…an acidosis and an alkalosis at the same time despite a normal pH. The lungs compensate for a primary metabolic disturbance within minutes by changing…

…with progression, hyperglycaemia and pancreatic β cell dysfunction. These abnormalities initiate self perpetuating metabolic and inflammatory pathways that injure the vasculature, heart and kidneys. Advanced…

…risk of type 2 diabetes, metabolic syndrome and specific cancers. BMI and cardiovascular outcomes High BMI is associated with several health conditions: Type 2 diabetes…

…ischaemia (ALI) is an abrupt reduction in arterial perfusion of an upper or lower limb that causes tissue metabolic requirements to exceed available blood flow…

…before or at the same time as carbohydrate administration. 3. Rapid identification of seizures, delirium tremens, infection, trauma and metabolic disturbance. 4. Monitoring at the…

…easy to trust too much. Two errors make the reading useless without anyone noticing: the transducer is at the wrong height , and the system is…

Endokrinologi & metabolism Akutsjukvård Lathundar About this quick reference Treatment protocols differ between regions. Always follow the local protocol for exact infusion rates, electrolyte concentrations and…

…Nielsen syndrome Romano Ward syndrome Idiopathic congenital long QT syndrome (LQTS) Metabolic disorders Hypokalemia Hypomagnesemia Hypocalcemia Starvation Anorexia nervosa Liquid protein diets Hypothyroidism Bradyarrhythmia Sinus…

…prediabetes, insulin resistance, metabolic syndrome, and hypertriglyceridaemia. Because triglyceride rich particles contribute additional cholesterol—often approximately 30 mg/dL—non HDL C treatment goals are…

…cardiac function, satiety, appetite, the gut microbiome and metabolic expenditure. Food processing, additives and cooking methods may also contribute. The cardioprotective effect is therefore likely…

…clinical disease. HeFH affects approximately 1 in 250–300 people and is the most common inherited metabolic disorder associated with premature cardiovascular disease. Prevalence is…

…provides tomographic information about relative regional perfusion. Imaging is generally performed at rest and during exercise or pharmacological stress, allowing comparison between myocardial blood flow…

Cardiology Endocrinology & metabolism Definition and pathophysiology Primary aldosteronism (PA), also termed primary hyperaldosteronism or Conn syndrome, comprises disorders in which aldosterone secretion is inappropriately increased…

…mortality in the cited international cohort evidence. Metabolic risk factors make a particularly large contribution to cardiovascular disease. Hypertension is a major component of this…

Cardiology Endocrinology & metabolism Pharmacology & dosing Definition and pharmacological basis Sodium glucose cotransporter 2 (SGLT2) inhibitors are a class of oral agents initially developed for glucose…

Cardiology Endocrinology & metabolism Definition and Pathophysiology Type 2 diabetes mellitus (T2DM) is a major cardiovascular risk condition. It is associated with a two to four…

…in the pulse generator or dislodgement or fracture of the leads. External causes are less common and include electrolyte disorders, metabolic disorders, hypoxemia, antiarrhythmic drugs…

…dioxide (CO 2 ) at the end of expiration. It provides an integrated view of ventilation , metabolism , and perfusion . Carbon dioxide, a byproduct of aerobic metabolism…

…with prolonged periods of no blood flow, due to the reduced metabolic rate that accompanies declining body temperature. For every 1°C reduction in body temperature…

…One metabolic equivalent (1 MET) is defined as the amount of oxygen consumed while sitting at rest and is equal to 3.5 ml O2…

…phase 4 to 10 minutes Compressions and ventilation, followed by defibrillation Metabolic phase 10 minutes Unknown Table 1 . The 3 phase model of sudden cardiac…

…FASS) before administration — concentrations and formulations differ between units, and most serious dosing errors arise at the dilution step, not in the choice of dose…

…confusion, disorientation, agitation, drowsiness or a reduced GCS Respiration A respiratory rate of at least 22/min, increased work of breathing, a new oxygen requirement…

…drowsiness or syncope oliguria a rising lactate or metabolic acidosis repeated fresh haematemesis haematochezia in combination with circulatory compromise a rapidly falling haemoglobin after fluid…

…The treatment looks simple — bicarbonate and a look at the urine dipstick — but it fails routinely for one single reason: without normal potassium the urine…

…CAD) increases in an approximately linear manner. At an eGFR of 15 mL/min/1.73 m², cardiovascular mortality risk may be as much as…

…with homozygous FH typically die from acute myocardial infarction at 20 to 30 years of age. People with familial hypercholesterolemia have no other metabolic aberration…

…capacity, expressed by exercise duration, workload or metabolic equivalents, is among the strongest predictors of mortality in patients with cardiovascular disease after accounting for age…

Cardiology Continous medical discussion: the ECG blog Endocrinology & metabolism Cardiovascular medicine is currently witnessing a paradigm shift. For decades, the management of type 2 diabetes…

…Thus, even a modest absolute reduction may be clinically important in individuals at high or very high risk. Prolonged exposure to lower LDL C concentrations…

… concealed diffuse atherosclerosis; myocardial bridging; myocardial metabolic abnormalities; and abnormal pain perception in patients without demonstrable ischaemia. The absence of obstructive disease therefore does not…

Cardiology Endocrinology & metabolism Definition and pathophysiology Obesity is a chronic, relapsing and biologically complex disease characterized by excessive accumulation of adipose tissue. It is an…

…global epidemics of obesity, diabetes mellitus, and metabolic syndrome [58] . Hypertension and coronary artery disease (CAD) remain the most potent population attributable risk factors. Furthermore…

…potentially causing angina during rest. Patients experiencing angina at rest are not suitable candidates for perfusion imaging. Detecting ischemic regions requires provocation using pharmacologic agents…

Endokrinologi & metabolism Farmakologi & dosering Lathundar Two situations are often confused: replacement therapy in adrenal insufficiency (which must be increased under stress) and pharmacological anti inflammatory…

Endokrinologi & metabolism Akutsjukvård Lathundar Emergency overview Measure the plasma glucose immediately in everyone with a reduced level of consciousness, seizures, confusion, a change in behaviour…

Endokrinologi & metabolism Lathundar An inpatient has a different insulin sensitivity from at home: less food, more stress, often corticosteroids, often impaired renal function. Prescribe basal…

Cardiology Endocrinology & metabolism Definition and pathophysiology Hypertriglyceridaemia (HTG) is defined by an increased concentration of circulating triglycerides. Both fasting and non fasting measurements provide prognostic…

Cardiology Endocrinology & metabolism Definition and pathophysiology Secondary hypertension is elevated blood pressure attributable to a specific, identifiable underlying cause. It should be considered in every…

…hypertensive emergency. Acute left ventricular failure. Mechanism of action Enalaprilat is the active metabolite (ester) of enalapril, an angiotensin converting enzyme (ACE) inhibitor. Enalaprilat lowers…

…stents (BMS) in response to restenosis caused principally by neointimal hyperplasia. Contemporary DES combine a metallic scaffold, a polymeric or polymer free drug delivery system…

…min Avoid morphine (the active metabolite accumulates). Oxycodone at a reduced dose, at longer intervals Age 75 years Start at half the adult dose and…

…coronary angiography within 48 hours of hospital admission, the loading dose should be administered at the time of PCI. Patients should also take acetylsalicylic acid …

…or at least four drinks for women or five for men on one occasion. Pharmacokinetics and pathophysiology Approximately 95% of ingested ethanol undergoes hepatic metabolism…

…doses, averaging approximately 0.5 mg/L (0.5 µg/mL) for each 100 mg/day at doses between 100 and 600 mg/day. Therapeutic…

…acid also activates adenosine monophosphate activated protein kinase, which regulates substrates involved in lipid metabolism and inflammatory signalling. ACLY additionally influences fatty acid synthesis and…

…have a rate reducing effect in selected circumstances. Ivabradine undergoes extensive first pass hepatic metabolism through CYP3A4. Dose adjustment is required in severe hepatic or…

…and calcium, as well as through the direct activation of voltage sensitive calcium channels. At lower doses, dobutamine stimulates beta2 and alpha receptors, inducing vasodilation…

…multiple QT prolonging medications, and drug accumulation secondary to renal or hepatic impairment or the inhibition of cytochrome P450 metabolism [1]. Nonmodifiable risk factors encompass…

…leading to unconsciousness. The myocardium responds to hypoxia by downregulating metabolism and thus contractility (a consistent finding in acute coronary syndromes). Between 3 8 minutes…

…by increasing heart rate and contractility (i.e contractile force), results in increased metabolism. Cardiac cells are highly capable of matching the supply and demand…

…stunning . This is a protective mechanism since the cessation of contractions leads to a marked reduction in cell metabolism and thus prolongs survival. Myocardial stunning…

…active renally excreted metabolite that causes late sedation and respiratory depression Marked liver failure A reduced dose of all of them, at a longer interval…

…0–3.0 Overlap with low molecular weight heparin (LMWH) for at least 5 days Mechanical aortic valve 2.5–3.5 Some centres use…

…hypertensive emergency. Acute left ventricular failure. Mechanism of action Enalaprilat is the active metabolite (ester) of enalapril, an angiotensin converting enzyme (ACE) inhibitor. Enalaprilat lowers…

…BMS). Clinical ISR is generally defined by recurrent symptoms or ischaemic events attributable to renarrowing within the stented segment or at its margins. Angiographic restenosis…

…Anxiety Chestpain. Palpitations. Headache Hypotension. Facial flushing. Sweating. Bronchospasm Dyspnea Nausea Metallic taste Tightness in throat Lightheadedness, dizziness, tingling in arms, numbness, blurred vision, burning…

…occurs after prolonged ischemia, which is a mechanism to protect the cell from continued ischemic damage by downregulating metabolism (and thus contractility). Stunning may persist…

…As for now, it is sufficient to note that the more myocardium supplied by an artery, the greater the ischemic area in case of occlusion…

…hypertensive emergency. Acute left ventricular failure. Mechanism of action Enalaprilat is the active metabolite (ester) of enalapril, an angiotensin converting enzyme (ACE) inhibitor. Enalaprilat lowers…