…patients with coronary heart disease, left ventricular function is actually a stronger predictor of death than the atherosclerotic burden. Assessment of the size, mass, geometry…

…fluid or blood products. Contrast medium for CT (this requires a large bore cannula in a suitable vein). Standby access in a patient at risk…

…Myocardial ischemia and infarction Pathological Q waves are evidence of myocardial infarction Myocardial infarction – particularly if extensive in size – typically manifests with pathological Q waves…

…colour Doppler small,, < 10 mm length, narrow origin variable large, wide origin Ratio pulmonic to aortic flow normal variable significantly increased References 1. Zoghbi…

…perivalvular (adjacent to the valves), etc. Cardiac tumors cause nonspecific symptoms that depend on the size of the tumor, localization, hemodynamic effects and possible impact…

…acute coronary syndromes. The LMCA supplies a large myocardial territory through the left anterior descending (LAD) and left circumflex (LCx) arteries (Figure 1). Acute obstruction…

…defects are categorized by their size, encompassing: Small defects : <10% of the left ventricular myocardium. Medium defects : 10–20% of the myocardium. Large defects : 20…

…example during mechanical ventilation or severe metabolic derangement. Major surgery with expected blood loss or large volume shifts. Patients in whom non invasive measurement is…

…Intramuscular — ventrogluteal The first choice for larger volumes and depot preparations; safer than the dorsogluteal site because the sciatic nerve and the superior gluteal artery…

Procedurer Almost all the complications of pleural aspiration arise from two errors: the needle is placed in the wrong site, and too much is drained…

…Indications Acute urinary retention. Chronic urinary retention with renal impairment or a large residual volume. A need for accurate measurement of urine output in a…

…based on the HCM Risk SCD formula , a validated risk prediction model developed I relatively large patient cohorts. It incorporates key clinical and echocardiographic parameters…

…especially affected. The principal determinant of adverse outcome is aneurysm size. Larger aneurysms and more rapid expansion are associated with increasing likelihood of symptoms, complications…

…tamponade with a relatively small volume, whereas a slowly enlarging effusion may reach a much larger size before producing haemodynamic compromise. As intrapericardial pressure rises…

…area small variable large if central, variable if excentric Coaptation defect mild moderate severe CW profile aortic regurgitation weak variable dense Size left atrium normal…

…Tono Pen). Procedure Systematic examination 1. Visual acuity in each eye separately , with the patient's usual glasses and then through a pinhole. This is…

…limit is not the clock but the degree of contamination, the depth and site of the wound, and how well the wound can be cleaned …

…area small variable large if central, variable if excentric Coaptation defect mild moderate severe CW profile aortic regurgitation weak variable dense Size left atrium normal…

…LDL C goals. Apolipoprotein B ApoB is the principal structural apolipoprotein of atherogenic lipoproteins. Each atherogenic lipoprotein particle carries one apoB molecule. Consequently, the plasma…

…allowing assessment several millimetres beyond the lumen and visualization of the external elastic membrane (EEM). IVUS is consequently useful for determining vessel size, plaque burden…

…may form at a site that was previously only mildly or moderately stenosed. Plaque rupture Plaques prone to rupture characteristically contain a large lipid pool…

…left ventricular volume Ejection fraction is also affected by left ventricular volume (size). For example, athletes have large ventricular dimensions and often lower ejection fraction…

…large bore peripheral cannula bridges the gap until conditions are controlled. Contraindications In life threatening conditions all contraindications are relative — but they govern which site…

…and mortality, as well as limb complications. Atherosclerotic lesions generally affect large and medium sized arteries. Pathological features include plaque formation with calcium deposition, medial…

…red marrow is abundant, and the distance to vessels and abdominal organs is large. The sternum may be used for aspiration when the iliac crest…

…straightforward: ultrasound to find the fluid, an insertion site in the left lower quadrant lateral to the rectus sheath, and a cell count plus albumin…

…and thrombosis interact to produce focal arterial lesions. Although epicardial coronary arteries are a major site of disease, atherosclerosis is systemic and may affect multiple…

…coronary intervention (PCI). Complications are uncommon, but their clinical spectrum ranges from transient arrhythmias and minor access site bleeding to myocardial infarction, stroke, coronary perforation…

…the true lumen Occlusion of a major epicardial artery or bypass graft Side branch occlusion or thrombus Disruption of collateral flow Distal embolization Stent thrombosis…

…to the opposite side Distended jugular veins Management Decompression using a venous cannula Can be executed in a pre hospital setting. A large venous cannula…

…right side can compromise venous return to the right ventricle. Therefore, in the presence of a tamponade, chest compressions have limited efficacy. Furthermore, administering large…

…artery. Depending on the size and form of the thrombus, it will occlude the main pulmonary artery or its branches. The larger the thrombus, the…

…of the aortic bulb. The LMCA is short and branches into the two arteries supplying the anterior and left side of the heart, as follows:…

…osteoarthritis related joint disease. Contraindications Infection of the skin or soft tissues over the puncture site — use another approach or refrain. Bacteraemia without suspicion of…

…the only absolute indication, and always urgent. A large pericardial effusion with symptoms despite medical treatment. Diagnostic drainage in suspected purulent pericarditis, tuberculosis or malignancy…

…calcium channel blocker exposure. The incidence of cardiogenic shock complicating STEMI has fallen with prompt reperfusion and reduction of infarct size. Earlier estimates approached 20…

…R''). Any negative wave occurring after a positive wave is an S wave. Large waves are referred to by their capital letters (Q, R, S…

…relieve pressure on the major vessels. A large uterus exerts pressure on the descending aorta and vena cava inferior . The pressure in the vena cava…

…neighboring particles in the medium. Mathematically, sound waves can be described by a sine curve . This curve is characterized by the following variables: wavelength , amplitude …

…dysfunction implies that the cells of the sinoatrial node are defective and fail to generate electrical impulses. Side effects of drugs (notably beta blockers, digitalis…

…A large side to side difference may suggest aortic dissection CT of the brain Exclude intracerebral haemorrhage and assess early ischaemic changes CT angiography The…

…with leg supports, and good, directable lighting. Specula in several sizes (small, medium, large; a long one for a high BMI), preferably warmed. Water based…

…inflate and are chosen on weight alone. When in doubt between two sizes in an adult: choose the larger , since a mask that is too…

…distances between the ribs increase, providing larger windows for the ultrasound beam. The operator can sit on either side of the patient, depending on preferences…

…sector is created using sequential activation of the piezoelectric crystals. The crystals are activated from one side to the other, as illustrated in Figure 2…

…See the separate guide to joint aspiration and injection. Indications Condition Injection site Comment : : : Subacromial bursitis, rotator cuff syndrome The subacromial space The best documented…

…yields a positive P wave in lead II ( Figure 2 , right hand side). The P wave is always positive in lead II during sinus rhythm…

…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…

…right ventricle (i.e parts on the atrial side of the tricuspid annulus) function as atrium and becomes dilated. The anterior leaflet is usually larger…

…times between dense structures ( i.e structures with high echogenicity). For each reflection, a portion of the sound waves return to the transducer and produce…

CPR Data sources for monitoring cardiac arrest and resuscitation There are currently several large registries monitoring resuscitation practices. Some data sources also monitor sudden cardiac…

…about increased QRS amplitudes. This is because large chambers may be positioned closer to the electrodes (chest leads) which therefore observe stronger electrical potentials. However…

…10 mm. At 50 mm/s a small square (1 mm) corresponds to 20 ms and a large square (5 mm) to 100 ms. Intervals…

…colour Doppler small,, < 10 mm length, narrow origin variable large, wide origin Ratio pulmonic to aortic flow normal variable significantly increased References 1. Zoghbi…

…anterior descending and left circumflex coronary territories. Because these vessels perfuse a large proportion of the left ventricular myocardium, left main disease carries a substantial…

…RVH). The electrical vector of the left ventricle is enhanced in LVH, which results in large R waves in left sided leads (V5, V6, aVL…

CPR Each recording presents two leads recorded simultaneously. Sex : Male Age : 43 years History : None Medications : None ECG 1 . Sinus rhythm interrupted by rapid ventricular…

…cardiopulmonary resuscitation (CPR) differ substantially from normal circumstances. The purpose of CPR is to create large variations in intrathoracic pressure by compressing, decompressing and ventilating…

…lymphoedema or a dialysis fistula in both arms, an arm circumference too large for the available cuffs, and in a patient who does not tolerate…