…is reached. Indications Diagnostic aspiration: a new pleural effusion of unclear cause. An effusion not confidently explained by heart failure must be aspirated. Suspected empyema…

…of free fluid depth with no bowel in the path of the needle and measure the skin to peritoneum distance. 2. Mark the site. Sterile…

Overview of diagnosis, classification and management of heart failure

…A stimulus delivered during the refractory period should not result in activation because the myocardium is refractory. The most common cause of failure to capture…

…50% during the past few decades, the incidence of heart failure has remained stable. New data suggest that the incidence of heart failure among young…

…50% during the past few decades, the incidence of heart failure has remained stable. New data suggest that the incidence of heart failure among young…

…including the Get With The Guidelines Heart Failure (GWTG HF) and the SWEDEHEART registries, demonstrate that while the incidence of HFrEF has stabilized or slightly…

…the diagnosis of heart failure is clinically secure and the LVEF measurement is reliable. Nevertheless, these findings increase diagnostic confidence. The presence of symptoms alone…

…introduced critical nuances to HF terminology to reflect the dynamic nature of myocardial remodeling. The designation "Heart Failure with improved Ejection Fraction" (HFimpEF) is now…

…between cardiac and renal dysfunction is particularly important. Cardiorenal syndrome may develop during acute decompensated heart failure, but worsening renal function does not necessarily indicate…

…Pneumonia, heart failure, pulmonary embolism, pneumothorax and acute coronary syndrome must be actively considered [1]. Do the following early: 1. Assess airway, work of breathing…

…therefore defined by symptoms and signs of congestion or impaired cardiac performance rather than by ejection fraction alone. Heart failure with preserved ejection fraction (HFpEF…

…heart failure and cardiac arrest. In cases with intermittent symptoms, it is important to establish a temporal correlation between symptoms and episodes of bradyarrhythmia on…

…medical treatment life threatening arrhythmias or cardiac arrest mechanical complications of acute myocardial infarction. acute heart failure recurrent dynamic ST segment or T wave changes…

…therapy. In this setting, the risk of sudden death and end stage heart failure is high, and assessment for advanced therapies may be required. Evaluation…

…and procedural risk factors The risk of adverse events is increased by: advanced age; diabetes mellitus; chronic kidney disease or renal failure; congestive heart failure…

…degree of ischemia, parasympathetic and sympathetic tone) while others take months or years to develop (e.g. myocardial remodeling in heart failure or after myocardial…

…increased during infections). As noted by Bonow et al, it is also reasonable to believe that patients with heart failure are at increased risk of…

…cardiac conditions (such as renal failure). To establish a diagnosis of MI, acute myocardial injury must be coupled with clinical evidence of acute myocardial ischaemia…

…disruption, rupture and compromise of branch vessels. Type A disease may cause cardiac tamponade, severe acute aortic regurgitation, coronary malperfusion, myocardial ischaemia, heart failure, shock…

…risk and should influence the urgency of management: Recurrent or ongoing chest pain despite medical treatment Acute heart failure presumed to result from ongoing myocardial…

…Mechanical or pump failure complications , including heart failure and cardiogenic shock. Most out of hospital deaths occur early and are commonly related to ventricular fibrillation…

…including: Cardiac causes Systemic causes Heart failure Sepsis Myocarditis Chronic kidney disease Cardiomyopathy Stroke or subarachnoid haemorrhage Takotsubo syndrome Pulmonary embolism Recent coronary revascularization Infiltrative…

…and respiratory instability, multiorgan failure, infections, seizures and temperature management. The ICU is the preferred level of care for the absolute majority. The CCU may…

…points Levosimendan alleviates heart failure symptoms, increases cardiac output, and lowers pulmonary artery pressure without increasing myocardial oxygen consumption. The inotropic effect of levosimendan is…

…choice of device therapy and also suggest whether other interventions (e.g. heart failure management, evaluation for coronary artery disease, etc .) are warranted. Management of…

…fewer than 5% of such lesions caused a clinical event during 3.4 years of follow up in a prospective study of patients with acute…

Procedurer In acute circulatory failure it is not the number of cannulae that matters but the flow per unit time . A large bore, short cannula…

Cardiology Critical care Pharmacology & dosing Definition and Pathophysiology In the management of acute heart failure and cardiogenic shock, intravenous vasoactive agents are categorised according to…

…coronary heart disease, hypertension, valvular disease or congenital heart disease. Cardiomyopathy leads to impaired cardiac function and heart failure. There are six main types of…

…ongoing unstable angina. Uncontrolled symptomatic arrhythmia. Symptomatic severe aortic stenosis. Decompensated heart failure. Acute pulmonary embolism or deep vein thrombosis. Acute myocarditis, pericarditis or endocarditis…

…cardiac arrest Solu Cortef HYDROCORTISONE SODIUM SUCCINATE HYDROCORTISONE SODIUM SUCCINATE Heart Damage wp less elevation of blood pressure mild Calcium Disodium Versenate EDETATE CALCIUM DISODIUM…

…antihypertensives, should prompt clinical suspicion [1]. Cardiac Signs and Symptoms Patients often present with symptoms of predominant right heart failure, including lower extremity edema, ascites…

…of heart failure, coronary artery disease, acute coronary syndromes and stroke ( Steyerberg et al ). Achieving this has been significantly more difficult for the prediction of…

…width ≥ 40% of the upper arm circumference — a cuff that is too narrow gives a falsely high reading The cuff at heart level Measure in…

Calculators CHA2DS2 VASc Score Calculator Congestive Heart Failure Hypertension Age = 75 years Diabetes Mellitus Stroke/TIA/TE Vascular disease Age 65 74 years Sex…

Info The ECG must always be interpreted systematically. Failure to perform systematic interpretation may actually be detrimental. We have therefore compiled a pocket guide with…

…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…

…in patients with acute myocardial infarction, unstable angina, severe aortic stenosis, decompensated heart failure, and uncontrolled arrhythmias. Pharmacologic stress agents have specific contraindications: Adenosine, Dipyridamole…

…Diastolic heart failure is particularly common among people with diabetes, hypertension, overweight/obesity, and the elderly ( Pieske et al ). Figure 1. Myocardial motion during (A…

…Contraindications • Contraindicated in pregnancy, severe renal artery stenosis, severe hyperkalemia. • Avoid in acute heart failure and acute myocardial infarction. Enalaprilat doses and administration in hypertension.

…egg), of which the maximum dose per 24 hours is 1000 mL. Adverse effects Headache. Nausea. Fever. Atrial fibrillation. Worsening of heart failure. Caution • Used…

…heart failure. Angina pectoris. Hypertension, hypertensive crisis/emergency. Pulmonary hypertension. Blood pressure control. Mechanism of action Nitroprusside provides nitric oxide (NO) that induces vasodilatation of…

…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…

…and a family history of heart failure, ventricular arrhythmias or sudden cardiac arrest is common. The following cardiomyopathies lead to dilation of the ventricle: Dilated…

…the side lying variant of the Dix–Hallpike test. Marked obesity or spinal disease that makes positioning impossible. Severe angina, heart failure or recent myocardial…

…or a very strong clinical suspicion. 3. Give intravenous calcium in the presence of hyperkalaemic ECG changes or arrhythmia. 4. Shift potassium into the cells…

…needed. Intubate for a threatened airway, a marked risk of aspiration, or failure that is not rapidly reversed by an antidote B Respiratory rate, saturation…

…2,3]. Respiratory complications occur, but untreated convulsive status itself carries a considerable risk of hypoxia and respiratory failure. In placebo controlled trials, respiratory depression…

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

…to 5 mg (two tablets) on days 1 and 2 in patients over 75, with a weight below 60 kg, heart failure, hepatic impairment, malnutrition…

…BMI and cardiovascular outcomes High BMI is associated with several health conditions: Type 2 diabetes Hypertension Coronary artery disease Heart failure Dyslipidemia (including high LDL…

…Bolus doses of 300 μg/kg can be repeated during infusion. Adverse effects Flushing. Nausea. Bronchospasm. AV block. Caution • Avoid in acute heart failure…

Info Table 1 provides a summary of the indications, contraindications, dosage, administration, warnings, precautions, and other relevant information for the drug Ticagrelor . Table 1 Summary…

…the serum creatinine up to 30% is considered acceptable. In the setting of acute heart failure, N terminal pro B type natriuretic peptide (NT proBNP…

…men after approximately 65 years of age. Hypertension related left ventricular hypertrophy, concentric remodelling, reduced longitudinal strain and heart failure with preserved ejection fraction are…

…β cell failure, endothelial dysfunction and atherosclerosis. Ectopic fat deposited around or within the heart and kidneys may exert direct compressive effects and releases additional…

Cardiology Substance : Adenosine Brand names : Adenocor Mechanism of action Adenosine works by slowing down the impulse transmission through the atrioventricular (AV) node, thereby interfering with…

…etc.). Among victims in whom the cardiac arrest was caused by VT or VF (e.g acute or chronic myocardial ischemia, heart failure, etc.), it…