…or when the volume limit is reached. Indications Diagnostic aspiration: a new pleural effusion of unclear cause. An effusion not confidently explained by heart failure…

…often lacks abdominal pain and peritonism and instead presents as encephalopathy, renal failure or simply deterioration. The procedure itself is straightforward: ultrasound to find the…

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…

…incidence of coronary heart disease and acute myocardial infarction has been reduced by approximately 50% during the past few decades, the incidence of heart failure…

…incidence of coronary heart disease and acute myocardial infarction has been reduced by approximately 50% during the past few decades, the incidence of heart failure…

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

…Heart failure with mildly reduced ejection fraction (HFmrEF) is a clinical syndrome defined by the combination of symptoms and/or signs of heart failure and…

…Definition of Heart Failure, endorsed by major global cardiovascular societies, defines HF as a clinical syndrome corroborated by elevated natriuretic peptide levels and/or objective…

…important. Cardiorenal syndrome may develop during acute decompensated heart failure, but worsening renal function does not necessarily indicate reduced cardiac output or impaired renal perfusion…

…Use of accessory respiratory muscles or paradoxical abdominal breathing Impending muscle fatigue Respiratory rate above 25 to 30 per minute Increased risk of ventilatory failure…

…of congestion or impaired cardiac performance rather than by ejection fraction alone. Heart failure with preserved ejection fraction (HFpEF) is characterized by: Symptoms and/or…

…are the strongest predictors of adverse outcomes. Non acute or asymptomatic bradycardia Non acute bradycardia is a common finding in both healthy and diseased individuals…

…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…

…fraction (LVEF). Heart failure with reduced ejection fraction (HFrEF) is defined by the combination of symptoms, with or without physical signs, and an LVEF below…

…of adverse events is increased by: advanced age; diabetes mellitus; chronic kidney disease or renal failure; congestive heart failure; prior stroke; emergency coronary angiography or…

…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…

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

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

…urgency of management: Recurrent or ongoing chest pain despite medical treatment Acute heart failure presumed to result from ongoing myocardial ischaemia Haemodynamic instability or cardiogenic…

…complementary objectives of initial STEMI management. The principal acute complications fall into two broad categories: Electrical complications , particularly ventricular arrhythmias. Mechanical or pump failure complications…

…4b and 4c fulfil the criteria for type 1 MI because they represent coronary atherothrombotic events in the setting of a stent thrombosis or restenosis…

…transferred to such centers. Post cardiac arrest syndrome (PCAS) Post cardiac arrest syndrome (PCAS) emerges after ROSC or initiation of ECMO. The syndrome was first…

…use of beta blockers. The vasodilating effect reduces preload and afterload, further reducing myocardial workload. Levosimendan is used in severe acute or chronic heart failure…

…failure management, evaluation for coronary artery disease, etc .) are warranted. Management of AV blocks aims to restore atrioventricular conduction either pharmacologically or by means of…

…hypertension with or without left ventricular hypertrophy. Among patients with NSTE ACS undergoing angiography, approximately 10% have no critical epicardial stenosis. In some of these…

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…

…acute heart failure to support systemic blood pressure through its infusion rate parameters. Clinical Presentation and Symptoms Acute heart failure necessitating inotropic or vasopressor support…

…valvular disease or congenital heart disease. Cardiomyopathy leads to impaired cardiac function and heart failure. There are six main types of cardiomyopathy: Hypertrophic cardiomyopathy (HCM…

…probability of coronary artery disease. Assessment of exercise capacity and symptoms in known heart disease. Risk assessment after myocardial infarction or before revascularisation. Evaluation of…

…Active Ingredient(s) Cardiotoxicity Label Section DICT Concern Cardiac side effects Severity of cardiotoxicity Hyaluronic Acid HYALURONIC ACID HYALURONIC ACID NA no no ZYPREXA Relprevv…

…or a reduced requirement for antihypertensives, should prompt clinical suspicion [1]. Cardiac Signs and Symptoms Patients often present with symptoms of predominant right heart failure…

…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…

…of hypertension is not made on a single reading. It requires repeated measurements on at least two occasions, and preferably confirmation by home measurement or…

…and the balance of risk and benefit determine whether treatment is initiated. High 3 9 As above. Very high Oral anticoagulation (warfarin or NOAC) is…

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…

…heart failure, and uncontrolled arrhythmias. Pharmacologic stress agents have specific contraindications: Adenosine, Dipyridamole, Regadenoson : Should be avoided in patients with active bronchospasm, severe hypotension, or…

…is the isovolumetric relaxation time (IVRT) . The ability of the myocardium to relax during IVRT is governed by left ventricular compliance. The greater the compliance…

…of effect, and significant individual variations in its effect. Drug Enalaprilat Brand names Vasotec IV ® Indications Hypertension and hypertensive emergency. Acute left ventricular failure…

…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…

…used for mor than 10 minutes. Administer sodium thiosulfate (cyanide into thiocyanate) and terminate infusion of nitroprusside if cyanide toxicity is suspected. Adverse effects • Nausea…

…inhibitor or ARNI, a beta blocker and a mineralocorticoid receptor antagonist. In this setting, ivabradine should be considered to reduce the risk of heart failure…

…dilation of the left ventricle . Patients with DCM typically develop heart failure early in life and a family history of heart failure, ventricular arrhythmias or…

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

…a dialysis patient, in severe acute kidney injury, in treatment failure or in ongoing massive potassium release. In cardiac arrest with suspected hyperkalaemia, advanced life…

…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…

…anaesthesia early with a prolonged seizure, repeated doses of benzodiazepine, aspiration, hypoventilation, circulatory failure or an anticipated need for anaesthesia. Consider a 12 lead ECG…

…symptomatic. Alkalosis increases the binding of calcium to albumin and lowers ionised calcium further; risk of tetany and seizures. Anuria or established renal failure. Without…

…patients over 75, with a weight below 60 kg, heart failure, hepatic impairment, malnutrition, concurrent amiodarone or known slow CYP2C9 metabolism. 4. Take the INR…

…not indicate the types or distribution of body fat. It may not be accurate for all populations, particularly at the extremes of height and weight…

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

…Hyperuricemia may occur during treatment with ticagrelor. Caution is advised for patients with hyperuricemia or gout. Use of ticagrelor is discouraged in patients with uric…

…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…

…disease, one in five for heart failure and one in five for stroke. Sex and gender are distinct but interacting determinants of cardiovascular health. Sex…

…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…

…seconds. Case reports have indicated that the risk of high degree AV block and ventricular arrhythmias is greater in patients on digoxin or verapamil, although…

CPR Cardiac arrest is a result of tachyarrhythmia, bradyarrhythmia or asystole. The tachyarrhythmias include ventricular fibrillation (VF) and pulseless ventricular tachycardia (VT). The bradyarrhythmias include…