…Pressures in the heart and pulmonary circulation Flow, resistance and oxygen transport Formulas Mean arterial pressure (MAP) = diastolic + (systolic − diastolic)/3 Cardiac output =…

…produce demonstrable ischaemia. Functional assessment with pressure or flow measurements, intravascular imaging, or fractional flow reserve derived from computed tomography can refine interpretation. Coronary plaque…

…causes of symptoms should be considered. When plaque is present but stenosis is minimal or mild, symptoms are also unlikely to be caused by flow…

…preservation of adequate right ventricular preload while supporting left ventricular performance and systemic circulation. Improvement in left ventricular function also lowers pulmonary arterial and pulmonary…

…hemodynamic parameter used to quantify the ratio of pulmonary blood flow (Qp) to systemic blood flow (Qs). This measurement is pivotal in diagnosing and managing…

…is clinically secure and the LVEF measurement is reliable. Nevertheless, these findings increase diagnostic confidence. The presence of symptoms alone is insufficient. Anaemia and pulmonary…

…level of consciousness and PEF improve at the same time. Acute severe asthma is characterised by bronchospasm, mucosal oedema and mucus plugging. Expiratory flow limitation…

…information. Coronary pressure measurements permit assessment of the physiological significance of selected stenoses using fractional flow reserve (FFR) and instantaneous wave free ratio (iFR). Other…

…employed to evaluate myocardial perfusion by measuring the intensity of their uptake within the myocardium. Furthermore, certain radiotracers enable direct measurement of coronary blood flow…

…1. Measurement of mitral inflow velocities. Mitral E wave velocity The E wave represents passive blood flow from the left atrium to the left ventricle…

…arteries are equally compromised, leading to uniform perfusion that may appear deceptively normal on SPECT. Detecting multivessel disease requires quantification of absolute coronary blood flow…

…response of the coronary circulation reflects both epicardial stenosis and the coronary microcirculation. Microvascular dysfunction may impair maximal vasodilation even when the epicardial arteries are…

…maximum arterial pulsatile pressure during systole. With auscultatory measurement, it corresponds to the appearance of the first Korotkoff sound. Diastolic blood pressure: the minimum arterial…

…whom non invasive measurement is unreliable: marked obesity, pronounced vasoconstriction, arrhythmia, intra aortic balloon pump. Assessment of stroke volume variation as part of fluid management…

…high Lp(a) level may lead to substantial underestimation of cardiovascular risk. Conversely, Lp(a) measurement provides limited additional reclassification beyond currently recommended global risk…

…dialysis catheter, not an ordinary triple lumen catheter). Measurement of central venous pressure and central venous oxygen saturation. Repeated blood sampling during intensive care. Exhausted…

…analyser. Blood gas equipment for arterial sampling. Urinary catheter with hourly urine output measurement — the treatment cannot be guided without reliable measurement of urine output…

…Prevention of recurrence after a healed venous ulcer. After deep vein thrombosis with post thrombotic syndrome. Differential diagnosis Feature Venous ulcer Arterial ulcer Diabetic foot…

…hypercholesterolaemia, and sedentary behaviour; family history, particularly in the broader assessment of peripheral arterial and aortic disease; planned surgery, especially carotid endarterectomy (CEA), coronary artery…

…care unit or another setting that allows frequent blood pressure measurement and continuous monitoring. An arterial line is often appropriate when very rapid or precise…

…measurement of beta hydroxybutyrate has high diagnostic accuracy [2]. A venous blood gas is generally sufficient for the assessment of pH and bicarbonate. An arterial…

…null The current ERC and ESICM recommendation is continuous core temperature measurement and the active prevention of fever — defined as a temperature above about 37…

…include consideration of treatable contributors, such as underlying comorbidities, supervised muscle strengthening physiotherapy, exercise, and coordination and balance training. Orthostatic Blood Pressure Measurement Before starting…

…the measurement after a few minutes' rest, if the patient's condition allows. 7. With titratable intravenous treatment and an unstable course, an arterial line…

…establish: The triglyceride concentration and whether the sample was fasting or non fasting. The presence of ASCVD, peripheral arterial disease or aortic disease. Secondary causes…

…disease (ASCVD). Atherosclerosis develops through the progressive deposition and retention of LDL C and other apoB containing lipoproteins within the arterial wall. This initiates inflammatory…

…with its most common waveforms. Important intervals and points of measurement are depicted. ECG interpretation requires knowledge of these waves and intervals. The P wave…

…e.g left ventricular diameter, are evaluated in several views in order to assess the reliability and reproducibility of the measurements. The parasternal and apical…

…atrial activity. The investigation is diagnostic, not therapeutic. An unstable patient should be cardioverted, not investigated. Contraindications Haemodynamic instability — hypotension, shock, impaired consciousness or pulmonary…

…to restart it after the procedure. Document the restart date in the medical record. Sources ESC Guidelines for the management of atrial fibrillation. Internetmedicin, DOACs…

…still and lowered at each measurement, and not to talk. Otherwise ordinary activities, including work. No showering or bathing. A diary of going to bed…

…diastolic reserve becomes evident, with a rise in left atrial and pulmonary pressures that contributes to exertional breathlessness and reduced exercise capacity. Multiorgan and comorbidity…

…12 lead ECG Initial hs cTn measurement Continuous cardiac monitoring The source material does not provide a detailed list of physical examination findings or a…

…adult patients with severe pulmonary stenosis, alongside right ventricular hypertrophy (RVH) and right atrial enlargement [8]. RAD is present in most cases of significant RVH…

…dilation. Atrial dilation causes a significantly increased risk of atrial fibrillation. The increase in left atrial pressure may also propagate backward to the pulmonary circulation…

…chronic coronary syndromes Chronic coronary syndromes (CCS) describe stable period clinical presentations arising from structural or functional abnormalities of the coronary arteries or coronary microcirculation…

…an adrenal incidentaloma Hypertension associated with sleep apnoea Hypertension with atrial fibrillation in the absence of an underlying structural cardiac explanation Early onset hypertension or…

…representative measurements, it is pivotal to align the M mode line such that it does not overestimate distances; e.g measuring the thickness of the…

…include: Ventilator or capnograph not activated. Displacement of the tracheal tube. Cardiac arrest without adequate blood flow or ineffective compressions. While ETCO 2 is optimally…

…with its most common waveforms. Important intervals and points of measurement are depicted. ECG interpretation requires knowledge of these waves and intervals. The P wave…

…Ejection fraction is routinely examined at rest, which does not reveal the functional (maximum) capacity of the left ventricle, as this would require measuring the…

…25% Normal FS, 2D measurement 18% Advantages of fractional shortening If ventricular geometry is normal and there are no regional wall motion abnormalities, then fractional…

…highly dependent on the precision of the Doppler measurement. The Doppler beam must be parallel to the direction of the blood flow (refer to The…

…measurement in evaluating aortic root morphology. Age stratified formulas help determine expected normal values based on body surface area (BSA), aiding in the diagnosis of…

…preferably confirmation by home measurement or 24 hour recording — the thresholds for which are lower than for office measurement. Classification of office blood pressure Category…

…Zoom in LVOT to improve the accuracy of the measurement. Flow velocity in LVOT : Velocity is measured in apical four chamber view (4C) or five…

Procedurer The value of the exercise test lies not in ST depression alone but in the overall picture : exercise capacity, symptoms, blood pressure response, heart…

…at the end of expiration, with the tape horizontal and without compressing the skin. Ratios and other measurements Measurement Calculation Threshold : : : Waist–hip ratio Waist…

…aphasia and radiological changes resembling ischaemic stroke. Glucose measurement is therefore always part of the initial stroke assessment [1]. Treat immediately when there are symptoms…

…of treatment effect and of disease progression. Assessment of pulmonary involvement in systemic disease, for example rheumatoid arthritis or scleroderma, and during treatment with pulmonary…

…How to measure the QT interval Measurement of the QT interval may be difficult due to T wave changes. Causes of prolonged QTc duration Antiarrhythmics …

…cardiovascular societies, defines HF as a clinical syndrome corroborated by elevated natriuretic peptide levels and/or objective evidence of pulmonary or systemic congestion [3] . Within…

…types of heart failure: HFPEF , HFmrEF and HFREF . This classification is based primarily on the measurement of left ventricular ejection fraction (LVEF). The majority of…

…types of heart failure: HFPEF , HFmrEF and HFREF . This classification is based primarily on the measurement of left ventricular ejection fraction (LVEF). The majority of…

…can be determined since the speed of ultrasound is constant in the body. The investigator specifies where the measurement should be performed by moving the…

…flow cytometry and genetics, while the biopsy shows marrow architecture and cellularity. What usually ruins the examination is not the technique but the handling of…

…features of acute coronary syndrome. The physical examination should include: Assessment of all major peripheral pulses. Blood pressure measurement in both arms. Cardiac auscultation. Pulmonary…

…contractile function) Several echocardiographic measurements are available to assess left ventricular systolic function. These methods elucidate slightly different aspects of systolic function and their combined…

Echocardiography Tissue Doppler (Tissue Velocity Imaging) Previous chapters on Doppler imaging have all focused on measurements of blood flow. However, the Doppler effect can also…

…Ca2+). These ions flow across cell membranes, enabling depolarization and repolarization, and between cells via gap junctions, facilitating the propagation of depolarization across the cells…