…the gestational duration remains uncertain, the cesarean section should be pursued if the fundal height of the uterus reaches or surpasses the level of the…

…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…

…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…

…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…

…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…

…hypertension and atherosclerotic coronary disease In patients with heavy alcohol use, left ventricular dilation may precede the development of increased left ventricular hypertrophy and mass…

…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…

…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…

…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…

…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…

…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…

…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…

…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…

…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…

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…

…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…

…and nicardipine in hypertensive emergencies. Time to onset of action 2 4 minutes Duration of action 5 15 minutes Delivery IV (infusion). Dose Initial dose:…

…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…