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

…normal accessory pathways. However, conduction may be blocked in unusual accessory pathways that possess long conduction times or decremental conduction properties. Furthermore, adenosine binds to…

…FVC Forced vital capacity FEV₁/FVC The ratio that defines obstruction PEF Peak expiratory flow — variability rather than the absolute value TLC Total lung capacity…

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…

…a patient with an impaired cough reflex, and the first feed then becomes a direct instillation into the lung. No tube may be used before…

…It may arise from pulmonary vascular disease, left sided cardiac disease, chronic lung disease or hypoxia, chronic thromboembolic obstruction, or a range of miscellaneous conditions…

…the heart comes closer to the thoracic wall, with less lung tissue covering the heart. Some images in adult TTE are obtained with the patient…

…departments — follow local protocol. Severe lung disease or a contralateral pneumothorax: avoid the subclavian and jugular routes on the healthy side, since a pneumothorax there…

…3 IV Pneumonia, in chronic lung disease amoxicillin 750 mg × 3 PO 5–7 days or benzylpenicillin 3 g × 4 IV Pneumonia, suspected atypical pathogen…

…major active metabolite. Both the parent drug and its metabolite accumulate extensively in various tissues, including the liver, lung, fat, and skin, with myocardial concentrations…

…flow velocity reserve (CFVR) Pulmonary congestion detected by B lines on lung ultrasound Myocardial perfusion when ultrasound contrast agents are used The technique is particularly…

…to moderate exacerbation of asthma symptoms. Adenosine should be used with caution in patients with obstructive lung disease or asthma. Irregular wide complex tachycardia (absolute…

…sound waves returning to the transducer are reflected back to the tissue. Reverberations are common when examining lung tissue; the double layered pleura produce reverberations…

…episodes Iatrogenic events (e.g., during central venous catheter insertion) Underlying lung pathologies In cases of benign pneumothorax, positive pressure ventilation can precipitate a tension…

…pericardiotomy syndrome. Acute transmural myocardial infarction. Rupture of the free ventricular wall. Neoplasms (particularly breast and lung cancer). Inflammatory conditions, such as rheumatoid arthritis, systemic…

…B Breathing Respiratory rate (12–20 / min) Chest wall movements Chest percussion Lung auscultation Pulse oximetry ( 95%) C Circulation Skin color Sweating Capillary refill time…

…to exercise, such as unstable angina, severe aortic stenosis, decompensated heart failure, or aortic aneurysm. Baseline ECG abnormalities rendering ST T interpretation difficult, including left…

…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…

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

…crisis. Contraindications There are no absolute contraindications in hypoxaemia. Take particular care in: A risk of hypercapnic respiratory failure — COPD, severe obesity with hypoventilation, neuromuscular…

…and where no liver, lung or vessel lies in the path of the needle. Access Puncture site Direction Comment : : : : Subxiphoid 1–2 cm below and…

…aspiration: a new pleural effusion of unclear cause. An effusion not confidently explained by heart failure must be aspirated. Suspected empyema or complicated parapneumonic effusion…

…in pregnancy and an alternative in cancer associated thrombosis. Warfarin in antiphospholipid syndrome and in marked renal failure. Duration of treatment: at least 3 months…

…CHA₂DS₂ VA Score The acronym CHA₂DS₂ VA represents the following parameters: C ongestive Heart Failure (1 point) H ypertension (1 point) A₂ ge ≥75 years…

…glycoside first described by William Withering in 1775, is the oldest pharmacologic agent in the heart failure armamentarium. Its use has declined over time due…

…In patients with pericarditis complicated by constriction, symptoms and signs of right sided heart failure may predominate. Pericardial effusions associated with post infarction pericarditis are…

…3. Atrial tachycardia. Causes of ectopic atrial tachycardia and ectopic atrial rhythm Side effect of digoxin. Heart failure. Lung disease (COPD, pulmonary hypertension, etc). Ischemic…

…long QT syndrome (LQTS) & ventricular arrhythmias (torsade de pointes) due to prolonged QT interval The QT interval is the time interval from the beginning of…

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

…drugs that may prolong the QT interval, and cause torsade de pointes (TdP) and long QT syndrome (LQTS) is presented below. With regards to drugs…

[calc_123lqts] Long QT Syndrome (LQTS) is an inherited cardiac channelopathy characterized by prolonged ventricular repolarization, which predisposes individuals to malignant ventricular arrhythmias, notably torsade…

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…

5 Year Risk of Life Threatening Ventricular Arrhythmias [calc_123lqts] Long QT Syndrome (LQTS) is an inherited cardiac channelopathy characterized by prolonged ventricular repolarization, which…

Kardiologi Lathundar Three questions determine the management: is the patient unstable, how long has the fibrillation lasted, and does the patient need an anticoagulant? The…

Arrhythmias and arrhythmology Drugs and electrolyte imbalance ECG Definition and Pathophysiology Acquired long QT syndrome (LQTS) is characterised by an abnormal prolongation of the QT…

…that drive coronary and cerebral perfusion, and ventilation of the lungs during cardiopulmonary resuscitation (CPR) differ substantially from normal circumstances. The purpose of CPR is…

…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…

…and dangerous in a few. The male urethra is about 25 cm long with two curves and a prostate that can grip; the female urethra…

Myocardial ischemia and infarction Pharmacology & dosing Definition and pathophysiological basis Secondary prevention after myocardial infarction (MI) encompasses long term interventions intended to reduce recurrent infarction…

…than a binary distinction between normotension and hypertension. Its long term relationship with cardiovascular risk is therefore graded, although practical clinical care requires diagnostic and…

…the symptoms began, whether they are continuous or episodic, how long an attack lasts, and whether anything actually triggers it [1,2]. The single most…

…an advanced version of the original SYNTAX Score, designed to improve the prediction of long term outcomes after revascularization. It incorporates both anatomical (from the…

…changes). Related topics ST segment and T wave changes Ischemic and nonischemic ST segment depressions Brugada syndrome Long QT syndrome Author Dr Araz Rawshani, MD…

…despite maximally tolerated therapy. It is a prodrug activated predominantly in the liver by very long chain acyl CoA synthetase 1. This activating enzyme is…

…It is frequently clinically silent, which promotes both patient and clinician inertia and contributes to inadequate long term control. The treatment objective is individualized blood…

…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…

…Management Definition and Clinical Characteristics Torsades de pointes (TdP) represents a multifactorial clinical entity typically associated with drug induced long QT syndrome (DI LQTS) [1]…

…ventricular dysfunction (heart failure) and arrhythmias. The annual risk of sudden cardiac arrest is <1% and median survival is 3 years. Long term prognosis in…

…a byproduct of aerobic metabolism, is transported from the tissues back to the lungs where it is exhaled. The final partial pressure of carbon dioxide…

…on the coronary arteries. The tumors can be asymptomatic for a long time and be detected randomly when investigating other conditions. More dramatic onset of…

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

…may also develop tachycardia induced cardiomyopathy (Gopinnathair et al). Long term prognosis is excellent, with the vast majority of patients recovering completely after restoration of…

…Two dimensional echocardiogram. This view is called parasternal long axis view (PLAX). Structures that are closest to the transducer are placed at the top of…

…same time despite a normal pH. The lungs compensate for a primary metabolic disturbance within minutes by changing ventilation. Renal compensation for a primary respiratory…

…effect or about suppression of the HPA axis, where a long half life produces more marked suppression. Stress dosing in known adrenal insufficiency A patient…

…coronary and renal perfusion, particularly in patients with long standing hypertension and a rightward shifted autoregulation [1,3]. The term hypertensive urgency is best avoided…

…few days. Principles Insulin component Function Who needs it : : : Basal insulin (intermediate or long acting) Covers fasting glucose production Everyone with type 1 diabetes, always…

…< 20 kPa (150 mmHg), and permissive hypercapnia as long as the pH stays above about 7.20. Different targets apply when the intracranial pressure…