…form under high shear conditions. Disruption of an atherosclerotic plaque or injury associated with PCI exposes thrombogenic material, promoting platelet activation, aggregation, and fibrin formation…

…luminal diameter A high degree of residual stenosis Long lesion length Diabetes Untreated edge dissection DES have reduced restenosis compared with BMS, and newer generation…

…than either drug alone. Long term efficacy data remain limited, and the possibility that chronic If channel blockade could increase sympathetic activity, with adverse remodelling…

…an emergency, where peripheral venous access often takes too long. Intraosseous access accepts all drugs, fluids and blood products that can be given intravenously , at…

…patients. Extension beyond 12 months DAPT beyond 12 months may be considered in patients who: Have tolerated DAPT without significant bleeding. Have high ischaemic risk…

…age, height and ethnicity — not against absolute figures. Since 2022 the z score with a lower limit of normal at z = −1.64 (the…

Procedurer Spirometry is the only investigation that distinguishes obstructive from restrictive impairment of lung function, and COPD cannot be diagnosed without it . The quality of…

…airway produces no reliable symptoms in a patient with an impaired cough reflex, and the first feed then becomes a direct instillation into the lung…

…liver disease, airway or lung disease, and hyperthyroidism; follow up and investigation of the cause of increased flow are appropriate. Exercise PH is defined by…

…e the frequency is reduced when studying distant objects). These concepts have been discussed in detail previously. The gain is regulated with TGC and gain…

…set against the chosen side. An ultrasound machine with a high frequency linear probe, a sterile probe cover and sterile gel. Chlorhexidine in alcohol 5…

…then 100 mg × 1 5–7 days Epiglottitis and other severe upper airway infection cefotaxime 1–2 g × 3 IV Depends on the diagnosis Always…

…lung, fat, and skin, with myocardial concentrations reaching 10 to 50 times those found in plasma. Plasma clearance is low, renal excretion is negligible, and…

…The pre test likelihood of obstructive CAD is moderate or high, generally greater than 15% and less than 85% Baseline ECG abnormalities make exercise ECG…

…seconds. Case reports have indicated that the risk of high degree AV block and ventricular arrhythmias is greater in patients on digoxin or verapamil, although…

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

…absence of sounds on the affected side. Ultrasonography can reveal pneumothorax (highlighted by a lack of lung tissue) and its impact on cardiac function. Clinically…

…free ventricular wall. Neoplasms (particularly breast and lung cancer). Inflammatory conditions, such as rheumatoid arthritis, systemic lupus erythematosus, scleroderma, and rheumatic fever. Aortic dissection rupturing…

…in atrial fibrillation (bradycardia–tachycardia syndrome) Individuals with sick sinus syndrome (sinus node dysfunction) are at high risk of developing atrial fibrillation, and vice versa…

…relaxing vascular smooth muscle. They are contraindicated in patients with bronchospastic lung disease, or a history of significant reactive airway disease. Contraindications also include second…

…to visualize clearly with trans thoracic echocardiography. Causes of right ventricular hypertrophy Lung disease (with increased pulmonary vascular resistance), congenital heart disease (transposition of the…

…tachycardia secondary to disease and medications : A wide range of diseases and medications may cause sinus tachycardia; e.g congestive heart failure, lung disease (e…

…of hypercapnia High flow nasal cannula 20–60 L/min 21–100 %, adjustable Humidified and warmed gas; it provides some positive airway pressure and washes…

…positive airway pressure further reduces the venous return. Procedure Choice of access The ultrasound, not tradition, determines the site. Scan subxiphoid, parasternally and apically, and…

…lung and the fluid level. 2. Choose a point with at least 15 mm depth of fluid throughout the respiratory cycle and where the lung…

…thrombolysis is the first line treatment in high risk embolism, unless there is an absolute contraindication. The agent and dose are according to the local…

…AF patients. Evidence suggests that the increased stroke risk in women is more closely associated with other comorbidities and age rather than sex alone. Consequently…

…a specific high affinity site on the extracytoplasmic face of the alpha subunit of the Na+ K+ ATPase. This binding is entropically driven and preferentially…

…upright and leaning forward. The frequency with which a rub is detected varies among clinical descriptions. It may be present intermittently during the illness and…

… however, it may recur and, in some instances, persist for extended durations. As for any long standing tachycardia, there is a risk of developing tachycardia…

Arrhythmias and arrhythmology ECG The QT interval, long QT syndrome (LQTS) & ventricular arrhythmias (torsade de pointes) due to prolonged QT interval The QT interval is…

ECG Please refer to the previous chapter: LQTS (Long QT Syndrome)

CPR Neurons are exceptionally vulnerable to hypoxia and anoxia ( Casas et al ). In cardiac arrest without chest compressions (i.e. if cerebral perfusion ceases), irreversible…

…Medical conditions Category Condition Congenital conditions Jervell and Lange Nielsen syndrome Romano Ward syndrome Idiopathic congenital long QT syndrome (LQTS) Metabolic disorders Hypokalemia Hypomagnesemia Hypocalcemia…

…M. R. (2017). Beta blocker therapy for long QT syndrome and catecholaminergic polymorphic ventricular tachycardia: Are all beta blockers equivalent? Heart Rhythm, 14(1), e41…

…The donation process begins long before any retrieval: it begins when someone in the intensive care unit identifies a possible donor and the deceased person…

Echocardiography Pericardial diseases: effusion and tamponade A long series of conditions can affect the pericardium (pericardium). The most common of these are acute pericarditis (perimyocarditis…

…M. R. (2017). Beta blocker therapy for long QT syndrome and catecholaminergic polymorphic ventricular tachycardia: Are all beta blockers equivalent? Heart Rhythm , 14(1), e41…

…the management: is the patient unstable, how long has the fibrillation lasted, and does the patient need an anticoagulant? The unstable patient Immediate electrical cardioversion…

…and dieting. Clinicians should maintain a high index of suspicion for drug induced arrhythmias in patients receiving agents known to alter the electrical properties of…

…likelihood of successful defibrillation is high in coarse VF (the early phase), but diminishes rapidly as the waveform becomes finer (Figures 2, 3 and 4)…

…Three questions come up again and again on call: which dose, how long to interrupt treatment before a procedure, and how to reverse in bleeding…

…for mobilisation and bladder training. Contraindications Type Condition : : Absolute Suspected urethral injury — blood at the meatus, a perineal or scrotal haematoma, a high riding or…

… preserve the benefit of coronary intervention while limiting major and clinically relevant bleeding. Long term antiplatelet therapy after STEMI is associated with approximately a 25…

Cardiology Definition and pathophysiology Blood pressure is a continuous cardiovascular exposure rather than a binary distinction between normotension and hypertension. Its long term relationship with…

…between dangerous and benign causes. Ask primarily how the symptoms began, whether they are continuous or episodic, how long an attack lasts, and whether anything…

…designed to improve the prediction of long term outcomes after revascularization. It incorporates both anatomical (from the original SYNTAX Score) and clinical variables (e.g…

…Long QT syndrome was identified several decades ago by Jervell et al . Brugada syndrome was identified in the early 1990s and early repolarization was identified…

…13,970 patients at high cardiovascular risk who were unable or unwilling to take statins. Approximately 70% were in secondary prevention and 30% in primary…

…inertia and contributes to inadequate long term control. The treatment objective is individualized blood pressure reduction sufficient to reduce cardiovascular risk while preserving tolerability and…

…persistent, long standing persistent and permanent—and is not determined solely by the apparent frequency or duration of documented episodes. The central therapeutic objective is…

…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…

…entity typically associated with drug induced long QT syndrome (DI LQTS) [1]. The condition arises in the setting of both modifiable and nonmodifiable risk factors…

…disease (atherosclerosis). The average age at diagnosis of aortic stenosis is 75 years in high income countries. In low and middle income countries, rheumatic heart…

…compressions. While ETCO 2 is optimally measured in tracheal tubes, it can also be gauged through supraglottic airway devices and Rubens' tubes. Following ROSC, ETCO…

…hemodynamic effects and possible impact on the coronary arteries. The tumors can be asymptomatic for a long time and be detected randomly when investigating other…

…systole. It is measured in parasternal long axis view (PLAX) using M mode. The end systolic and end diastolic left ventricular diameters are measured. The…

…rate (Table 1). Children and healthy adults may also develop tachycardia induced cardiomyopathy (Gopinnathair et al). Long term prognosis is excellent, with the vast majority…

…called parasternal long axis view. The ultrasound image contains several important parameters (Figure 4). The ECG signal is presented at the bottom and it is…

…process : : : : Low High Normal or high Respiratory acidosis Low Low Low Metabolic acidosis with respiratory compensation, or a mixed metabolic and respiratory acidosis if the…