…membrane potential and action potential duration of affected myocardial cells. The resulting voltage gradient between normal and ischaemic myocardium generates currents of injury that are…

Referensvärden Haemodynamic measurements become interpretable only when related to one another. A low blood pressure may be due to low flow, low vascular tone or…

…ECMO) initiation ( Soar et al ). ETCO 2 trends can vary during CPR depending on various factors such as the cause of cardiac arrest, compression efficacy…

…the diameter is greatest (usually halfway through systole). Zoom in LVOT to improve the accuracy of the measurement. Flow velocity in LVOT : Velocity is measured…

…confidence interval touched the null The current ERC and ESICM recommendation is continuous core temperature measurement and the active prevention of fever — defined as a…

…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…

…the ratio of pulmonary blood flow (Qp) to systemic blood flow (Qs). This measurement is pivotal in diagnosing and managing congenital or acquired cardiac shunts…

…functional cardiac abnormality or raised natriuretic peptides is not mandatory for HFmrEF when the diagnosis of heart failure is clinically secure and the LVEF measurement…

…should include: palpation of peripheral pulses; auscultation for carotid, femoral, and abdominal bruits; bilateral brachial blood pressure measurement; cardiac auscultation; inspection of the legs and…

…are elevated. The syndrome is therefore defined by symptoms and signs of congestion or impaired cardiac performance rather than by ejection fraction alone. Heart failure…

…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…

…offers greater precision in the calculation of ejection fraction, and 3D measurements will presumably replace 2D measurements in the future. Cardiac MRI (magnetic resonance imaging…

…Consequently, current guidelines recommend a 3 generation family history and consideration of genetic testing for all patients with non ischemic HFrEF. Toxic and infiltrative causes…

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…

…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…

…decreases and vice versa. The physiological purpose of this phenomenon is to allow for faster cardiac cycles during tachycardia (e.g during physical exertion). Therefore…

…since they compare electrical currents in two measurement points. The electrophysiological basis of the ECG leads The movement of charged particles generates an electric current…

…heart vector [3]. The orientation and intensity of this vector fluctuate throughout the cardiac cycle as depolarization and repolarization progress [3]. The mean electrical axis…

…that current troponin assays are extremely sensitive. These assays, referred to as high sensitive cardiac troponin, may actually detect the presence of troponins in most…

…This section discusses hemodynamic principles and how these can be leveraged to calculate stroke volume, cardiac output, pressure conditions, severity of stenoses and regurgitations, etc …

…tool for clinicians worldwide (Narula et al). This chapter discusses the principles of the standard echocardiographic examination. Currently, three dimensional (3D) echocardiography is the most…

…identification of focal severe stenoses. Coronary anomalies Coronary artery anomalies are uncommon among the general population but account for a substantial proportion of sudden cardiac…

…a suitable vein). Standby access in a patient at risk of rapid deterioration. Intraosseous access: Cardiac arrest where venous access is not immediately available. Shock…

…interpreted in isolation. The initial diagnosis and triage depend on integration of symptoms, vital signs, the ECG, and serial cardiac troponin measurements. Evaluation and physical…

…serial measurements demonstrate a rise and/or fall. A stable elevation indicates chronic myocardial injury . Myocardial injury is not synonymous with myocardial infarction. Cardiac troponin…

…and permits delineation of the coronary lumen. Coronary imaging is technically demanding because the vessels are small and are subject to both cardiac and respiratory…

…low output, or persistent severe symptoms require close monitoring and consideration of invasive haemodynamic assessment when precise measurements are needed to guide therapy. Diagnostics Electrocardiography…

…with sleep apnoea Hypertension with atrial fibrillation in the absence of an underlying structural cardiac explanation Early onset hypertension or cerebrovascular accident at a young…

…risk factors and relevant comorbidities Evidence of hypertension mediated organ damage Existing cardiac, cerebrovascular, or renal disease The possibility of a secondary cause The medical…

…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…

…orifice. There are many causes of mitral stenosis, the most common of which are rheumatic heart disease, congenital malformations, radiation complications, metastases, myxoma, cardiac thrombi…

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

…using pulsed Doppler. Estimating left ventricular filling pressure via e' . Measurement of deceleration time (DT) . Diastolic function can be estimated from E/A ratio, e'…

…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…

…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…

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

…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…

…dysfunction in the conduction system. The J point and the ST segment The ST segment corresponds to the plateau phase (phase 2) of the action

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

…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…

…continuous recording; automated or manual blood pressure measurement. Resuscitation trolley with defibrillator, oxygen, suction and emergency drugs in the room. Staff with current CPR competence;…

…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…

…Insert a urinary catheter and start hourly urine output measurement. 5. Give a bolus of sodium bicarbonate 1–2 mmol/kg intravenously in symptomatic salicylate…

…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…

…Indications Investigation of chronic cough, dyspnoea, wheeze or reduced exercise capacity. Suspected asthma or COPD — diagnosis and follow up. Risk groups: current or former smokers…

…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 …

…majority of all clinical trials, epidemiological studies and mechanistic studies have been carried out in HFREF (heart failure with reduced ejection fraction) . Thus, our current…

…majority of all clinical trials, epidemiological studies and mechanistic studies have been carried out in HFREF (heart failure with reduced ejection fraction) . Thus, our current…

…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…

…up and staging of lymphoma and myeloma. Suspected bone marrow metastasis. Assessment of treatment response and measurement of residual disease (MRD). Fever of unknown origin…

…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…

…reference to the intravenous antihypertensive drugs used in a hypertensive emergency. It summarises the mechanism of action, the onset, the duration of effect, the dosing…

…case add toe pressure measurement. Absolute: ABI < 0.5 or toe pressure < 30 mmHg. Decompensated heart failure — compression of both legs acutely increases…

…of breathing Accessory muscle use Cyanosis, exhaustion, hypotension or collapse The classification is based on a combination of clinical findings, oxygenation and objective measurement of…

…laboratory measurements, not by the values on admission alone. Diagnosis Current diagnostic criteria According to the international consensus report of 2024, the diagnosis of DKA…

…in haematological malignancy. Investigation of dementia with biomarkers (amyloid, tau, phospho tau). Measurement of the opening pressure in suspected idiopathic intracranial hypertension. Therapeutic drainage in…

…impairment or a large residual volume. A need for accurate measurement of urine output in a critically ill patient. Perioperatively and postoperatively in longer procedures…