…an intravenous fluid resuscitation using a crystalloid solution at a dose of 30 ml/kg. Should fluid resuscitation fail to maintain a mean arterial pressure …

…Classification of office blood pressure Category Systolic Diastolic : : : : : Optimal < 120 and < 80 Normal 120–129 and/or 80–84 High normal 130–139…

…with hemodynamic effects is a potentially life threatening condition and should be managed urgently. The risk of cardiogenic shock and cardiac arrest is high and…

…Indications, dosing and effects Note that abrupt changes in blood pressure activate autonomic reflexes that influence the haemodynamic result. Reflex tachycardia is the rule after…

…Overview of vasopressors and inotropes Inotropes and vasopressors. Table 1. Drug manual for inotropes and vasopressors Drug Indications Dose α1 effect β1 effect β2 effect…

…and with a measurement interval of no more than 30 minutes throughout the 24 hours. Phenotype Office blood pressure ABPM : : : Normotension Normal Normal White coat…

…surgeon. Dislocation of a native hip (as opposed to a prosthesis) — a high risk of avascular necrosis of the femoral head and of vascular injury…

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

…to the high risk of reflex sympathetic stimulation. Drug Hydralazine Brand names Apresoline ®, Bidil ® Mechanism of action • Induces arteriolar vasodilation. No effect on…

…high prevalence of hypertension that is ubiquitous in high income Western countries. Fortunately, modern antihypertensive therapy enables most patients to return to normal blood pressure…

…volume of the ventricle (EDV) is reduced. Constrictive pericarditis also leads to right sided heart failure, which is explained by the fact that high pressure…

…lowers blood pressure by inhibiting ACE. Effects • The hypotensive effect of enalaprilat depends on plasma volume and plasma renin activity. Volume depletion and high plasma…

…Overview of vasopressors and inotropes Inotropes and vasopressors. Table 1. Drug manual for inotropes and vasopressors Drug Indications Dose α1 effect β1 effect β2 effect…

…decades, the management of type 2 diabetes mellitus (T2DM) and obesity was siloed, with clinicians focusing primarily on hemoglobin A1c (HbA1c) reduction, blood pressure, lipids…

…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…

…display SB at rest due to high vagal tone. These individuals have developed a highly efficient left ventricle, capable of generating sufficient cardiac output at…

…Their effects are multidimensional and cannot be adequately inferred from changes in a single intermediate marker such as cholesterol. Dietary composition may influence blood pressure…

…perfusion. • Dose dependent elevation of intracranial pressure (ICP) and reduction in cerebral blood flow. Caution • Used cautiously in patients with high intracranial pressure or azotemia…

…neutrophil chemotaxis toward inflammatory sites. Its cardiovascular effects therefore appear to reflect modulation of vascular inflammation rather than lipid lowering. Other anti inflammatory strategies have…

… First of all, don't confuse various lipids, since they are extremely different with regards to their effects and hazards. For example, high HDL cholesterol…

…lowers blood pressure by inhibiting ACE. Effects • The hypotensive effect of enalaprilat depends on plasma volume and plasma renin activity. Volume depletion and high plasma…

…lowers blood pressure by inhibiting ACE. Effects • The hypotensive effect of enalaprilat depends on plasma volume and plasma renin activity. Volume depletion and high plasma…

…These sympatho inhibitory effects decrease serum norepinephrine levels, plasma renin levels, and potentially aldosterone levels. Clinical Presentation and Symptoms In the management of heart failure…

…Drug side effects (diltiazem, verapamil, beta blockers, digitalis, amiodarone, clonidine, procainamide). Hypoxia (hypoxemia) Hyperkalemia. Hyperthermia Increased intracranial pressure Irreversible causes of sinus node dysfunction Age…

…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…

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…

…marked work of breathing — the strongest indication, with a rapid effect on dyspnoea and oxygenation. Atelectasis and postoperative hypoxaemia. Hypoxaemic failure where high flow nasal…

…a left main coronary stenosis of at least 50% is considered significant. These thresholds describe luminal narrowing, not necessarily the physiological effect of the lesion…

…region. The time limit is not a guarantee. Where the stroke risk is high or the time of onset uncertain, choose the more cautious course…

…Instillation therapy and contrast studies of the urinary tract. Wound healing with a sacral pressure sore or extensive perineal wounds where urinary leakage prevents healing…

…converting to Torsade de Pointes ventricular tachycardia. Notice how arterial blood pressure (ABP) drops at the onset of TdP. ECG by Nakstad et al (Scand…

…anticipated effect of the result on management. ICA with available coronary pressure assessment is recommended in patients with a very high clinical likelihood of obstructive…

Cardiology Continous medical discussion: the ECG blog Infectious diseases Cardiovascular effects of COVID 19 Coronavirus disease 2019 (COVID 19) has caused a global public health…

…high risk of developing life threatening arrhythmias. Antiarrhythmic drugs Disopyramide Indications Prophylaxis and treatment of symptomatic ventricular tachyarrhythmias. Prophylaxis and treatment of atrial fibrillation. Effects…

…This side effect lasts a few seconds. Case reports have indicated that the risk of high degree AV block and ventricular arrhythmias is greater in…

…lowers circulating high sensitivity C reactive protein, reduces thrombogenicity, and favourably modifies inflammatory and collagen related components of atherosclerotic plaque. These effects help explain why…

Cardiology Endocrinology & metabolism Definition and pathophysiology Hypertriglyceridaemia (HTG) is defined by an increased concentration of circulating triglycerides. Both fasting and non fasting measurements provide prognostic…

…HFrEF. Toxic and infiltrative causes are increasingly recognized. The burgeoning field of cardio oncology has highlighted the cardiotoxic effects of anthracyclines, HER2 inhibitors (trastuzumab), and…

…moderate or near a treatment decision threshold. Failure to account for a high Lp(a) level may lead to substantial underestimation of cardiovascular risk. Conversely…

…which specific antidotes are available. The detrimental effects of these substances can potentially be reversed if interventions are promptly instituted. In scenarios where an antidote…

…etc. Cardiac tumors cause nonspecific symptoms that depend on the size of the tumor, localization, hemodynamic effects and possible impact on the coronary arteries. The…

…digoxin treatment. Adverse effects of digoxin The incidence of adverse drug reactions is high, owing to the narrow therapeutic index of the drug. Digoxin is…

…AV block in these individuals can be challenging. A high suspicion of intermittent infrahisian block should be maintained, particularly in older patients and those exhibiting…

…Functional limitation and effect on activities of daily living. Workload or exertion required to provoke symptoms. Response to current antianginal therapy. Adverse effects that restrict…

…the combined effects of contrast exposure and other ischaemic or nephrotoxic stresses. The kidney is particularly vulnerable to toxic injury because of its high blood…

…of skin rash, mucosal lesions, or hypersensitivity. Interactions Pharmacodynamic interactions Anticoagulants, thrombolytics, or other platelet aggregation inhibitors: Salicylates inhibit platelet function and enhance the effect…

…adenosine requires a rapidly delivered bolus to achieve sufficiently high concentrations at its clinical site of action—the coronary artery perfusing the AV node—before…

…an effect not shared to the same extent by statins. Inclisiran Inclisiran is a liver targeted small interfering RNA. It promotes degradation of the messenger…

…infarction. Hemodynamic effects of right ventricular infarction include low cardiac output, hypotension, sensitivity to drugs that reduce preload (nitrates, morphine, diuretics), high degree AV block…

…Side effects of drugs (diltiazem, verapamil, beta blockers, digitalis). Hypoxia. Myocardial ischemia/infarction. Hyperkalemia. Treatment of sinoatrial arrest/pause Sinus arrest/pause due to increased…

…node, a phenomenon known as the bathmotropic effect . In contrast, parasympathetic stimulation increases resistance within the AV node, further slowing the transmission of impulses. Intense…

…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…

…condition and should be managed urgently. The risk of cardiogenic shock is high and pharmacological interventions are often futile. A transcutaneous pacemaker is often necessary…

…severe episodes, with concurrent physical illness or after prolonged very high intake More than 90 percent of withdrawal seizures occur within 48 hours. Seizures later…

…Heart failure, pulmonary oedema and other conditions with a high risk of fluid overload — a relative contraindication requiring invasive monitoring and slower administration. Significant metabolic…

…of blood flow. However, the Doppler effect can also be used to study myocardial motion. Myocardial motion during systole and diastole alter the frequency of…

…duration of 6 months after ACS is generally considered too short for routine use, but it may be considered in selected patients with a high…

…the larger effect of a PCSK9 inhibitor. Place in lipid lowering therapy General treatment sequence High intensity statin therapy remains the foundation of lipid lowering…

…acute myocardial infarction in order to assess the presence of myocardial ischemia, evaluate angina pectoris, evaluate exercise performance, evaluate the effect of interventions and medications…

…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…