…pulses. Blood pressure measurement in both arms. Cardiac auscultation. Pulmonary auscultation. Evaluation for heart failure. Assessment for circulatory compromise, haemodynamic instability, or electrical instability. Posterior…

…may be due to low flow, low vascular tone or both, and the appropriate action differs fundamentally between these cases. Pressures in the heart and…

…for a flat ETCO2 curve include: Ventilator or capnograph not activated. Displacement of the tracheal tube. Cardiac arrest without adequate blood flow or ineffective compressions…

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

…contractility of hypothermia are not tolerated. A decision to withhold further life sustaining treatment. Preparation and equipment Continuous core temperature measurement. An oesophageal probe or…

…plasmapheresis or other extracorporeal therapy (requires a large bore dialysis catheter, not an ordinary triple lumen catheter). Measurement of central venous pressure and central venous…

…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…

…before non cardiac surgery should be questioned specifically about neurological symptoms during the preceding 6 months. Those with symptoms suggestive of TIA or stroke require…

…of congestion or impaired cardiac performance rather than by ejection fraction alone. Heart failure with preserved ejection fraction (HFpEF) is characterized by: Symptoms and/or…

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

…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…

…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…

…apex of the heart is fixed to the diaphragm via pericardium and connective tissue. Therefore the apex does not move much during the cardiac cycle…

…loss or large volume shifts. Patients in whom non invasive measurement is unreliable: marked obesity, pronounced vasoconstriction, arrhythmia, intra aortic balloon pump. Assessment of stroke…

…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…

…or very little) turnover of myocardial cells and therefore myocardial troponins should not be detected in the blood. It should be noted, however, that current…

…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…

…can refine interpretation. Coronary plaque and future events Angiographic stenosis severity is an imperfect predictor of future myocardial infarction or sudden death. Lesions causing only…

…patient at risk of rapid deterioration. Intraosseous access: Cardiac arrest where venous access is not immediately available. Shock, severe trauma, burns or status epilepticus when…

…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…

…rise and/or fall in cardiac troponin with at least one value above the 99th percentile upper reference limit; and Clinical evidence of acute myocardial…

…low to intermediate likelihood of CAD when cardiac troponin and/or the ECG is normal or inconclusive. The principal diagnostic strength of CCTA is its…

…Clinical evidence of low cardiac output or shock RVI may produce severe venous congestion even when the left sided filling pressure is normal or only…

…in the absence of an underlying structural cardiac explanation Early onset hypertension or cerebrovascular accident at a young age in the patient or family Hypertensive…

…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…

…and P3 (posterior or lateral scallop). Figure 1. Anatomy of the mitral valve The leaflets are connected to the papillary muscles via chordae tendineae (Figure…

…or ambulatory pressure. Masked hypertension: office pressure below the hypertension threshold but hypertensive home or ambulatory pressure. Office measurements provide only a limited representation of…

…across the mitral valve using pulsed Doppler. Estimating left ventricular filling pressure via e' . Measurement of deceleration time (DT) . Diastolic function can be estimated from…

…and parasympathetic influences; sympathetic stimulation leads to vasoconstriction through the release of norepinephrine, while parasympathetic activation can cause vasodilation via acetylcholine release. These mechanisms collectively…

…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…

…or supranormal ejection fraction , despite manifest heart failure and severe symptoms. These individuals exhibit pronounced hypertrophy, resulting in a reduction of ventricular volume and subsequently…

…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

…valves. Importantly, in the setting of valvular stenosis or regurgitation, the proximal velocity (v 1 ) is very small compared to the distal velocity (v 2 )…

…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…

…than for office measurement. Classification of office blood pressure Category Systolic Diastolic : : : : : Optimal < 120 and < 80 Normal 120–129 and/or 80–84…

…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…

…in oedema and ascites, and in people under 18 years of age, where iso BMI or percentile charts should be used. Waist circumference Measure the…

…checked with a capillary or venous measurement [5]. Treatment The awake patient who can swallow safely Give 15 to 20 g of rapid acting carbohydrate…

…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…

…myelodysplastic syndrome or myeloproliferative neoplasm. Work up and staging of lymphoma and myeloma. Suspected bone marrow metastasis. Assessment of treatment response and measurement of residual…

…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…

…may be falsely normal because of medial sclerosis — in that case add toe pressure measurement. Absolute: ABI < 0.5 or toe pressure < 30…

…on a combination of clinical findings, oxygenation and objective measurement of airflow. International thresholds vary somewhat, but a PEF of 50 percent or less together…

…admission alone. Diagnosis Current diagnostic criteria According to the international consensus report of 2024, the diagnosis of DKA requires three components: diabetes or hyperglycaemia, ketosis…

…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…

…retention. Chronic urinary retention with renal impairment or a large residual volume. A need for accurate measurement of urine output in a critically ill patient…