…workload leads to increased oxygen demand but the stenosis limits the volume that can be delivered to the heart muscle supplied by the atherosclerotic artery…

…is associated with cardiac hypertrophy, myocardial fibrosis, diastolic dysfunction and heart failure. Compared with patients with primary hypertension matched for age, sex and blood pressure…

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…

…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…

…atrial fibrillation: the Swedish Atrial Fibrillation cohort study. Eur Heart J . 2012;33(12):1500 1510. doi:10.1093/eurheartj/ehr488. Champsi S, et al…

…adenosine antagonizes catecholamine stimulated adenylate cyclase. This inhibition decreases the accumulation of cyclic adenosine monophosphate (cAMP), which in turn reduces the L type calcium current…

…for up to 20% of sudden cardiac deaths in patients without structural heart disease and is the leading cause of SCD in men under the…

…a collection bag or suction, and a clamp. pH indicator paper with a scale that discriminates within the acidic range — ordinary litmus paper that only…

…ecstasy) or amphetamines. In either scenario, there is sustained muscle activation, leading to marked heat generation, acidosis, and the subsequent development of hyperkalemia. This condition…

…saw, protective sheeting Hot water gives faster setting and more heat production — a risk of burns Document the distal neurovascular status before casting : sensation, motor…

…of hypertension, type 2 diabetes, coronary disease, stroke, peripheral arterial disease, heart failure, depression, dementia and osteoporosis. It also improves functional capacity, skeletal health, muscular…

…fluids (crystalloids). Heated and moistened oxygen. Warm covers. Heat fan. Remove any cold or damp textiles. Administer cardiopulmonary resuscitation (CPR) following standard protocols, emphasizing concurrent…

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

…regarded as a series of completely discrete diseases. Heart failure extends across the full range of LVEF, and echocardiographic measurement is subject to meaningful variability…

…than by ejection fraction alone. Heart failure with preserved ejection fraction (HFpEF) is characterized by: Symptoms and/or signs of HF. A left ventricular ejection…

…Crucially, contemporary definitions distinguish HFpEF from "Heart Failure with improved EF" (HFimpEF). HFimpEF refers to patients with a historical baseline LVEF ≤40% that has subsequently…

Cardiology Definition and terminology Heart failure (HF) is a complex clinical syndrome characterized by symptoms and signs resulting from structural or functional impairment of ventricular…

…Waagstein, Hjalmarsson, and Swedberg proposed using beta blockers – which have negative inotropic and negative chronotropic effects – to treat heart failure, they were met with skepticism…

…Waagstein, Hjalmarsson, and Swedberg proposed using beta blockers – which have negative inotropic and negative chronotropic effects – to treat heart failure, they were met with skepticism…

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

…significant geographical variations. Roughly 25% of children with congenital heart disease require intervention during their first year of life ( Triedman et al ). According to the…

…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…

…reaching 4%. ECG in takotsubo cardiomyopathy (broken heart syndrome) 80% of patients have localized ST segment elevations (mostly in the chest leads). The morphology of…

Overview of diagnosis, classification and management of heart failure

…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…

ECG Introduction to ECG interpretation The electrical axis of the heart Although often ignored, assessment of the electrical axis is an integral part of ECG…

…I and II. Heart axis deviation: right axis deviation (RAD) and left axis deviation (LAD) Causes of right axis deviation Normal in newborns. Right ventricular…

…adequately increase heart rate Chronotropic incompetence is an independent predictor of overall and cardiovascular mortality. The condition is very common among individuals with heart failure…

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…

ECG Video lecture: Assessment of the electrical axis of the heart

…the physical activity. It is based on the subjective physical sensations experienced during exercise, including increased heart rate, increased respiratory rate and depth, increased sweating…

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

Referensvärden A child's ECG changes continuously with age: the heart rate, the electrical axis and the waveform in the newborn differ markedly from adult…

Info The ECG shows AV block III (complete heart block). P waves are not related to QRS. PP interval is constant, but independent of RR…

Echocardiography Endocarditis Endocarditis implies that a bacterial infection engages the heart valves and this is a serious condition. The focus of infection on the flap…

Echocardiography Right ventricular strain When assessing the right half of the heart, it is important to familiarize yourself with the principles of hemodynamics and conditions…

Arrhythmias and arrhythmology ECG Sinus rhythm: the normal rhythm of the heart A rhythm is defined as three consecutive heartbeats with identical waveforms on the…

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…

…Corrected QT Interval. QTc Calculator Heart Rate QT Interval (in msec) Calculate QTc Values $(document).ready(function() { $(" qtc form").on('submit', function(event…

…Drug Nitroprusside Brand names Nipride ®, Nipride RTU ®, Nitropress ®. Indications Pulmonary edema, congestive heart failure. Angina pectoris. Hypertension, hypertensive crisis/emergency. Pulmonary hypertension…

Myocardial ischemia and infarction ECG Posterior (posterolateral) acute myocardial infarction (STEMI) The heart is rotated 30° to the left in the thorax. This positions the…

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…

Echocardiography Pulmonary (pulmonic) stenosis Pulmonary stenosis is virtually always a consequence of congenital heart disease. The stenosis can be fixed or dynamic, depending on the…

CPR Each recording presents two leads recorded simultaneously. Sex : Female Age : 72 years History : heart failure Medications : digoxin, quinidine ECG 1 . The initial beats are…

…Definition and Pathophysiology Angiotensin converting enzyme inhibitors (ACE inhibitors) constitute a cornerstone in the management of cardiovascular disease, heart failure, and chronic kidney disease (CKD)…

Arrhythmias and arrhythmology Emergency medicine Pharmacology & dosing Definition and Pathophysiology Bradycardia encompasses a spectrum of rhythm disturbances characterized by an inappropriately slow heart rate. Within…

…medicine Procedurer Definition and Pathophysiology Cardiac tamponade is a life threatening clinical syndrome in which increased intrapericardial pressure compresses the heart and impairs ventricular filling…

…ECG blog Coronary artery disease: On LDL cholesterol, dietary fat & statins You are probably aware that ischemic heart disease, also known as coronary artery disease…

…The amplitude of the waveform recorded in any given lead correlates directly with the projection of the heart vector onto that specific lead vector [3]…

Drugs and electrolyte imbalance ECG Digoxin ECG changes: arrhythmias, conduction defects and waveform changes Digoxin may be used in patients with heart failure, atrial fibrillation…

…causes & management Definition of sinus bradycardia Sinus bradycardia fulfills the criteria for sinus rhythm but the heart rate is slower than 50 beats per minute…

Echocardiography Tricuspid valve stenosis Tricuspid stenosis is a rare condition that may be caused by rheumatic valvular disease, congenital heart disease, Whipple’s disease, or…

…sufficient explanation for all acute dyspnoea in a patient with COPD. Pneumonia, heart failure, pulmonary embolism, pneumothorax and acute coronary syndrome must be actively considered …

…are routinely missed. The third thing to know by heart is that an arterial line must never be confused with a venous access. Indications Continuous…

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

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

…and patients with advanced renal failure, marked heart failure or circulatory shock require a specific protocol and early specialist involvement. DKA and HHS are dynamic…

…symptoms, blood pressure response, heart rate response, arrhythmias and recovery. A patient who stops at a low workload with a fall in blood pressure is…