…s outcome: Neurological injury Myocardial dysfunction Systemic response to reperfusion and ischemia Effects of the underlying cause of cardiac arrest Neurological injuries may cause coma…

CPR Hyperthermia and malignant hyperthermia Hyperthermia is characterized by a body temperature exceeding the typical range of 36.5 37.6°C (97.7 99.7°F)…

…clinically or radiologically confirmed dislocation of the shoulder, elbow, finger, patella, jaw or hip prosthesis. A dislocation with neurovascular compromise or skin tenting — reduce promptly…

Echocardiography The Doppler effect When sound waves hit objects some of the sound waves are reflected back to the sound source. If the reflector (i…

…natriuretic peptide levels and/or objective evidence of pulmonary or systemic congestion [3] . Within this spectrum, Heart Failure with Reduced Ejection Fraction (HFrEF) is specifically…

…until the risk of hypercapnia has been assessed. 3. Take an arterial blood gas in respiratory compromise, low saturation, suspected carbon dioxide retention, reduced consciousness…

…tracer uptake plateaus. This saturation effect can lead to an underestimation of blood flow in regions affected by significant coronary artery disease, potentially resulting in…

…pacemaker therapy. Treatment of AV block in the acute setting Treatment in the acute setting is directed at managing bradycardia and reduced cardiac output. Bradycardia…

…structural heart disease or reduced left ventricular function are not eligible. Effects of propafenone and flecainide on ECG, heart rhythm and conduction Effect on sinoatrial …

…sound waves with reduced frequency (Figure 1). Figure 1. The Doppler effect. The Doppler shift The Doppler shift depends on the velocity of blood flow…

…morphine Morphine has an active renally excreted metabolite that causes late sedation and respiratory depression Marked liver failure A reduced dose of all of them…

…would not be prepared to show a colleague. Indications Investigation of chronic cough, dyspnoea, wheeze or reduced exercise capacity. Suspected asthma or COPD — diagnosis and…

…antagonist. In this setting, ivabradine should be considered to reduce the risk of heart failure hospitalisation and cardiovascular death. The recommendation is class IIa, level…

…durability of the response is central to its clinical use. After the initial treatment phase, administration is required only twice annually. This may reduce the…

…arrest, agonal breathing or cardiac arrest — intubate. Inability to protect the airway: a reduced level of consciousness not attributable to hypercapnia, marked swallowing difficulty, vomiting…

…dose , titrated against clinical effect. 2. Parenteral thiamine early , preferably before or at the same time as carbohydrate administration. 3. Rapid identification of seizures, delirium…

…methods may also contribute. The cardioprotective effect is therefore likely to result from the cumulative influence of multiple modest dietary changes. Mediterranean type diets provide…

…of LDL particles from the circulation. Statins also reduce production of apoB 100 containing lipoproteins and exert effects beyond LDL C reduction, including modulation of…

…main physiological effects of exercise are summarized below. Parasympathetic fibers innervate both the sinoatrial (SA) node and atrioventricular (AV) node. Parasympathetic stimulation reduces the automaticity…

…of premature atherosclerotic cardiovascular disease (ASCVD), particularly coronary artery disease (CAD). FH results from pathogenic variants affecting proteins in the hepatic LDL receptor pathway. Reduced…

…be generated during exercise. Effect of preload and afterload on ejection fraction Ejection fraction is highly dependent on preload and afterload. A rapid increase in…

…partial effect Unfractionated heparin Protamine Antiplatelet agents Platelet transfusion has weak evidence; discuss with the on call coagulation service Always in parallel: mechanical control of…

…the effects of ACE inhibitors, it is preferable to optimize the dose of diuretic first. However, clinicians may need to reduce the dose of diuretic…

…myocardial contractility and heart rate. Coronary compression and a Venturi or “suction” effect have been proposed as mechanisms of inducible ischaemia. The functional impact depends…

…patients with impaired renal function, reflecting both reduced clearance and the high prevalence of structural heart disease in this population. Obesity is associated with lower…

…inhibit the antiplatelet effect of low dose acetylsalicylic acid when taken simultaneously. Clinical significance is unclear. Metamizole: May reduce the antiplatelet effect of acetylsalicylic acid…

…reflects the combined influence of epicardial stenosis, resting flow and microvascular vasodilator capacity. The two measures may therefore be discordant. A reduced FFR with preserved…

…with a reduced level of consciousness, focal neurological signs or seizures — because the delay costs more than the scan contributes. Only clinical signs of herniation…

…extremity symptoms are much more common than upper extremity symptoms. The severity of symptoms should be described by their effect on walking distance, daily activities…

…according to effect, not according to total body weight Concomitant benzodiazepine A markedly increased risk of respiratory depression. Avoid the combination, or reduce both Red…

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

…and harms In secondary prevention trials involving patients with previous vascular disease, aspirin reduced the combined incidence of non fatal MI, non fatal ischaemic stroke…

…atherosclerotic vascular disease or familial hypercholesterolaemia, addition of bempedoic acid to statin therapy reduced LDL C by approximately 16.5%; the reduction in a subgroup…

…CKD), which itself promotes cardiovascular disease and amplifies cardiovascular and all cause mortality. The excess risk is mediated by the combined effects of hyperglycaemia, hypertension…

…correlates best with total cumulative dose—may be a better predictor of long term tolerability. Hemodynamic Effects Amiodarone acts as a peripheral and coronary vasodilator…

…eGFR of 30 40 mL/min for lower urinary tract infection. At an eGFR <30 mL/min the antibacterial effect is lost. Dosed independently of…

…of hospital cardiac arrests in Melbourne, Australia. Emerg Med 2013;30:3842. Luna GK, Pavlin EG, Kirkman T, Copass MK, Rice CL. Hemodynamic effects of…

…Clevidipine reduces blood pressure without affecting cardiac filling pressures. • Clevidipine is more effective than nitroglycerin, nitroprusside, and nicardipine in hypertensive emergencies. Time to onset of…

…Hemodynamic effects of constrictive pericarditis Diastolic heart failure and right heart failure The rigid pericardium prevents all four heart chambers from dilating adequately during diastole…

…serum concentration. Alkalinisation increases renal elimination several fold and at the same time reduces the passage of salicylate into the central nervous system. Contact your…

…min. Maximum infusion dose: 300 μg/kg/min. Bolus doses of 300 μg/kg can be repeated during infusion. Adverse effects Flushing. Nausea…

…the anterior axillary line. Thoracostomy This method is generally deemed safer than using a needle due to reduced risk of injury. Thoracostomy should be performed…

…the concurrent use of beta blockers. The vasodilating effect reduces preload and afterload, further reducing myocardial workload. 1 The pharmacokinetic profile of levosimendan is modulated…

…gaze palsy — that can be assessed before and during the window of effect. The muscarinic effect may at the same time produce marked bradycardia and…

…therapies in cardiovascular medicine, widely utilized for the management of hypertension, chronic ischemic heart disease, heart failure with reduced ejection fraction (HFrEF), and post myocardial…

…reduces heart rate, myocardial oxygen consumption and myocardial contractility. Less pronounced blood pressure lowering effect than esmolol and labetalol. Time to onset of action 20…

…proved that beta blockers prolong life, alleviate symptoms and reduce the risk of hospitalization for patients with heart failure. Several landmark studies followed and proved…

…proved that beta blockers prolong life, alleviate symptoms and reduce the risk of hospitalization for patients with heart failure. Several landmark studies followed and proved…

…increase heart rate, and reduces myocardial oxygen consumption. Time to onset of action: 5 minutes. Effects Lowers blood pressure, reduces heart rate, myocardial oxygen consumption…

…reduces thrombogenicity, and favourably modifies inflammatory and collagen related components of atherosclerotic plaque. These effects help explain why reductions in cardiovascular events are substantially greater…

…reduced HDL cholesterol and increased small, dense LDL particles. Increased apoB containing particles and remnants may provide a more accurate assessment of atherogenic burden than…

…Withdraw slowly. • Simultaneous use of tricyclic antidepressants reduces the effect of clonidine. • Clonidine increases the CNS depressive effects of alcohol and sedatives. Clonidine doses and…

…with plasma uric acid reduction of approximately 10% to 15% Possible effects on erythropoietin activity and erythropoiesis SGLT2 inhibition may also activate adenosine 5′ monophosphate…

…bundle of His or the bundle branches. Tachycardia can cause AV blocks during or after the tachycardia episode. Under certain circumstances, bradycardia can actually reduce…

…and consequently reduced cardiac output. A substantial reduction in pulmonary perfusion and the subsequent reduction in left ventricular preload lead to a cascade of hemodynamic…

…water soluble and short acting, not a depot preparation, and gives a shorter duration of effect. Lidocaine 10 mg/mL without adrenaline , 2–5 mL…

…Warfarin has a narrow therapeutic index, a half life of several days and more than a hundred clinically relevant interactions. What determines whether the treatment…

…does not reduce cardiovascular or all cause mortality. Reported relative effects include: Approximately 11% reduction in cardiovascular events in a meta analysis of primary prevention…

…conventional risk factors have sex dependent effects: Blood pressure rises more steeply in women from young adulthood, resulting in a greater lifetime burden of hypertension…

…reduce ischaemic events but increases bleeding. Standard DAPT duration after ACS Default strategy The standard treatment after ACS is DAPT for 12 months , irrespective of…