…flow continues to rise, tracer uptake plateaus. This saturation effect can lead to an underestimation of blood flow in regions affected by significant coronary artery…

…certain radiotracers enable direct measurement of coronary blood flow, providing absolute quantification. The resting myocardium rarely reveals evidence of significant coronary artery stenosis unless the…

…the development of heart failure in the preserved and mildly reduced EF ranges, and obesity is increasingly recognised as a potential contributor. Coronary artery disease…

…profile is increasingly driven by the global epidemics of obesity, diabetes mellitus, and metabolic syndrome [58] . Hypertension and coronary artery disease (CAD) remain the most…

…than anomalous origin of the right coronary artery. High risk anatomical features include: An interarterial course between the aorta and pulmonary artery A slit like…

…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…

…which may have important prognostic and preventive implications even when stenosis is not flow limiting. CCTA should be distinguished from coronary artery calcium (CAC) scoring…

…left anterior descending artery are more likely to affect flow because they supply a larger myocardial territory. The response of the coronary circulation reflects both…

…The thrombosis causes occlusion of the artery; blood flow may be partially or completely obstructed. Consequently, the myocardium supplied by the occluded artery becomes ischemic…

…family history, particularly in the broader assessment of peripheral arterial and aortic disease; planned surgery, especially carotid endarterectomy (CEA), coronary artery bypass grafting (CABG), or…

…on the particle. Genetic and Mendelian randomization studies support a causal relationship between Lp(a) associated genetic variants and coronary artery disease. Associations have also…

…Indications Evaluation of chest pain with an intermediate pre test probability of coronary artery disease. Assessment of exercise capacity and symptoms in known heart disease…

…of lesions that may not be fully characterized by angiography. Standard gray scale IVUS demonstrates the principal vessel wall layers and allows quantitative measurements of…

…LCX or the right coronary artery (RCA). For details, refer to chapter The Coronary Arteries. Mitral valve disease A wide range of conditions may cause…

…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…

…by almost two decades without any major breakthrough in the management of heart failure. In 2014 the PARADIGM HF study introduced a new drug class…

…by almost two decades without any major breakthrough in the management of heart failure. In 2014 the PARADIGM HF study introduced a new drug class…

…ECG. Evaluation includes prompt measurement of vital signs and a focused examination directed toward both alternative diagnoses and high risk features of acute coronary syndrome…

…Basic principles of treatment The patient should be managed in an emergency department, an intensive care unit, a coronary care unit or another setting that…

…variable and echocardiographic measurement has meaningful variability. Patients with LVEF 40% have substantial morbidity and mortality, despite often having a greater burden of cardiovascular and…

…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…

…airway, breathing, circulation and level of consciousness. 2. Attach ECG, pulse oximetry and repeated blood pressure measurement when a hypertensive emergency is suspected. 3. Insert…

…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…

Emergency medicine Myocardial ischemia and infarction Definition and pathophysiology Acute coronary syndrome (ACS) comprises a spectrum of clinical presentations caused by suspected acute myocardial ischaemia…

…Imaging evidence of new loss of viable myocardium or a new regional wall motion abnormality in an ischaemic distribution Identification of a coronary thrombus by…

…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…

…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…

…A ratio is derived by measuring flow velocities across the mitral valve using pulsed Doppler. Estimating left ventricular filling pressure via e' . Measurement of deceleration…

…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…

…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…

…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…

…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…

…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…

…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…

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

…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…

…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 …

…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…

…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…

…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…

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…

…three to six months during ongoing compression therapy, and always in the event of new or increasing pain. Preparation and equipment Doppler for the ankle…

…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…

…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…

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

…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…

…velocities greater than the Nyquist limit. Aliasing implies that neither the direction nor velocity of flow can be determined. This results in the Doppler signal…

…Drug Standard dose Reduced dose and criterion : : : Apixaban 5 mg twice daily 2.5 mg twice daily if at least two of: age ≥80 years…

…and a warm, well perfused hand carry more weight. Choice of vessel The radial artery is the first choice : superficial, easy to compress, with a…

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…

…of the chosen finding — measurement, photograph or video. 3. Give atropine 0.5 mg intravenously (alternatively glycopyrronium 0.2 mg) to reduce the risk of…

…wave. The whole value of the investigation lies in the ratio between the number of atrial and ventricular complexes — more atrial than ventricular complexes, the…