…the examiner can further increase the amount of gain applied to incoming sound waves. This is done using gain control or time gain compensation (TGC…

…viable segments that are dysfunctional because of repeated ischemic episodes or chronic reductions in perfusion. The amount and distribution of both viable and nonviable myocardium…

…extensive myocardium at risk, severe baseline stenosis, multivessel coronary artery disease, or diffuse disease. No reflow represents impaired antegrade myocardial perfusion in the absence of…

…Assessment should integrate the history, physical examination, laboratory data and diagnostic testing. Examination for congestion Useful bedside indicators of persistent or improving congestion include: J

…a chronic, relapsing and biologically complex disease characterized by excessive accumulation of adipose tissue. It is an important cause of cardiovascular disease (CVD), cardiovascular risk…

…in most patients with severe cardiovascular disease or in those who are otherwise haemodynamically unstable. The benefit of its administration in these patients should be…

…20–30% of patients, while clinically evident restenosis, manifested by recurrent angina attributable to the treated segment, occurred in 10–15% during the first year…

…include: Diabetes and insulin resistance Thyroid disease Kidney disease Excessive alcohol consumption Diets high in carbohydrate or fat Glucocorticoids Beta blockers Oestrogen therapy Some antiretroviral…

…PR interval, while leaving the QRS duration largely unchanged. Continuous ECG monitoring is mandated during hospital initiation to detect excessive QT prolongation, proarrhythmia, and severe…

…disease or excessive beta blocker or calcium channel blocker exposure. The incidence of cardiogenic shock complicating STEMI has fallen with prompt reperfusion and reduction of…

…the COPD exacerbation apart from many other causes of acute dyspnoea: oxygen must be titrated cautiously and the blood gas determines the need for ventilatory…

…for the assessment of pH and bicarbonate. An arterial blood gas is needed mainly when concomitant respiratory failure or an exact assessment of oxygenation requires…

…in lead II. Causes of bradyarrhythmia: sinus bradycardia, SA block, sinus arrest, sick sinus syndrome, second degree or third degree AV block. An escape rhythm…

…Contraindications Atrial fibrillation or flutter of unknown or excessive duration without adequate anticoagulation or exclusion of thrombus — the most important relative contraindication to elective cardioversion…

…newly detected for the first time, or newly developed during management of an acute illness. The clinical relationship between AF and acute deterioration is often…

…than 70% of older adults presenting with myocardial infarction, stroke, acute aortic syndromes, or heart failure have preexisting hypertension. The relationship between blood pressure and…

…from selected populations, frequently with low or intermediate ischemic risk and under representation of patients with STEMI or other very high risk features. Noninferiority studies…

…microvascular disease and vasospasm may coexist with atherosclerosis or may be the dominant cause of ischaemia. Other mechanisms capable of obstructing coronary arteries include embolism…

…CYP2C9 variants) (1 point) E xcessive fall risk (1 point) S troke (1 point) HEMORR₂HAGES Score Risk category Incidence of major bleeding (per 100 patient…

…wave infarction) Lead Definition of pathological Q wave Normal variants V2–V3 ≥0,02 s or QS complex None All other leads ≥0,03 s…

…2 to 3 days, and often 1 to 3 weeks or occasionally longer; loading doses mitigate this delay. During chronic therapy, plasma concentrations correlate well…

…LV systolic function. The principal mechanisms are the combination of an abnormal thrombogenic endocardial surface and blood stasis. During the acute infarction phase, endocardial inflammation…

…sign Hepatomegaly as evidence of systemic venous congestion Blood pressure and evidence of hypotension Clinical evidence of low cardiac output or shock RVI may produce…

…abruptly interrupts blood flow to both the left anterior descending (LAD) and left circumflex (LCx) coronary artery territories, resulting in extensive myocardial ischemia or infarction…

…the other arm. 2. Ankle pressure. Place the cuff just above the malleoli, with its lower edge about 2 cm above the tip of the…

…of aspiration: a non fasted patient, ileus, third trimester pregnancy, marked reflux. A need for high airway pressures, for example severe ARDS, marked obesity or…

…from them Full bladder Have the patient void, or catheterise, before puncture Pregnancy, previous extensive abdominal surgery Ultrasound guidance; choose a new site if in…

…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…

…commonly develops during the third or fourth decade in males and approximately 10 years later in females. Untreated HoFH is associated with extensive premature and…

Cardiology Pharmacology & dosing Definition and pharmacological basis Ivabradine is a selective inhibitor of the If, or “funny,” current in sinoatrial node pacemaker cells. This current…

…2%–24% of patients with CAD. The pathophysiology of refractory angina is heterogeneous. In obstructive CAD, symptoms may result from extensive or diffuse epicardial disease…

…segment elevation or an equivalent electrocardiographic pattern in a patient with symptoms of myocardial ischaemia. The immediate therapeutic objective is restoration of coronary blood flow…

…hypertrophy, LV dysfunction, or other pathology that could affect the safety or interpretation of the examination. Evaluation and Physical Examination Before stress echocardiography, clinical assessment…

…and subsequent sudden death are rare, the arrhythmia is precipitated by an extensive list of "torsadegenic" or "QT liability" drugs. This includes Class III antiarrhythmic…

…S Ca 2+ 2.6 mmol/L In approximately 90% of cases, hypercalcemia is attributed to primary hyperparathyroidism or neoplastic etiologies. Other causes include immobilization…

…this chapter, you will learn the physiological basis of all ECG waves and how to determine whether the ECG is normal or abnormal. Although heart…

…obstruction the more extensive the ischemia/infarction. The location of the thrombus in the artery: a proximally located thrombus will cut off blood flow to…

…Extensive myocardial infarction may lead to papillary muscle rupture. The risk of rupture is greater for the posteromedial papillary muscle, which only receives blood supply…

…or after suturing over a joint. Pain relief and stabilisation for transfer in a suspected fracture. Clinical suspicion of a scaphoid fracture despite a normal…

…4 g × 4 IV Exacerbation of COPD with an indication for antibiotics amoxicillin 750 mg × 3 PO 5–7 days or doxycycline 200 mg × 1…

…associated with extensive atherosclerosis and frequently occurs in older patients with multiple vascular comorbidities. An isolated PAU is one without associated IMH, dissection, or saccular…

…typical circuits occurring in diseased atria—most frequently following surgery or extensive ablation, or under the influence of antiarrhythmic drugs—can produce atypical ECG patterns…

…with acute coronary syndrome, randomized evidence has demonstrated lower rates of access site bleeding, surgical repair, and blood transfusion with radial access. Radial access has…

…dysfunction suggesting extensive obstructive CAD. A high risk result on non invasive testing. Symptoms that are strongly suggestive of obstructive CAD. Uncertain or inconclusive non…

…130 msec in females , along with slurring or notching of the mid QRS in at least two left facing leads [7]. These stricter parameters correlate…

…consequences of extensive myocardial ischaemia, including heart failure, haemodynamic compromise and rhythm disturbance. The source material does not provide a specific examination profile or diagnostic…

…a continuum of myocardial injury ranging from minor or reversible injury to extensive necrosis. Causes of myocardial injury Important causes include: Mechanism or clinical setting…

…from out of hospital cardiac arrest should not routinely undergo immediate angiography. A selective or delayed approach is recommended in this setting unless other findings…

…battery with a lifespan of 5–10 years. A shorter lifespan can be expected if the pacing requirement is extensive, or if the stimulus threshold…

…the other hand, is caused by a complete coronary artery occlusion, which results in the complete stop of blood flow and thus more extensive myocardial…

…on either side of the patient, depending on preferences. The operator should have an elbow rest, and also avoid bending the back during the examination…