…the initial dose should be reduced to 3 mg. Heart transplant patients: Due to denervation, which makes the sinus and AV nodes supersensitive to the…

…In this position, the heart comes closer to the thoracic wall, with less lung tissue covering the heart. Some images in adult TTE are obtained…

…pulmonary vascular disease. This state is termed unclassified PH. Potential explanations include congenital heart disease, liver disease, airway or lung disease, and hyperthyroidism; follow up…

…episodes Iatrogenic events (e.g., during central venous catheter insertion) Underlying lung pathologies In cases of benign pneumothorax, positive pressure ventilation can precipitate a tension…

…to exercise, such as unstable angina, severe aortic stenosis, decompensated heart failure, or aortic aneurysm. Baseline ECG abnormalities rendering ST T interpretation difficult, including left…

…diseases and medications may cause sinus tachycardia; e.g congestive heart failure, lung disease (e.g COPD), fever, infections, anemia, myocardial ischemia/infarction, pulmonary embolism…

…glycoside first described by William Withering in 1775, is the oldest pharmacologic agent in the heart failure armamentarium. Its use has declined over time due…

Echocardiography Myocardial ischemia and infarction Definition and Pathophysiology Stress echocardiography is a functional cardiac imaging technique used primarily to identify inducible myocardial ischaemia and to…

…g skeleton, calcifications, mechanical heart valves) and reflect virtually all sound waves, leaving too few waves to explore the area behind the reflector. This results…

…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…

…study. Eur Heart J . 2023;45(36):3718 3726. doi:10.1093/eurheartj/ehad456. Stroke Risk Stratification: CHA₂DS₂ VA or CHA₂DS₂ VASc? Heart Lung Circ …

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

…is a clinical diagnosis supported by echocardiography: Finding Comment : : Hypotension, distended neck veins, muffled heart sounds Beck's triad; complete in a minority Tachycardia, tachypnoea…

…aspiration: a new pleural effusion of unclear cause. An effusion not confidently explained by heart failure must be aspirated. Suspected empyema or complicated parapneumonic effusion…

…of deep vein thrombosis 3 Pulmonary embolism is the most likely diagnosis 3 Heart rate 100/min 1.5 Immobilisation ≥ 3 days or surgery in…

…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…

…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…

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

…the heart rate, and the resulting QT interval is referred to as corrected QT interval, or simply QTc interval. The primary hazard lies in long…

…Yet, long term survival is slightly better among patients with HFPEF, as compared with patients with HFREF. Table 1. Types of heart failure. Type Description…

…Yet, long term survival is slightly better among patients with HFPEF, as compared with patients with HFREF. Table 1. Types of heart failure. Type Description…

…sinus rate. Its principal therapeutic distinction from beta blockers is that it lowers heart rate without directly reducing myocardial contractility or altering vascular tone. Accordingly…

…all beta blockers equivalent? Heart Rhythm, 14(1), e41–e44. Schwartz, P. J., Crotti, L., & Insolia, R. (2012). Long QT syndrome: From genetics to man

Echocardiography Pericardial diseases: effusion and tamponade A long series of conditions can affect the pericardium (pericardium). The most common of these are acute pericarditis (perimyocarditis…

Kardiologi Lathundar Three questions determine the management: is the patient unstable, how long has the fibrillation lasted, and does the patient need an anticoagulant? The…

Arrhythmias and arrhythmology Drugs and electrolyte imbalance ECG Definition and Pathophysiology Acquired long QT syndrome (LQTS) is characterised by an abnormal prolongation of the QT…

Echocardiography Cardiac tumors Cardiac tumors are rare. They can occur anywhere in the heart or surrounding tissue. Tumors can be localized in the myocardium, pericardium…

…R. (2017). Beta blocker therapy for long QT syndrome and catecholaminergic polymorphic ventricular tachycardia: Are all beta blockers equivalent? Heart Rhythm , 14(1), e41–e44…

Echocardiography Principles of flows and volumes in the heart If the flow in a cylinder is constant, then flow (Q) is the product of the…

…ESC EACVI Guidelines for Valvular Heart Disease (2018). Filsoufi F, Anyanwu AC, Salzberg SP, Frankel T, Cohn LH, Adams DH. Long term outcomes of tricuspid…

…can increase the sinus rate, there are generally no reliable and safe drugs available for long term heart rate augmentation without undesirable side effects. Drugs…

…an advanced version of the original SYNTAX Score, designed to improve the prediction of long term outcomes after revascularization. It incorporates both anatomical (from the…

…symptom control rather than modification of long term cardiovascular outcomes. With the important exception of beta blockers in selected patients after acute myocardial infarction (MI)…

…than a binary distinction between normotension and hypertension. Its long term relationship with cardiovascular risk is therefore graded, although practical clinical care requires diagnostic and…

…transient, self terminating AF during ST elevation myocardial infarction may indicate an increased long term risk of stroke. In patients with acute decompensated heart failure…

…particularly when angina or a previous myocardial infarction (MI) is absent. Heart failure (HF) symptoms may result from several overlapping processes: Recurrent or extensive MI…

…persistent, long standing persistent and permanent—and is not determined solely by the apparent frequency or duration of documented episodes. The central therapeutic objective is…

…Management Definition and Clinical Characteristics Torsades de pointes (TdP) represents a multifactorial clinical entity typically associated with drug induced long QT syndrome (DI LQTS) [1]…

…aortic and mitral valve). Rheumatic heart disease is rare in high income countries, presumably because streptococcal infections are treated very liberally. Figure 1 shows the…

…presentations, SHD provides the macroscopic architectural abnormalities necessary for arrhythmogenesis. Ischemic heart disease (IHD), particularly prior myocardial infarction (MI), is the most prevalent etiology. The…

…cardiomyopathy Takotsubo cardiomyopathy Tachycardia induced cardiomyopathy Non compaction cardiomyopathy Peripartum cardiomyopathy Cardiomyopathy secondary to valvular heart disease Long term prognosis varies markedly across these conditions…

…orient and display the heart using the long axis of the left ventricle and selected planes oriented at 90° angles relative to the long axis…

…Complete heart block (third degree AV block) and second degree AV block Mobitz type 2. Marked sinus bradycardia, sinus arrest, sick sinus syndrome with long…

…require careful consideration by a heart team. Predict Outcomes : The score has been validated to predict major adverse cardiac events (MACE) , including mortality, myocardial infarction…

…changes). Related topics ST segment and T wave changes Ischemic and nonischemic ST segment depressions Brugada syndrome Long QT syndrome Author Dr Araz Rawshani, MD…

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

Myocardial ischemia and infarction Definition and Pathophysiology Left main coronary artery disease (LMCAD) refers to atherosclerotic narrowing of the left main coronary artery, which supplies…

…heart rate. The length is shortened as heart rate increases and vice versa. Thus, long cycles (i.e. long RR intervals) are associated with long…

…Concurrently, the atrial myocardium undergoes structural remodeling driven by aging, hypertension, heart failure, and the arrhythmia itself. This remodeling manifests as interstitial fibrosis, atrial dilation…

…ST segment elevation myocardial infarction (Non STEMI, NSTEMI) in detail. Although myocardial ischemia may affect every aspect of the ECG – from heart rhythm to QTc…

…since it may affect the choice of device therapy and also suggest whether other interventions (e.g. heart failure management, evaluation for coronary artery disease…

…disease, both at the population and individual levels. Several prediction models have been developed and validated for the prediction of heart failure, coronary artery disease…

…may also develop tachycardia induced cardiomyopathy (Gopinnathair et al). Long term prognosis is excellent, with the vast majority of patients recovering completely after restoration of…

…heart failure , cardiomyopathy (dilated cardiomyopathy, hypertrophic obstructive cardiomyopathy), valvular disease . Less common causes are arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/ARVD), Brugada syndrome , long QT…

…analgesic; always give it in parallel unless contraindicated NSAID PO According to the preparation Avoid in renal failure, heart failure, a history of peptic ulcer…

…QTc interval Bazett's formula is several decades old and has been questioned because it performs poorly at low (<50) and high ( 100) heart rates…

…Its relationship with cardiovascular risk is nonlinear: even light smoking carries a substantial proportion of the excess ischaemic heart disease risk associated with heavy smoking…

…AV block, acute myocardial ischemia, old myocardial infarction, long QT, and bundle branch block. Cardiac monitoring is indicated for patients with a high pretest probability…

…compensates by increasing cardiac output (CO); this is achieved by increasing heart rate and producing larger stroke volumes. Failure to increase cardiac output sufficiently will…