…pressure and thereby increases ventilation and lowers the carbon dioxide. Pulmonary oedema calls for the former, a COPD exacerbation with carbon dioxide retention for the…

…patient with COPD. Pneumonia, heart failure, pulmonary embolism, pneumothorax and acute coronary syndrome must be actively considered [1]. Do the following early: 1. Assess airway…

…The shunt fraction (Qp/Qs) is a critical hemodynamic parameter used to quantify the ratio of pulmonary blood flow (Qp) to systemic blood flow (Qs)…

…Myocardial ischemia and infarction Definition and Clinical Role Coronary computed tomographic angiography (CCTA) is a non invasive anatomical examination that depicts the coronary arterial lumen…

…patients with a high to very high risk of CAD, invasive coronary angiography is the first line option. Coronary computerized tomography angiography (CCTA) is currently…

…target Doses in venous thromboembolism Treatment doses in deep vein thrombosis and pulmonary embolism differ from the atrial fibrillation doses and include an initial high…

…severe right sided failure and cardiogenic shock. The haemodynamic disturbance results from impaired right ventricular contraction and reduced forward flow through the pulmonary circulation. Consequently…

…Heart failure, pulmonary oedema and other conditions with a high risk of fluid overload — a relative contraindication requiring invasive monitoring and slower administration. Significant metabolic…

…with HFpEF, acute hypertension is a frequent trigger of decompensation and may produce abrupt pulmonary oedema, sometimes requiring non invasive ventilation or intubation. Aortic disease…

…PH is defined invasively by a mean pulmonary arterial pressure (mPAP) greater than 20 mmHg. The haemodynamic phenotype is then determined using pulmonary arterial wedge…

…increases cardiac output, and lowers pulmonary artery pressure without increasing myocardial oxygen consumption. The inotropic effect of levosimendan is not affected by the concurrent use…

…LV) filling pressures, defined invasively as a pulmonary capillary wedge pressure (PCWP) ≥15 mmHg at rest or ≥25 mmHg during exercise [4] . This hemodynamic criterion…

Myocardial ischemia and infarction Procedurer Definition and Clinical Role Invasive coronary angiography (ICA) is a catheter based investigation that visualizes the coronary arterial tree after…

…revascularization outweigh its potential benefit. A routine invasive strategy does not reduce all cause mortality across the overall NSTE ACS population, but it reduces composite…

…patients with a high probability, testing may add little diagnostic value and invasive coronary angiography may be more appropriate when symptoms, risk or anatomical considerations…

Myocardial ischemia and infarction Procedurer Definition and scope Coronary angiography is an invasive fluoroscopic procedure in which contrast media are injected selectively into the epicardial…

Cardiology Myocardial ischemia and infarction Definition and pathophysiology Fractional flow reserve (FFR) is an invasive, lesion specific physiological index used to estimate the functional significance…

Cardiology Principles of myocardial perfusion imaging Myocardial perfusion imaging (MPI) is a non invasive technique for detecting and quantifying coronary artery disease (CAD). It offers…

…Myocardial ischemia and infarction Definition and Pathophysiology Coronary artery calcium (CAC) scoring is a non invasive method for detecting and quantifying calcified coronary atherosclerotic plaque…

…diagnosis depends on functional assessment. Coronary microvascular dysfunction (CMD) is characterized invasively by reduced CFR and increased microvascular resistance, measured by the index of microcirculatory…

…a substantial minority of intermediate lesions. Over the past three decades, invasive physiological indices, led by fractional flow reserve (FFR), have been validated against outcomes…

…metabolic derangement. Major surgery with expected blood loss or large volume shifts. Patients in whom non invasive measurement is unreliable: marked obesity, pronounced vasoconstriction, arrhythmia…

…reflexes, vomiting with a risk of aspiration. Inadequate oxygenation despite maximal oxygen or non invasive ventilation. Inadequate ventilation with a rising pCO₂ and respiratory acidosis…

…calculation relies on readily available clinical parameters, eliminating the need for more invasive and costly direct measurements of GFR. Limitations of MDRD eGFR Accuracy at…

…10–21 mmHg). Tonometry is contraindicated with suspected perforation or infection. Removal Proceed from the least to the most invasive technique. 1. Irrigate with sterile…

…non invasive blood pressure methods. Limitations in measuring and interpreting MAP Despite its clinical utility, there are limitations in measuring and interpreting MAP. Non invasive…

…study, PET, SPECT, genetic profiling — add information but are too costly or invasive to screen a population. The surface ECG is the obvious cheap, standardized…

…has not been shown to reduce stroke risk, and detection may lead to inappropriate anxiety and invasive procedures. Symptomatic disease Symptoms of carotid disease include…

…treatment. The presence of ST segment changes or a positive troponin assay identifies patients in whom an invasive strategy is generally preferred over selective angiography…

…Iatrogenic lesions commonly follow cardiac surgery, coronary angiography or other invasive procedures, and affected patients may be relatively painless compared with those with spontaneous dissection…

…physical signs for LMCAD. Diagnostic Assessment Coronary angiography Invasive coronary angiography defines: The presence and severity of left main stenosis Ostial, shaft or distal bifurcation…

…likelihood that symptoms are attributable to the CTO is increased when non invasive testing demonstrates significant inducible ischaemia and preserved viability in the myocardial territory…

…or attempted chronic total occlusion recanalization. Patient preferences concerning additional medication, invasive investigation, and device based treatment. Refractory angina should be distinguished from symptoms caused…

…oxygenation (ECMO). In the absence of ECMO, both non invasive and invasive rewarming techniques should be pursued. Heated intravenous fluids (crystalloids). Heated and moistened oxygen…

…ischemic ST T changes. This is acknowledged in the latest recommendation issued by the International Society for Holter and Non Invasive Electrocardiology , where it is…

…including apparently healthy individuals. Exercise stress testing in the age of non invasive cardiovascular imaging Advances in computerized tomography (CT), cardiac magnetic resonance imaging (cMRI…

…activity. This is partly due to the rise of cardiac imaging and invasive electrophysiological methods which allow for detailed in vivo studies of arrhythmias. However…

…the remaining ones are malignant. • Secondary cardiac tumours have spread to the heart by metastasis or invasion from surrounding tissue. Differential Diagnostics There are several…