…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…

…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…

…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…

…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…

…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…

…with a subsequent measurement of 40% [14] . This distinction is paramount for practicing cardiologists: HFimpEF represents a state of myocardial remission rather than true recovery…

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…

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

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…

…skin and enables the recording of electrical currents. An ECG lead is a graphical description of the electrical activity of the heart and it is…

…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…

…sensitive and specific for myocardial injury. Elevated levels of cardiac troponins is firm evidence of myocardial necrosis (i.e infarction). This is explained by the…

…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 …

…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…

…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…

…During physical activity, mitral stenosis may become symptomatic already at 2.5 cm 2 . A normal mitral valve has an area of 4 to 6…

…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'…

…1.3 mL/min/g of myocardial tissue During hyperemia (maximum stress): Approximately 3.58 ± 1.14 mL/min/g Total hyperemic flow for the…

…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…

…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…

…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…

…Bernoulli principle is based on the law of conservation of energy , which states that the total energy of an isolated system remains constant over time…

…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…

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…

…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…

…aside time, coach actively, and do not accept a trace you would not be prepared to show a colleague. Indications Investigation of chronic cough, dyspnoea…

…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…

…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…

…hypoxia, drug withdrawal and incorrect blood pressure measurement must be corrected before treatment is intensified [1,2]. The evidence that any particular intravenous drug improves…

…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…

…total osmolality but not in the effective osmolality, because urea crosses cell membranes relatively freely and therefore does not produce the same sustained shift of…

…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…