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

…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…

…trauma and metabolic disturbance. 4. Monitoring at the appropriate level of care , with readiness for respiratory support. 5. Treatment of the alcohol use disorder and…

…primary disorder 4 Is there a metabolic acidosis? Calculate the anion gap even when the pH is normal, if the HCO₃ is low or the…

…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…

…association is not the same as causation . A cause is something completely different. It took roughly 50 years for researchers to finally conclude that high…

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…

…and Pathophysiology Angina with non obstructive coronary arteries (ANOCA) describes anginal symptoms in patients whose epicardial coronary arteries are normal or show no obstructive disease…

…of sleep disordered breathing Hypoventilation Peripheral oedema or venous disease Reduced mobility Osteoarthritis and low back pain Symptoms of type 2 diabetes or metabolic syndrome…

…failure (HF) is a complex clinical syndrome characterized by symptoms and signs resulting from structural or functional impairment of ventricular filling or ejection of blood…

…have given carbohydrate or glucagon. In a person without diabetes, a hypoglycaemic disorder is defined primarily by Whipple's triad : 1. Symptoms or signs consistent…

…the initiating disorder. Earlier diagnosis is associated with a greater likelihood of cure. When to investigate General indications Patients with suggestive signs, symptoms, or medical…

…Waist circumference is particularly important because intra abdominal, or visceral, adipose tissue is more closely related to insulin resistance and the risk of diabetes and…

…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…

…Repeated blood gases, for example during mechanical ventilation or severe metabolic derangement. Major surgery with expected blood loss or large volume shifts. Patients in whom…

…the international consensus report of 2024, the diagnosis of DKA requires three components: diabetes or hyperglycaemia, ketosis and metabolic acidosis. A very high glucose value…

…with apoB. Discordantly high apoB is especially associated with metabolic syndrome and mildly elevated triglycerides, even when LDL C is normal or low. Clinical Significance…

…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…

…metabolism. Areas with reduced perfusion but preserved 18F FDG uptake represent a perfusion–metabolism mismatch and may indicate viable, hibernating myocardium. Clinical Indications Suspected or…

…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…

…rather than treatments directed at a particular symptom complex. The source material does not describe a characteristic symptom profile at initiation or during routine therapy…

…cardiovascular disease is complex. Glycaemic control is important for prevention of microvascular complications, but intensive glucose lowering alone has shown little or no consistent effect…

…Following ROSC, ETCO 2 can rise up to threefold from levels observed during compressions. A sudden increase in ETCO 2 indicates either ROSC or an…

…Warm covers. Heat fan. Remove any cold or damp textiles. Administer cardiopulmonary resuscitation (CPR) following standard protocols, emphasizing concurrent rapid rewarming of the patient. Consider…

…weight × min. Metabolic equivalents are used because the concept offers an easy way of expressing the energy cost of any exercise. The energy cost is…

…demonstrate that the available interventions are time sensitive, and to maximize the likelihood of restoring spontaneous circulation, interventions should be adapted to the current phase…

…mmol in hyperkalaemia or tricyclic poisoning 1 mmol/kg Reversible causes: hypoxia, hypovolaemia, hypo /hyperkalaemia and metabolic disturbance, hypothermia, tamponade, toxins, thrombosis (coronary or pulmonary)…

…mmHg or less, a MAP below 65 mmHg, delayed capillary refill, cold or mottled skin Metabolism and perfusion A lactate above 2 mmol/L, metabolic…

…are: hypotension or a postural drop tachycardia a cold periphery and delayed capillary refill confusion, drowsiness or syncope oliguria a rising lactate or metabolic acidosis…

…Significant metabolic alkalosis or an arterial pH above 7.55 already before starting. Severe hypernatraemia. Preparation and equipment Two peripheral venous cannulas, or a central…

…The following categories describe the principal eGFR stages: CKD stage eGFR Clinical context Cardiovascular or renal significance 1 60 mL/min/1.73 m² Abnormal…

…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…

…significant metabolic risk. 3 For patients with a BMI below 35 kg/m², direct assessments such as waist circumference, waist to hip ratio, or dual…

…high or very high risk. Prolonged exposure to lower LDL C concentrations is associated with lower ASCVD risk. Atherogenic particle burden is not completely represented…

…by local metabolic mechanisms, which adjust vascular tone in response to myocardial oxygen demand, and myogenic responses, where vascular smooth muscle constricts or dilates in…

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 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…

…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…

…to restenosis caused principally by neointimal hyperplasia. Contemporary DES combine a metallic scaffold, a polymeric or polymer free drug delivery system, and an antiproliferative agent…

…8/min, or an increasing level of sedation , are signs of overdose. Sedation precedes respiratory depression; monitor it. Naloxone is titrated to spontaneous breathing, not…

…either primary or delayed percutaneous coronary intervention (PCI). Contraindications Prasugrel should not be used in the following situations: Hypersensitivity to the active substance or any…

…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…

…first pass extraction. Following a single oral dose, plasma concentrations peak within 3 to 6 hours. The agent undergoes extensive hepatic metabolism, yielding desethylamiodarone as…

…cholesterol (LDL C), particularly when statins cannot be tolerated or when LDL C remains above goal despite maximally tolerated therapy. It is a prodrug activated…

…or “funny,” current in sinoatrial node pacemaker cells. This current is a mixed inward Na⁺/K⁺ current activated by hyperpolarisation and contributes to spontaneous diastolic…

…The drug possesses an active, acetylated metabolite with a half life exceeding 80 hours, allowing for sustained hemodynamic effects for days after the infusion is…

…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…

…A complete airway obstruction results in PEA and cardiac arrest within 8 minutes. Cardiac arrest as a result of asphyxia or hypoxia is managed according…

…adenosine triphosphate) as the primary energy source. ATP is produced by metabolizing carbohydrates (glucose), fats or proteins, whichever is available. ATP fuels all cellular functions…

…These estimates should be viewed as approximations due to the following: Registry data indicate that survival is possible with longer periods of no flow ( Rawshani…

…or oxycodone Morphine 6 glucuronide begins to accumulate eGFR < 30 or dialysis Oxycodone or hydromorphone ; avoid morphine Morphine has an active renally excreted metabolite…

…heart failure, hepatic impairment, malnutrition, concurrent amiodarone or known slow CYP2C9 metabolism. 4. Take the INR on day 3. The dose that day is determined…

…Edema. Dizziness. Caution Should be used cautiously in patients with myocardial ischemia and/or heart failure. Nicardipine doses and administration in hypertension (hypertensive crisis/emergency)…

…rather than by negative remodelling. Pathophysiology Neointimal hyperplasia The principal mechanism of ISR is neointimal hyperplasia following vessel wall injury. PCI and stent implantation produce…

…is considered safe for patients with narrow complex tachycardia (NCT). Adenosine typically causes a short lasting second or third degree AV block which may be…

…coronary care unit (CCU), or catheterization laboratory. A 12 lead ECG must be obtained immediately after ROSC in order to identify cases with ST segment…

…ischemic zone. Newly formed vessels, which may originate from other branches of the same coronary artery or another coronary artery, will alleviate the ischemia, improve…

…Edema. Dizziness. Caution Should be used cautiously in patients with myocardial ischemia and/or heart failure. Nicardipine doses and administration in hypertension (hypertensive crisis/emergency)…