…Weak or absent May be palpable despite ischaemia ABI 0.9 < 0.9 Often falsely high Contraindications to compression The ankle brachial index measured…

…A pot of 4 % formalin, and for immunofluorescence Michel's medium or saline according to local procedure. Photograph and draw in the site before the…

…Figure 1. Orientation using the index marker. Image quality Various methods for optimizing image quality have been discussed earlier (refer to Optimization of the ultrasound…

…Coronary Flow Reserve (CFR) & Index of Microcirculatory Resistance (IMR) CFR: ratio of hyperemic to resting coronary flow/velocity (Doppler or thermodilution wire) — reflects combined epicardial…

…with oxymetazoline 0.5 % on pledgets. Mineral oil or lidocaine to kill an insect in the ear canal. A 30–60 mL syringe with a…

…BMI categories as follows: Underweight : Less than 18.5 Normal weight : 18.5 to 24.9 Overweight : 25 to 29.9 Obese : 30 and above…

…ultrasound travels through tissue that behaves as a lens which causes significant refraction, directing the ultrasound to an area interrogated simultaneously by other sound waves…

…waves are sent out in pulses. Each pulse consists of a few sound waves emitted in 1 to 2 milliseconds. These sound waves travel through…

…ultrasound lines to create a 90° wide and 15 cm deep image requires approximately 40 milliseconds (ms). Increasing the number of ultrasound lines or image…

…in millimetres, the time to diplopia on upward gaze, or the number of seconds the patient can hold the head lifted off the couch. Filming…

…required, in addition to the mealtime dose Never stop basal insulin in a person with type 1 diabetes , not even before fasting or an investigation…

…to look. Compression can be preceded by a dose of decongestant spray. This alone stops the majority of all anterior bleeds. Step 2 — cautery 1…

…NA sp ambiguous hypotension(Pediatric Use) mild BAL DIMERCAPROL Dimercaprol Mixed ar less tachycardia/blood pressure mild Trelstar TRIPTORELIN PAMOATE TRIPTORELIN PAMOATE Mixed wp most…

…or as a constant dose infusion. Bolus regime : • 20 mg IV bolus over 2 minutes, followed by 20 to 80 mg every 10 minutes to…

…Mechanism of action Beta 1 adrenergic blocker. Effects Lowers blood pressure, reduces heart rate, myocardial oxygen consumption and myocardial contractility. Less pronounced blood pressure lowering…

…syncope, or circulatory collapse. Slowly accumulating effusions may produce a large pericardial collection with initially limited symptoms because the pericardium has had time to adapt…

…beans, whole grains, nuts and seeds, yogurt, seafood and plant oils. They contain less refined grain, starch, added sugar, salt, trans fat, processed meat and…

…results. Patients with suspected ACS are categorized into a STEMI pathway or an NSTE ACS pathway according to the initial ECG and clinical presentation. For…

…inferior infarction. Extensive involvement is less common in patients with inferoposterior left ventricular infarction, while infarction confined predominantly to the right ventricle is rare. The…

…the shockable rhythm by several minutes, allowing for EMS or bystanders to connect a defibrillator or AED and defibrillate. Watanabe et al studied 132 patients…

…commonly attributable to abnormal automaticity or re entry mechanisms; triggered activity is a less frequent cause. The atrial rate typically ranges from 120 to 250…

…Less than three consecutive beats are referred to as junctional beats (also called junctional escape beats). Three or more consecutive junctional beats are referred to…

…but, depending on the etiology, may be more or less echogenic. It is important to estimate the volume, echogenicity and location of the effusion. Regarding…

…embolize to the pulmonary artery or its branches. In the majority of cases, the thrombus is formed in the deep veins of the legs or…

…or convex ST segment strongly suggest acute transmural ischemia ( Figure 1 A ). Concave ST segment elevations, on the other hand, are much less likely to…

…is used thereafter Two to three measurements one minute apart, taking the mean of the last two Orthostatic testing after 1 and 3 minutes of…

…moisture better, more expensive and stiffer to mould Elastic bandage Holds the slab in place; wound on without tension Tepid water, plastic gloves, plaster scissors…

…in septic shock or in certain or highly likely sepsis 0 to 60 min Noradrenaline if the MAP remains below 65 mmHg or the hypotension…

…is less specific than fresh haematemesis and can also be seen when the bleeding is slow or has stopped. The first steps Step Content : : 1…

…AAA may also be associated with mesenteric ischemia or acute renal failure, either through atherosclerotic or atherothrombotic disease. Mural thrombus may predispose to peripheral embolization…

…attributed to rupture of the vasa vasorum, although improved imaging demonstrates small intimal disruptions in approximately 20%–60% of cases. These disruptions may initiate or…

…limb salvage. Evaluation and physical examination ALI requires immediate clinical assessment by a vascular specialist or urgent transfer to a facility with vascular expertise. The…

…hypotension or ventricular ectopy is generally asymptomatic and hemodynamically stable. However, when the sinus rate is extremely low—such as less than 40 to 50…

…progressive increases in systolic blood pressure (SBP), while diastolic blood pressure (DBP) rises less steeply and may remain stable or decline later in life. Consequently…

…important therapeutic objectives. Evidence from randomized trials is often less applicable to very frail or multimorbid patients because these groups have historically been underrepresented. Consequently…

…directed therapies. Anti inflammatory treatment seeks to reduce this residual risk without necessarily altering lipid concentrations, blood pressure or other conventional risk factors. Colchicine is…

…atherosclerotic burden rather than as a direct measure of luminal obstruction. Calcified plaque is generally less likely to rupture than non calcified, lipid rich plaque…

…syndrome Exercise ECG may be used in selected patients with suspected chronic coronary syndrome when the result is expected to influence diagnostic strategy or management…

…first decade, rises progressively through adulthood and becomes less steep in later life, although diagnoses may still occur after the age of 65 years. Overall…

…LDL cholesterol, partly by reducing LDL receptor availability. Tacrolimus appears to have less adverse effect on lipids. Sirolimus may cause particularly prominent triglyceride elevation, including…

…intimal flap. Propagation may be antegrade or, less commonly, retrograde. Distal re entry tears may allow blood to return to the true lumen, whereas disruption…

…with apolipoprotein(a) structure and kringle IV repeat number. Assays show substantial variability, partly because apolipoprotein(a) isoform size can lead to underestimation or ov

…from adding PCSK9 inhibition to statin therapy when LDL C is ≥1.8 mmol/L. In peripheral arterial disease, addition to statins further reduces major…

…device resetting, inhibition of pacing, inappropriate ICD therapy, or, less commonly, device damage. Oversensing is more likely with unipolar leads. Electrocautery is the most frequent…

…Bilateral adrenal hyperplasia Primary or unilateral adrenal hyperplasia Rare aldosterone producing adrenal carcinoma Less commonly, ectopic aldosterone production Familial forms include familial hyperaldosteronism type 1…

…a QTc value is borderline or abnormal and the heart rate is less than 50 beats/min? A: Proceed directly to an exercise ECG test…

…usually involves the central chest or epigastrium, may radiate to the arms, and less often to the abdomen, back, lower jaw, neck, or occipital region…

…elevation or an equivalent electrocardiographic pattern in a patient with symptoms of myocardial ischaemia. The immediate therapeutic objective is restoration of coronary blood flow to…

…wave. Because of the long duration of the plateau phase most contractile cells are in this phase at the same time (more or less). Moreover…

…more prolonged, or provoked by less exertion. Angina occurring after a recent myocardial infarction. UA belongs to the broader spectrum of acute coronary syndromes, which…

…isoproterenol, or transcutaneous pacing for post shock bradycardia, and use of biphasic defibrillators , which are standard due to superior efficacy over monophasic devices. Electrode position…

…to dilate. Approximately 50% of cases exhibit biventricular cardiomyopathy, although the disease is less pronounced in the left ventricle. Rarely the condition is confined to…

…antiarrhythmic drugs, or electromagnetic disturbance caused by other machines/devices. Below follows ECG tracings demonstrating each type of failure. Figure 1. Failure to pace. Figure…

…cTnT are specific to cardiac muscle cells. Cardiac troponin levels are extremely low in healthy subjects; the 99 th percentile is less than a few…

…maximally. Only two variables are needed to determine whether chronotropic incompetence exists, namely age and heart rate. The following equation is used: Figure 1. Maximum…

…Pointed T waves are tall and narrow at the top. Refer to Figure 1 . Patients with left ventricular hypertrophy may instead display normalization of secondary…

…atrioventricular node. The PR segment serves as the baseline (also referred to as the reference line or isoelectric line ) of the ECG curve. The amplitude…

…patients in the milrinone group and 54% in the dobutamine group, with a relative risk of 0.90 (95% CI: 0.69 to 1.19…

…fibrous cap measuring less than 65 micrometers in thickness. Macrophage derived matrix metalloproteinases (MMPs) degrade the interstitial collagen of the cap, leading to structural failure…

…to 16 years of age, and greater than 80 ms in children less than 8 years of age without meeting the criteria for RBBB or…