…and ultimately asystole and death is not an absolute rule. While it often holds true for cardiac arrests caused by chronic or acute ischemic heart…

…major active metabolite. Both the parent drug and its metabolite accumulate extensively in various tissues, including the liver, lung, fat, and skin, with myocardial concentrations…

…Potential explanations include congenital heart disease, liver disease, airway or lung disease, and hyperthyroidism; follow up and investigation of the cause of increased flow are…

…lung and the fluid level. 2. Choose a point with at least 15 mm depth of fluid throughout the respiratory cycle and where the lung…

…Valve function and stress related haemodynamic changes Diastolic function Pulmonary hypertension Coronary flow velocity reserve (CFVR) Pulmonary congestion detected by B lines on lung ultrasound…

…the heart failure armamentarium. Its use has declined over time due to the advent of more efficacious agents with wider therapeutic to toxic windows, and…

…unless there is an absolute contraindication. The agent and dose are according to the local protocol. Alternatives when there is a contraindication: catheter directed treatment…

…In patients with pericarditis complicated by constriction, symptoms and signs of right sided heart failure may predominate. Pericardial effusions associated with post infarction pericarditis are…

…tachycardia secondary to disease and medications : A wide range of diseases and medications may cause sinus tachycardia; e.g congestive heart failure, lung disease (e…

…tachycardia and ectopic atrial rhythm Side effect of digoxin. Heart failure. Lung disease (COPD, pulmonary hypertension, etc). Ischemic heart disease (coronary artery disease). Structural heart…

…wall movements Chest percussion Lung auscultation Pulse oximetry ( 95%) C Circulation Skin color Sweating Capillary refill time (<2 s) Palpate pulse Heart auscultation Blood pressure…

…trans thoracic echocardiography. Causes of right ventricular hypertrophy Lung disease (with increased pulmonary vascular resistance), congenital heart disease (transposition of the great arteries, pulmonary valve…

…bacterial, and tuberculous infections. Post pericardiotomy syndrome. Acute transmural myocardial infarction. Rupture of the free ventricular wall. Neoplasms (particularly breast and lung cancer). Inflammatory conditions…

…the heart and the ultrasound transducer, and because less air filled lung tissue covers the heart. In adults, however, the distance between the heart and…

…absence of sounds on the affected side. Ultrasonography can reveal pneumothorax (highlighted by a lack of lung tissue) and its impact on cardiac function. Clinically…

…less ultrasound and become darker in the image. Acoustic shadowing Some structures have very high echogenicity (e.g skeleton, calcifications, mechanical heart valves) and reflect…

…causing vasodilation. Dobutamine Dobutamine is a chronotropic and inotropic agent. It increases heart rate, myocardial contractility, and blood pressure, thereby simulating the effects of exercise…

…of fluid is widest and lies most superficially, where the distance from the skin is shortest, and where no liver, lung or vessel lies in…

…clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor based approach: the Euro Heart Survey on Atrial Fibrillation…

Info Heart rate (bpm) = 60000 / cycle length Cycle length (ms) = 60000 / heart rate Heart rate (BPM) Cycle length (ms) Heart rate (BPM) Cycle…

…the heart cannot deliver blood at a rate appropriate to tissue requirements unless filling pressures are elevated. The syndrome is therefore defined by symptoms and…

Overview of diagnosis, classification and management of heart failure

…pulmonary congestion, peripheral edema and body weight, often within days. However, diuretic treatment has not been shown formally to reduce heart failure mortality; its established…

…HFrEF, LVEF <35%, sinus rhythm and resting heart rate 75 beats/min, based on a retrospective subgroup analysis in which a survival benefit was observed…

Arrhythmias and arrhythmology ECG Chronotropic incompetence: inability to adequately increase heart rate Chronotropic incompetence is an independent predictor of overall and cardiovascular mortality. The condition…

…Diagnostic phenotype Criterion HFmrEF Symptoms and/or signs of heart failure Required LVEF 41–49% Natriuretic peptides BNP ≥35 pg/mL or NT proBNP ≥125…

…41–49%), and HFpEF (≥50%) [1] [2] . Crucially, contemporary definitions distinguish HFpEF from "Heart Failure with improved EF" (HFimpEF). HFimpEF refers to patients with a…

…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…

…LVEF). Heart failure with reduced ejection fraction (HFrEF) is defined by the combination of symptoms, with or without physical signs, and an LVEF below 40%…

…elevation is typically discrete and not on a par with the degree of left ventricular impairment. Pathophysiology of takotsubo cardiomyopathy (broken heart syndrome) This topic…

…European Society for Cardiology, 2800 adults per 1 million individuals have congenital heart defects, and half of them have moderate or complicated defects; the remaining…

…with age: the heart rate, the electrical axis and the waveform in the newborn differ markedly from adult reference values and normalise gradually through childhood…

…heart valves; for these patients, warfarin is chosen instead (Class 1 B recommendation). There are several models for risk stratifying patients with atrial fibrillation, and…

…synonymous with ischemic heart disease, is the most common form of cardiovascular disease. It has been the number one killer in Western and high income…

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…

…incidence of heart failure among young adults has increased in recent years ( Nabel et al, Savarese et al ). This is a paradoxical and worrisome trend…

…incidence of heart failure among young adults has increased in recent years ( Nabel et al, Savarese et al ). This is a paradoxical and worrisome trend…

…there are generally no reliable and safe drugs available for long term heart rate augmentation without undesirable side effects. Drugs, With Doses and Practical Co

Arrhythmias and arrhythmology ECG Sinus bradycardia: ECG, causes & management Definition of sinus bradycardia Sinus bradycardia fulfills the criteria for sinus rhythm but the heart rate…

…PE) ↓ ↑ ↑ ↓ Vital signs and measures of perfusion Parameter Normal Comment : : : Heart rate 50–100/min MAP 70–105 mmHg Target ≥ 65…

…biological protection. Potentially favourable associations with myocardial infarction may coexist with adverse effects on stroke, heart failure, cardiovascular mortality and atrial fibrillation. Consequently, alcohol should…

…for screening and population level risk estimation, but it does not characterize body composition, fat distribution, skeletal muscle mass, physical fitness or individual health status…

…different physiology, and the commonest source of error is confusing them. CPAP delivers a constant pressure that recruits alveoli and unloads the heart, whereas bilevel…

…counselling and, where appropriate, molecular testing. The approach is particularly relevant to cardiomyopathies, channelopathies, heritable aortopathies, selected congenital heart diseases, pulmonary arterial hypertension and thromboembolic…

…His Purkinje system. The underlying pathophysiology varies widely and may involve intrinsic cardiac disease, extrinsic systemic conditions, or pharmacologic effects. Inflammatory heart disease, caused by…

Arrhythmias and arrhythmology ECG Atrial flutter Atrial flutter is the second most common pathological tachyarrhythmia. Only atrial fibrillation is more common. Atrial flutter occurs almost…

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

…pericardium has had time to adapt. Hypotension and muffled heart sounds are important when present but are relatively insensitive findings. Some patients with subacute tamponade…

…leads are introduced into one of the larger veins (typically the subclavian vein) and guided further down to the heart where they contact the endocardium…

…Velocity and direction of blood flow can be calculated by using the Doppler equation. Blood flow in the heart and vessels A liquid flowing in…

…inhibitors are prescribed. Evaluation and Physical Examination Prior to initiating an ACE inhibitor, it is essential to evaluate the patient's volume status. Because fluid…

…blood pressure, heart rate, left ventricular function, comorbidities, concomitant medications, potential drug interactions, the presumed mechanism of ischaemia, patient preferences, local availability, and cost. The…

…underlying genetic predisposition, structural heart disease, and diabetes [1]. Although TdP and subsequent sudden death are rare, the arrhythmia is precipitated by an extensive list…

…pathophysiology is rooted in autonomic dysregulation within a structurally normal heart. During an episode, decreased cardiac output and a potential paradoxical vasodilation with hypotension occur…

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

…which is why expeditious management is warranted. Initial management includes assessing the patient's clinical status (symptoms, hemodynamics), ECG and risk factors (age, previous disease…

…measures are taken and the principles that are common to all protocols. Children, pregnant women and patients with advanced renal failure, marked heart failure or…

…Heart failure, acute or chronic. Bradycardia (second line option). 3.0–10.0 μg/kg/min + ++++ + +++++ Intermediate dose dopamine activates β1, releases noradrenaline and…

…newly discovered complete heart block without current symptoms, alternating bundle branch block in acute anterior infarction, and before drugs or procedures with a known risk…