…risk of preeclampsia with severe features during the subsequent two weeks. Cerebral circulatory autoregulation is also disturbed. This helps explain the neurological manifestations of preeclampsia…

…rapidly with intravenous drugs. Restart or optimise oral treatment and ensure follow up. Rapid lowering can worsen cerebral, coronary and renal perfusion, particularly in patients…

…beds. Malignant hypertension represents an extreme form in which acute microvascular injury occurs, classically involving fibrinoid necrosis of small arteries in the kidneys, retina, and…

…hypoxemia, antiarrhythmic drugs, or electromagnetic disturbance caused by other machines/devices. Below follows ECG tracings demonstrating each type of failure. Figure 1. Failure to pace…

…pressure in the left ventricle. Disturbance in ventricular relaxation results in the disruption of pressure conditions in the left ventricle. Ventricular pressure should drop rapidly…

Procedurer The value of the exercise test lies not in ST depression alone but in the overall picture : exercise capacity, symptoms, blood pressure response, heart…

…ECG Aberrant ventricular conduction (aberrancy, aberration) Aberrant conduction is not a mechanism of arrhythmia; it is a ventricular conduction disturbance . It is discussed in this…

…greater resistance and any disturbance in ventricular activation will reduce the efficiency of the pumping function. The primary ECG manifestations of conduction defects are prolonged…

…90 percent of withdrawal seizures occur within 48 hours. Seizures later than this, focal seizures or status epilepticus should raise strong suspicion of another or…

…with fatigue, depression, sleep disturbance or altered mental status rather than prominent breathlessness. Hemodynamic phenotypes Initial assessment should distinguish congestion from hypoperfusion. This distinction provides…

…acute aortic dissection, thrombosis of a graft or aneurysm, popliteal artery entrapment, trauma, phlegmasia cerulea dolens, ergotism, hypercoagulable states or iatrogenic vascular injury. Acute occlusion…

…of AV block upon instigation of beta blockers suggests concealed conduction disturbance in the AV system. Thus, beta blockers can reveal people at risk of…

…but only if the examiner is trained. Brief attacks triggered by the position of the head relative to gravity: perform Dix Hallpike and, if needed…

…why mixed acid base disorders are missed. The blood gas describes the physiology at the moment of sampling, but does not by itself identify the…

…symptoms An inadequate supply of glucose to the brain can cause: difficulty concentrating irritability or abnormal behaviour slurred speech visual disturbance confusion focal neurological signs…

…Myocardial bridging is an anatomical variant in which a segment of an epicardial coronary artery passes through the myocardium rather than remaining on the epicardial…

…to patients with symptoms. Current guidance supports revascularisation for significant left main stenosis irrespective of symptomatic status or the documented ischaemic burden. In chronic coronary…

…back pain Symptoms of type 2 diabetes or metabolic syndrome Depression, low self esteem or body image disturbance The number and severity of obesity related…

…inferior left ventricular infarction. At least minor right ventricular necrosis is found in approximately one third of patients with inferior infarction. Extensive involvement is less…

…and cardiac arrest, with hyperkalemia being the most prevalent electrolyte disturbance observed in cardiac arrest scenarios. Hypocalcemia, although capable of causing cardiac arrest, is an…

…is the most common cause of false activations of the catheterization laboratory. LBBB may mask (conceal) ongoing ischemia : LBBB causes severe disturbance of ventricular repolarization…

…is available; in VF/VT only after the 3rd defibrillation 0.01 mg/kg (0.1 mL/kg of 0.1 mg/mL), maximum 1…

…haemodynamic instability. Digitalis toxicity — a risk of refractory ventricular arrhythmias. Therapeutic digoxin levels, by contrast, are no obstacle. Untreated hypokalaemia or marked electrolyte disturbance; correct…

…These cells are capable of spontaneous depolarization (i.e they display automaticity) and can therefore act as latent pacemakers (which become active when atrial impulses…

…history of ulcer, not routinely Infection Consider Pneumocystis prophylaxis with high doses over a long period, according to the local protocol Psychiatric symptoms Sleep disturbance…

…Delirium is common but often missed. On medical and geriatric wards a substantial proportion of older patients are affected, and the incidence is particularly high…

…With iodinated contrast, the observed renal dysfunction may therefore reflect a combination of: direct tubular toxicity; renal haemodynamic disturbance and ischaemia; pre existing or concurrent…

…complexes indicate that ventricular depolarization is slow, which may be a consequence of disturbances in the electrical conduction system. The J point and the ST…

…The youngest children often display spontaneous movements of limbs, neck and trunk, which may cause disturbances and thus reduce the quality of the ECG recording…

…dosing Definition and Pathophysiology Bradycardia encompasses a spectrum of rhythm disturbances characterized by an inappropriately slow heart rate. Within the context of acute coronary syndromes…

…with nonspecific intraventricular conduction delays are at twice as great a risk of all cause death and cardiovascular death, compared to patients without such disturbances…

…with symptoms of digitalis toxicity, which manifests across multiple organ systems. Non cardiac symptoms include headache, nausea, vomiting, generalized malaise, and visual disturbances such as…