…heart disease or reduced left ventricular ejection fraction (LVEF). Sustained VT: Defined as VT lasting longer than 30 seconds or requiring termination earlier due to…

…ischaemic symptoms despite the exhaustion of conventional therapeutic options. It is defined by symptoms lasting more than 3 months and attributable to established reversible myocardial…

…affects 2% of the population and leads to gradual prolapse of the valve leaflets (Figure 1). Rheumatic heart disease is the leading cause of mitral…

…during airway management , and both are predictable. Indications Inability to protect the airway: reduced level of consciousness, loss of pharyngeal reflexes, vomiting with a risk…

…of diastole, but it becomes incomplete because the ventricles cannot expand normally. This leads to diastolic heart failure. The systolic function is usually unaffected, but…

…Due to a genetic mutation in the RYR1 receptor, resulting in persistent muscle contraction upon administration of halogenated anesthetic agents. As an idiosyncratic response to…

…the symptoms that should make them seek help immediately. Indications An undisplaced or reduced fracture to be treated conservatively. Immobilisation after reduction of a dislocation…

…cardiovascular disease, an exercise test may provide objective information on peak exercise capacity and the heart rate, blood pressure and symptom responses to exertion. These…

…with prolonged periods of no blood flow, due to the reduced metabolic rate that accompanies declining body temperature. For every 1°C reduction in body temperature…

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

…relaxation and filling. Hypertension and diabetes can contribute to the development of heart failure in the preserved and mildly reduced EF ranges, and obesity is…

…Definition and classification Heart failure (HF) is a clinical syndrome in which the heart cannot deliver blood at a rate appropriate to tissue requirements unless…

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

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

…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…

…and progressive neurohormonal activation. The therapeutic rationale for disease modifying treatment is to reduce mortality, prevent recurrent hospitalization for worsening heart failure, and improve symptoms…

…25% of children with congenital heart disease require intervention during their first year of life ( Triedman et al ). According to the European Society for Cardiology…

…lowers heart rate without directly reducing myocardial contractility or altering vascular tone. Accordingly, the source material describes no haemodynamic or contractility effects attributable to ivabradine…

…induced cardiomyopathy) Takotsubo cardiomyopathy (broken heart syndrome) is a rather peculiar and certainly acute condition. Much research has been devoted to it in recent years…

Overview of diagnosis, classification and management of heart failure

…However, diuretic treatment has not been shown formally to reduce heart failure mortality; its established role is symptom relief and prevention of recurrent congestion and…

…extreme axis deviation Extreme axis deviation is rare. It is most likely due to misplaced limb electrodes. If the rhythm is tachycardia with wide QRS…

…been excluded. Causes of extreme axis deviation Rare. Most likely due to misplaced limb electrodes. If the rhythm is tachycardia with wide QRS complexes, then…

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

…the heart muscle supplied by the atherosclerotic artery. Whenever oxygen demand exceeds oxygen (blood) delivery ischemia occurs and this manifests with chest discomfort referred to…

…patients with unknown etiology for acute severe heart failure. A recent echocardiographic examination should be available or performed urgently to evaluate ventricular and valvular function…

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

…does lead to tachypnea (increased respiratory rate), which should, however, be distinguished from dyspnea which is shortness of breath. Dyspnea may be due to poor…

…If oral anticoagulation is indicated, NOACs should be chosen except in patients with moderate to severe mitral stenosis or mechanical heart valves; for these patients…

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…

…Infections are difficult to heal because the heart valves are not vascularized and therefore it is difficult for the immune system to reach the bacteria…

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

…large boxes between two R waves: 600/10 = 60 beats/min. Refer to Figure 3 for clarification. Figure 3. Manual calculation of heart rate.

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…

…refer to the chapter QT Duration and Corrected QT Interval. QTc Calculator Heart Rate QT Interval (in msec) Calculate QTc Values $(document).ready(function…

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

…centre with advanced heart failure care capabilities, including mechanical circulatory support and transplantation, is warranted. Diagnostics Hemodynamic and functional monitoring is central to the safe…

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…

…rare. They can occur anywhere in the heart or surrounding tissue. Tumors can be localized in the myocardium, pericardium, perivalvular (adjacent to the valves), etc…

…Carcinoid heart disease : Carcinoid syndrome is a paraneoplastic syndrome that occurs due to carcinomas secreting kallikrein and serotonin. In the heart, this can lead to…

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…

…is greatest in patients with the most severe heart failure. In stable patients, it is advisable to add therapy with beta blocking agents before full…

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…

…with initially limited symptoms because the pericardium has had time to adapt. Hypotension and muffled heart sounds are important when present but are relatively insensitive…

…That study spread like a virus through social media and it is likely that it may have resulted in increased mortality due to stopping statins…

…with the projection of the heart vector onto that specific lead vector [3]. When the direction of cardiac activation is parallel to the lead axis…

…be used in patients with heart failure, atrial fibrillation, atrial flutter, and in selected cases of paroxysmal supraventricular tachycardia. Due to its profound pro arrhythmic…

…rest due to high vagal tone. These individuals have developed a highly efficient left ventricle, capable of generating sufficient cardiac output at low heart rates…

…or mechanical prostheses. The former is preferred due to the lower risk of thrombosis and evidence demonstrating long term durability (Filsoufi et al). Percutaneous interventions…

…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…

…may be due to low flow, low vascular tone or both, and the appropriate action differs fundamentally between these cases. Pressures in the heart and…

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

…Decompensated heart failure. Acute pulmonary embolism or deep vein thrombosis. Acute myocarditis, pericarditis or endocarditis. Acute aortic dissection. Physical inability to perform the test safely…

…without being found. Indications A traumatic wound that gapes and cannot be expected to heal with good function or cosmesis without apposition. A wound that…