…Beyond its direct cellular actions, digoxin exerts significant systemic effects via the autonomic nervous system. It attenuates carotid sinus baroreceptor activity and acts centrally and…

…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…

…salicylate poisoning, intubation with an inadequate minute ventilation can rapidly worsen the acidaemia and increase the entry of salicylate into the central nervous system. Discuss…

…be underestimated. Offer a chaperone according to local procedure; this is recommended for all examinations of the breasts, the genitalia and the rectum. Ask about…

…of image optimization in echocardiography In order to obtain optimal ultrasound images, it is necessary to adjust several parameters continuously during the examination. Typically, examinations…

…or a hand held device (iCare, Tono Pen). Procedure Systematic examination 1. Visual acuity in each eye separately , with the patient's usual glasses and…

…one third of the patients who ultimately had a favorable neurological recovery exhibited an abnormal pupillary reflex upon initial examination. Notably, 31.2% of patients…

…afterwards whether a nerve injury was caused by the injury or by the treatment. Indications A clinically or radiologically confirmed dislocation of the shoulder, elbow…

…MI) is a clinical diagnosis that integrates myocardial injury, evidence of acute myocardial ischaemia, electrocardiographic findings, cardiac biomarkers, imaging, angiography, and, occasionally, pathological examination. Pathologically…

…maximum 3 mg IV. T½ 3 h. 50% renal elimination. • Typically the first choice of drug. • Effective in sinus bradycardia or AV node block. • Dose…

…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

…patients without severe ischaemia. Evaluation and Physical Examination The initial evaluation should be structured to establish a working diagnosis of STEMI rapidly, identify haemodynamic or…

…conventional hypertension threshold. The traditional diagnostic threshold of 140/90 mmHg derives from epidemiological observations associating pressures above this level with increased mortality. Contemporary management…

Echocardiography The echocardiographic examination The use of echocardiography has increased dramatically during the past few decades. Advances in echocardiography have been propelled by breakthroughs in…

…on the left side of the marker in the image. Echocardiographic windows Figure 1. Echocardiographic windows to obtain images. The standard examination include the following…

Echocardiography Principles of echocardiographic examinations In small children, it is possible to perform the entire transthoracic echocardiography (TTE) with the child in the supine position…

…Assessment of regional wall motion is an integral aspect of virtually every echocardiographic examination. Wall motion is assessed in each segment of the left ventricle…

…an anatomical examination, whereas contemporary decision making increasingly combines anatomical imaging with functional assessment. A central practical principle is that the visual severity of a…

… otherwise further examination is warranted. Figure 1. Sinus arrhythmia (respiratory sinus arrhythmia). Treatment of sinus arrhythmia Sinus arrhythmia is a normal finding among young and…

…context of cardiac arrest, focused echocardiography entails a swift evaluation of ventricular contractions and the status of the pericardium by an experienced clinician. The examination…

…Examination of the right ventricle with echocardiography The right ventricle is relatively difficult to examine, which is due to the location of the ventricle in…

…and impaired ventricular relaxation [10]. There is also an increased risk of intracardiac thrombus and stroke or systemic embolization, even in patients in sinus rhythm…

…malignancy, amyloidosis). In case of suspicion of pericardial disease, in the first place, an echocardiographic examination is done. With echocardiography, good conditions are obtained for…

…The test presupposes that the patient has spontaneous nystagmus at the time of examination and that the examiner is experienced with the head impulse test…

…dysfunction, or both. The clinical consequences of extracellular volume expansion include elevated cardiac filling pressures, pulmonary congestion, systemic venous hypertension, and peripheral interstitial edema. These…

…rate. Within the context of acute coronary syndromes, particularly ST elevation myocardial infarction (STEMI), ischemic injury can disrupt the conduction system at any level, producing…

…peripheral artery disease (PAD), and other manifestations of systemic atherosclerosis. The principal clinical concern is cerebral embolism or haemodynamic compromise leading to transient ischaemic attack…

…tomographic angiography (CCTA) is a non invasive anatomical examination that depicts the coronary arterial lumen, atherosclerotic plaque, and the severity and distribution of coronary stenosis…

…direct activation of voltage sensitive calcium channels. At lower doses, dobutamine stimulates beta2 and alpha receptors, inducing vasodilation, decreasing aortic impedance and systemic vascular resistance…

…Additional examinations (e.g coronary angiography, cardiac MRI) are frequently necessary. Ischemic cardiomyopathy should be suspected if there is significant stenosis ( 75% luminal obstruction) of…

…baseline physical examination of patients prior to sotalol initiation. Diagnostics Electrocardiography (ECG) Electrocardiographic monitoring is central to the safe initiation and maintenance of sotalol therapy…

…including subacute rupture. Evaluation and physical examination The diagnosis of pericarditis is clinical and is supported by additional findings. A definite diagnosis requires a compatible…

…neurological findings are absent in roughly half of patients with a central cause. A normal routine neurological examination is therefore not sufficient to exclude stroke…

…What usually ruins the examination is not the technique but the handling of the specimen — an aspirate that clots before the smears are made is…

…cornerstone in the management of cardiovascular disease, heart failure, and chronic kidney disease (CKD). These agents interfere with the renin angiotensin aldosterone system (RAAS) by…

…and scope Familial and genetic screening in cardiovascular medicine is the systematic assessment of relatives and other individuals who may carry an inherited predisposition to…

…an increased concentration of circulating triglycerides. Both fasting and non fasting measurements provide prognostic information regarding cardiovascular risk. Thresholds vary among guideline systems: Classification Fasting…

…patients require a mechanism based assessment rather than reassurance based solely on the absence of obstructive CAD. Evaluation and Physical Examination Clinical assessment The asses

…complete physical and neurologic examination. Blood pressure and heart rate should be measured in the supine position and after 3 minutes of standing to determine…

…other symptoms suggestive of the five conditions listed above. It is important that history taking and physical examination is carried out systematically and carefully without…

…should begin with a comprehensive history and physical examination. Clinicians should inquire about historical clues suggesting alternative etiologies, such as a sensation of postnasal drip…

…embolization in the systemic circulation. The complications can be fatal. Approximately 500 Swedes are affected annually by endocarditis and the median age of 70 years…

…wishes are properly established. Two things determine the outcome — that the confirmation of death is carried out in a formally unimpeachable way, and that the…

…plug. The tympanic membrane cannot be inspected and the examination is needed for the diagnosis. Before audiometry or the fitting of a hearing aid. Recurrent…

…for up to 50% of SCA cases, though determining the exact underlying cause and its reversibility is often difficult. Physical examination and clinical evaluation should…

…and distal to the suspected obstruction Arterial and venous Doppler signals Evidence of systemic disease or a potential embolic source Neurological assessment is central to…

…Physical examination should therefore focus on: Blood pressure and evidence of hypotension Heart rate and tachycardia Respiratory rate and oxygenation Evidence of systemic congestion or…

…chemistry & laboratory medicine Definition and Pathophysiology B type natriuretic peptide (BNP) and N terminal pro BNP (NT proBNP) are circulating markers of myocardial wall stress…

…a specific examination profile or diagnostic physical signs for LMCAD. Diagnostic Assessment Coronary angiography Invasive coronary angiography defines: The presence and severity of left main…

…ECG acquisition and consideration of additional leads. Evaluation and Physical Examination At first medical contact, assessment should occur concurrently with acquisition of the initial ECG…

…The whole purpose of the exercise ECG is to provoke physiological reactions that are not noticeable at rest. Hence, the examination may only be considered…

…for acute severe heart failure. A recent echocardiographic examination should be available or performed urgently to evaluate ventricular and valvular function. Levosimendan drug is generally…

…Doppler). Usage of M mode M mode is commonly used to complement the examination of the following structures: Left ventricular (LV) dimension and function. Right…

…Physical examination Vital sign assessment 12 lead ECG Initial hs cTn measurement Continuous cardiac monitoring The source material does not provide a detailed list of…

…of the examination. Evaluation and Physical Examination Before stress echocardiography, clinical assessment should establish: The nature and stability of symptoms Exercise capacity The presence of…

…level. Physical examination can identify a large aneurysm as a palpable, pulsatile, expansile mass, although absence of a palpable abnormality does not exclude AAA. Plain…

…instability. Evaluation and physical examination Initial assessment should establish whether AF is associated with acute haemodynamic compromise, pulmonary oedema, or evidence of coronary ischaemia. These…

…the risk of sudden death and end stage heart failure is high, and assessment for advanced therapies may be required. Evaluation and physical examination Assessment…

…physical examination Assessment begins with systematic lipid screening and a careful clinical, medical, social and multigenerational family history. The evaluation should establish: The magnitude of…

…as an anatomical examination, contemporary ICA can provide complementary functional and structural information. Coronary pressure measurements permit assessment of the physiological significance of selected stenoses…