…necrosis of small arteries in the kidneys, retina, and brain. Its clinical retinal signature includes flame haemorrhages, cotton wool spots, and papilloedema. Associated complications may…

…sickness Aspiration Chronic obstructive pulmonary disease (COPD) Bronchospasm (asthma) Other : Coma Central hypoventilation syndromes Neuromuscular diseases Anemia The natural course of asphyxia Should ventilation be…

…are the strongest predictors of adverse outcomes. Non acute or asymptomatic bradycardia Non acute bradycardia is a common finding in both healthy and diseased individuals…

…ACE) inhibitors are foundational therapies in cardiovascular medicine, widely utilized for the management of hypertension, chronic ischemic heart disease, heart failure with reduced ejection fraction …

…4. Monitoring at the appropriate level of care , with readiness for respiratory support. 5. Treatment of the alcohol use disorder and planned follow up , not…

…absolute contraindications in hypoxaemia. Take particular care in: A risk of hypercapnic respiratory failure — COPD, severe obesity with hypoventilation, neuromuscular disease, marked chest wall deformity…

…risk of myocarditis, given the similarities between COVID 19 and MERS (Middle East Respiratory Syndrome, coronavirus). Recent studies on COVID 19 and cardiovascular disease Cardiovascular…

Arrhythmias and arrhythmology ECG Definition of sinus arrhythmia (respiratory sinus arrhythmia) Sinus arrhythmia and respiratory sinus arrhythmia both refer to the same phenomenon. Sinus arrhythmia…

…scale) should prompt termination of the stress test (refer to Termination criteria during stress testing). Dyspnea (dyspnoea) Exercise does lead to tachypnea (increased respiratory rate)…

…delay in persistent hypercapnic respiratory acidosis, if invasive ventilation is not immediately required. 8. Document the ceiling of care and the decision on intubation early…

…dissection. Coronary embolism of cardiac or non cardiac origin. Oxygen supply–demand mismatch, including demand related events in the presence of fixed coronary disease. More…

…Depression, low self esteem or body image disturbance The number and severity of obesity related complications generally increase as the degree of obesity rises. Nevertheless…

…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…

…Assessment of pulmonary involvement in systemic disease, for example rheumatoid arthritis or scleroderma, and during treatment with pulmonary toxic drugs. Contraindications Forced expiration raises the…

…important to detect the disease early in the course. Hemodynamic effects of constrictive pericarditis Diastolic heart failure and right heart failure The rigid pericardium prevents…

…responders. Left heart disease is the most common risk factor for PH. It produces postcapillary PH through elevation of left atrial and pulmonary venous pressure…

…a non pregnant adult of normal weight, and individual assessment. See the separate quick reference for dosing in impaired renal function. Respiratory tract Diagnosis Agent…

…a clock. The respiratory rate is counted manually. Naloxone 0.4 mg/mL out and checked before the first intravenous dose is given. Oxygen with…

…hypoxaemia. Hypoxaemic failure where high flow nasal oxygen is insufficient and the carbon dioxide is normal. Bilevel NIV: Acute exacerbation of COPD with respiratory acidosis …

…heart disease, it is often not true in other circumstances (e.g. pulmonary embolism, trauma, respiratory causes, drug overdoses, etc.). Among victims in whom the…

…marked obstructive airways disease — relative; the risk of bronchospasm is real. Hypotension and haemodynamic instability. Respiratory compromise during an ongoing crisis. Distinguish the conditions instead…

…FEV₁ or FVC of 10 % of the predicted value after a bronchodilator suggests asthma. Severity in COPD Arterial blood gas Type 1 respiratory failure: PaO₂…

…may coexist, and certain disease entities can span both categories; for example, acute heart failure may occur in the context of acute myocardial ischaemia, though…

…an important first line investigation for selected patients with suspected coronary artery disease (CAD), particularly those with stable chest pain, no previous diagnosis of CAD…

…hypotension Heart rate and tachycardia Respiratory rate and oxygenation Evidence of systemic congestion or acute RV failure Syncope or altered clinical status Comorbid cardiopulmonary disease…

…motion abnormality in an ischaemic distribution Identification of a coronary thrombus by angiography or autopsy, where applicable to the relevant infarction category Myocardial infarction results…

…the risk of inducing osmotic demyelination syndrome (ODS). It is therefore recommended to raise serum sodium by a maximum 8 mEq/L in the first…

…may affect hemodynamics and the underlying cause is often serious (e. g. malignancy, amyloidosis). In case of suspicion of pericardial disease, in the first place…

…pediatric and neonatal care must have knowledge of age related variations in the ECG, as well as cardiac diseases that may affect infants and children…

…deaths are the first manifestation of cardiovascular disease. Furthermore, sudden cardiac arrests account for 50% of all years of life lost due to cardiovascular disease …

…pediatric and neonatal care must have knowledge of age related variations in the ECG, as well as cardiac diseases that may affect infants and children…

…abruption Pregnancy loss Polycystic ovary syndrome Functional hypothalamic amenorrhoea Fertility therapy and assisted reproductive technology The extent to which these conditions confer risk independently of…

…rheumatic diseases Ehlers Danlos syndrome (may also cause aortic dissection) Subaortic membrane Endocarditis Echocardiography in aortic regurgitation 2D Echocardiography The images are acquired in PLAX…

…in the first decade, rises progressively through adulthood and becomes less steep in later life, although diagnoses may still occur after the age of 65…

…may be the first clinically important manifestation of an otherwise unrecognized inflammatory disease. Epidemiology and disease specific patterns Patients with inflammatory rheumatic disease have a…

…in the autonomic nervous system, with increased sympathetic input (leading to stimulation of beta adrenergic receptors) and parasympathetic withdrawal. Sinus tachycardia secondary to disease and…

…Hemodynamic determinants of MAP Hemodynamically, MAP is influenced by cardiac output (CO) and systemic vascular resistance (SVR), as described by the relationship: MAP = (CO…

…Severe heart failure. Doses 100 mg/day during the third trimester of pregnancy. Dosage Acute myocardial infarction: Initial loading dose: 300–500 mg as soon…

…classification is clinically useful but should not be regarded as a series of completely discrete diseases. Heart failure extends across the full range of LVEF…

…infectious diseases physician early in a high risk course, in instability, with resistance problems, or with suspected fungal infection 10 Document the times of triag

…structural heart disease, etc. Over the years, a large number of parameters have been introduced to assess left ventricular function. The majority of these parameters…

…atherothrombosis. It is usually precipitated by disruption of an atherosclerotic plaque through rupture or erosion. The relative contributions of plaque disease and thrombus vary considerably…

…stenoses must be graded in order to optimize management according to disease severity. The most important parameter, for grading of stenoses, is the opening area

…diffuse, leading to underestimation of the overall disease burden. Angiography also provides limited information about plaque composition, vulnerability and the risk of future plaque rupture…

…hypercholesterolaemia, and sedentary behaviour; family history, particularly in the broader assessment of peripheral arterial and aortic disease; planned surgery, especially carotid endarterectomy (CEA), coronary artery…

…angina) at any time during the disease course. Some patients may experience an acute coronary syndrome as the first manifestation of their coronary artery disease…

…angina) at any time during the disease course. Some patients may experience an acute coronary syndrome as the first manifestation of their coronary artery disease…

…may dominate clinical outcomes and limit tolerance of otherwise evidence based interventions. Hypertension and vascular disease Hypertension is the most common modifiable cardiovascular risk factor…

…directed at identifying individuals at increased risk and reducing exposure to established, modifiable determinants of cardiovascular disease. The principal targets include blood pressure, lipid abnormalities…

…of Chest Pain: A Clinical Overview The evaluation of acute chest discomfort requires a systematic differential diagnosis, as the syndrome associated with ischemic heart disease…

…approximately 80% of all cardiac arrests are caused by acute or chronic coronary artery disease, with the latter being the most common. The figure 80…

…emerged for coronary microvascular and vasospastic disease using coronary flow reserve (CFR) and the index of microcirculatory resistance (IMR). This review synthesizes the physiological basis…

…least 85% of the age adjusted MHR. Heller et al. demonstrated the following, among patients with known coronary artery disease: Achieving 85% of age adjusted…

…defining the extent of coronary artery disease because it provides anatomical information while permitting functional assessment and, when appropriate, immediate percutaneous coronary intervention (PCI). Complications…

…a lesion proximal to the first septal perforator of the left anterior descending artery was associated with lower five year survival than a more distal…

…over 40 years of age, atherosclerosis is the predominant cause. Other mechanisms include thrombosis, embolism, vasculitis, fibromuscular dysplasia, arterial entrapment, cystic adventitial disease and trauma…

…a risk of permanent hypopigmentation. Areas with poor circulation, above all the lower leg in a patient with peripheral arterial disease or diabetes — the wound…

…Disease Epidemiology Collaboration (CKD EPI) equation, incorporating relevant demographic variables; cystatin C may also be used as a filtration marker. CKD is one of the…

…clinical context, the diagnosis requires evidence of new myocardial ischaemia, which may manifest through symptoms, ECG changes, or angiographic complications. Evaluation and Physical Examination The

…is also influenced by sympathetic and parasympathetic influences; sympathetic stimulation leads to vasoconstriction through the release of norepinephrine, while parasympathetic activation can cause vasodilation via…