…beginning of the next inspiration. Normal ETCO 2 : 38 mmHg (5 kPa) or 5%. Monitoring ETCO 2 aids in: Assessing ventilation quality. Determining ventilation rate…

…aortic opening. Cardiac output (CO) Cardiac Output (L/min) is the product of stroke volume and heart rate: CO = SV • HR CO = cardiac…

…a rate appropriate to tissue requirements unless filling pressures are elevated. The syndrome is therefore defined by symptoms and signs of congestion or impaired cardiac…

…↓ or normal ↑ or normal Obstructive (tamponade, PE) ↓ ↑ ↑ ↓ Vital signs and measures of perfusion Parameter Normal Comment : : : Heart rate 50…

…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…

…measurement of the diameter. Cardiac output (CO) Cardiac output is the product of stroke volume (SV) and heart rate (HR). CO = HR · SV Cardiac…

…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…

…rate. As the heart rate increases, the QT interval decreases and vice versa. The physiological purpose of this phenomenon is to allow for faster cardiac…

…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…

…imaging. Some measurements are still done using M mode echocardiography. A formal consensus regarding the components of the standard study has not been established, although…

…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…

…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…

…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…

…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…

…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…

…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…

…enabling depolarization and repolarization, and between cells via gap junctions, facilitating the propagation of depolarization across the cells. Electrical potential differences arise as the electrical…

…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…

…levels of cardiac troponins is firm evidence of myocardial necrosis (i.e infarction). This is explained by the fact that there is no (or very…

…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 …

…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…

…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…

…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…

…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…

…this chapter, you will learn the physiological basis of all ECG waves and how to determine whether the ECG is normal or abnormal. Although heart…

…2 ) This formula is excellent for measuring pressure gradients across small openings, such as the valves. Importantly, in the setting of valvular stenosis or regurgitation…

…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…

…with a braked, workload controlled resistance; 12 lead ECG with continuous recording; automated or manual blood pressure measurement. Resuscitation trolley with defibrillator, oxygen, suction and…

…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…

…age, the sex and the ancestry before the measurement; the reference values are based on them. In kyphosis, or when the patient cannot stand, the…

…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 …

…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…

…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…

…Condition Overall strategy Common first choices : : : Acute aortic syndrome Immediate rate control and rapid reduction of the systolic blood pressure towards 100 to 120 mmHg…

…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…

…Treatment protocols differ between regions. Always follow the local protocol for exact infusion rates, electrolyte concentrations and level of care. This quick reference is intended…

…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…