuspid aortic valve Rheumatic heart disease Calcified aortic valves Idiopathic aortic dilatation …

…and dilation. Atrial dilation causes a significantly increased risk of atrial fibrillation. The increase in left atrial pressure may also propagate backward to the pulmonary…

…pulmonary gas exchange efficiency, the concentration of catecholamines, angiotensin, hemoglobin, etc. A vivid example of how cardiac function can be affected by targeting peripheral mechanisms…

…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…

…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…

…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…

…in antiphospholipid syndrome and in marked renal failure. Duration of treatment: at least 3 months. Extended treatment in unprovoked pulmonary embolism, a persisting risk factor…

…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…

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

…P pulmonale: right atrial enlargement (hypertrophy, dilatation) Enlargement of the right atrium is commonly a consequence of increased resistance to empty blood into the right…

…onset of action : 1 minute. Duration of action : <10 minutes. Effects Potent blood pressure lowering. Antianginal effect. Reduces afterload and preload. Effective in pulmonary edema…

…patients with an initial shockable rhythm, compressions and ventilation can extend the duration of the shockable rhythm by several minutes, allowing for EMS or bystanders…

…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…

…diastolic dysfunction, or both. The clinical consequences of extracellular volume expansion include elevated cardiac filling pressures, pulmonary congestion, systemic venous hypertension, and peripheral interstitial edema…

…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…

…ECMO. Furthermore, ECMO might be required to facilitate procedures such as percutaneous coronary intervention (PCI) or pulmonary embolectomy. Thus ECMO acts as a bridge, offering…

…Time to onset of action 2 to 5 minutes Duration of action 5 to 10 minutes Delivery IV Dose Initial infusion dose: 5 μg…

…autosomal dominant mechanisms. Complex or multifactorial genetic architecture. The inheritance pattern affects the appropriate scope and duration of family surveillance. For example, heterozygous carriers in…

…of the following: A systolic blood pressure < 90 mmHg caused by the arrhythmia. Ongoing myocardial ischaemia with chest pain and ECG changes. Acute pulmonary…

…Indications Emergency, irrespective of duration and anticoagulation status: Tachyarrhythmia with haemodynamic compromise: hypotension, shock, pulmonary oedema, myocardial ischaemia or a falling level of consciousness. Unstable…

…can shorten the time to diagnosis and facilitate triage of patients with suspected ST segment elevation myocardial infarction to a percutaneous coronary intervention capable hospital…

…is loss of contractile myocardium, with reduced cardiac output and systemic hypoperfusion. LV failure may produce elevated filling pressures, pulmonary venous hypertension, and pulmonary congestion…

…treatment LV function requires evaluation in the setting of suspected ischaemia or previous infarction Dyspnoea requires assessment of dynamic LV function, valve disease, pulmonary pressure…

…the number of months until the next check. Interruption before an elective procedure The duration of interruption is governed by the bleeding risk of the…

…Whether an accessory pathway is suspected, particularly before administration of digoxin The duration of the AF episode, if known The presence of thromboembolic risk fa

…investigations. The emergency differential also reflects distinct mechanisms of acute cardiopulmonary disease: Pulmonary embolism and spontaneous pneumothorax may produce abrupt chest pain and respiratory distress…

…annular dilatation, or both; progressive ventricular remodeling may also occur in primary valvular disease. Increasing severity of mitral regurgitation is associated with worse outcomes. Pulmonary…

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…

…mitrale: increased P wave duration and increased bifid appearance in II, together with a more pronounced biphasic deflection in V1. P pulmonale: increased P wave…

…complexes (QRS duration ≥0,12 s) : ventricular tachycardia is the most common cause and it is potentially life threatening. Note that 10% of wide complex…

…complexes (QRS duration ≥0,12 s) : ventricular tachycardia is the most common cause and it is potentially life threatening. Note that 10% of wide complex…

…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…

…DCM) Dilated cardiomyopathy (DCM) is defined as dilation of one or both ventricles. Dilation of the left ventricle is virtually always accompanied by impaired left…

…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): [ …

…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…

…and the arrhythmia itself. This remodeling manifests as interstitial fibrosis, atrial dilation, and endocardial denudation, which collectively promote local inflammation and create a highly prothrombotic…

…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…

…although the exact exposure threshold and duration required are not established. The source material identifies chronic intake of approximately 60 g daily in males and…

…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…

…pressure, which subsequently causes right atrial dilation. Vena cava inferior may also dilate secondarily. Principles of management Medical therapies do not alter disease progression. Diuretics…

…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…

…titration. Half of all opioid dosing errors arise at the dilution step, and an undiluted syringe of 10 mg/mL makes small adjustments impossible. Procedure…

ECG Introduction to ECG interpretation The QRS complex (ventricular complex): normal and abnormal configurations and intervals A complete QRS complex consists of a Q , R…

…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…

…to measure the QT interval Measurement of the QT interval may be difficult due to T wave changes. Causes of prolonged QTc duration Antiarrhythmics (procainamide…

…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…

…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…