…expected pCO₂ or HCO₃. A value outside the expected range means there is a further primary disorder 4 Is there a metabolic acidosis? Calculate the…

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…

…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…

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

…proBNP are more frequent in this pattern. Endothelial dysfunction may contribute to both microvascular and epicardial vasomotor disorders. Endothelial activation can promote the release of…

…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…

…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…

…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…

…Some examples follow. Consider people with the genetic disorder familial hypercholesterolemia (FH), which is caused by genetic mutations affecting the elimination of LDL cholesterol from…

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…

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…

…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…

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

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…

…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…

…blood flow and myocardial flow reserve with PET. Evaluate myocardial viability, particularly when combined with metabolic imaging. Contribute to assessment of cardiac inflammation, infective endocarditis…

…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…

…exhaled. The final partial pressure of carbon dioxide in exhaled air represents the sum of ventilation, metabolic activity, and perfusion. Increased aerobic metabolism, perfusion, and…

…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…

…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…

…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…

…mL/kg Sodium bicarbonate 50 mmol in hyperkalaemia or tricyclic poisoning 1 mmol/kg Reversible causes: hypoxia, hypovolaemia, hypo /hyperkalaemia and metabolic disturbance, hypothermia, tamponade…

…refill, cold or mottled skin Metabolism and perfusion A lactate above 2 mmol/L, metabolic acidosis or a rising lactate Kidney A rise in creatinine…

…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…

…overload — a relative contraindication requiring invasive monitoring and slower administration. Significant metabolic alkalosis or an arterial pH above 7.55 already before starting. Severe hypernatraemia…

…kidney metabolic syndrome, in which adiposity, insulin resistance, diabetes, hypertension, CKD and CVD reinforce one another. Dysfunctional adipose tissue contributes to inflammatory and metabolic abnormalities…

…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…

…LDL C or non HDL C, particularly in patients with metabolic syndrome or elevated triglycerides despite normal or low LDL C. HDL cholesterol (HDL C…

…typically within a range of 50 120 mmHg. This process is primarily mediated by local metabolic mechanisms, which adjust vascular tone in response to myocardial…

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…

…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…

…in renal failure Morphine PO 5–10 mg as needed The active metabolite accumulates in renal failure Oxycodone IV 2.5–5 mg Oxycodone PO…

…mg once daily. Rationale: Patients in this age group have higher bleeding risk and increased exposure to the active metabolite of prasugrel. Patients weighing <…

…women or five for men on one occasion. Pharmacokinetics and pathophysiology Approximately 95% of ingested ethanol undergoes hepatic metabolism. Alcohol dehydrogenase converts ethanol to acetaldehyde…

…The agent undergoes extensive hepatic metabolism, yielding desethylamiodarone as a major active metabolite. Both the parent drug and its metabolite accumulate extensively in various tissues…

…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…

…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…

…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…

… avoid morphine Morphine has an active renally excreted metabolite that causes late sedation and respiratory depression Marked liver failure A reduced dose of all of…

…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…

…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…

…Factors associated with restenosis The risk of restenosis after metallic stent implantation is increased by: Small reference vessel size A small post procedural luminal diameter…

…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…

…and still is, suggested that ischemic myocardium secretes protective substances that affect and precondition the metabolism of myocardial cells. Researchers have pushed the notion that…

…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…