Cardiology Endocrinology & metabolism Definition and Pathophysiology Metabolic syndrome is a clustering of cardiometabolic abnormalities centred on abdominal adiposity, insulin resistance, dyslipidaemia, elevated blood pressure and…

…Condition Congenital conditions Jervell and Lange Nielsen syndrome Romano Ward syndrome Idiopathic congenital long QT syndrome (LQTS) Metabolic disorders Hypokalemia Hypomagnesemia Hypocalcemia Starvation Anorexia nervosa…

…as well as greater cardiovascular mortality. Metabolic syndrome and diabetes are also more prevalent. Epidemiology and clinical significance The reported prevalence depends on the population…

…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…

…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…

…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…

…3. Rapid identification of seizures, delirium tremens, infection, trauma and metabolic disturbance. 4. Monitoring at the appropriate level of care , with readiness for respiratory support…

…overdose. Tumour lysis syndrome appears as an indication in older protocols but is no longer routinely recommended — alkaline urine increases the precipitation of calcium phosphate…

…18F FDG uptake represent a perfusion–metabolism mismatch and may indicate viable, hibernating myocardium. Clinical Indications Suspected or Known Chronic Coronary Syndrome Stress SPECT or…

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…

…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…

…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…

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

…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…

…Management Definition and Clinical Characteristics Torsades de pointes (TdP) represents a multifactorial clinical entity typically associated with drug induced long QT syndrome (DI LQTS) [1]…

…combination with acetylsalicylic acid (ASA), is indicated for the prevention of atherothrombotic events in adult patients with acute coronary syndromes (ACS), including: Unstable angina (UA…

…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…

…prosthesis — warfarin is mandatory, and direct oral anticoagulants (DOACs) are contraindicated. Antiphospholipid syndrome, particularly triple positive disease or after an arterial event, where DOACs have…

…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…

…pre excited atrial fibrillation (i.e. atrial fibrillation with impulses conducted via an accessory pathway [see Wolff Parkinson White Syndrome]); blocking AV node conduction may…

…arrest. Post resuscitation care is an integral component of the chain of survival. It includes diagnosis of post cardiac arrest syndrome (PCAS), optimization of ventilation…

…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…

…all ischemic episodes are asymptomatic (refer to The Ischemic Cascade). Acute coronary syndromes occur when atherosclerotic plaques rupture or erode, leading to atherothrombosis and occlusion…

…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…

…same time despite a normal pH. The lungs compensate for a primary metabolic disturbance within minutes by changing ventilation. Renal compensation for a primary respiratory…

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…

…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…

…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…

…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…

…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…

…die from acute myocardial infarction at 20 to 30 years of age. People with familial hypercholesterolemia have no other metabolic aberration, besides high LDL cholesterol…

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…

… 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…

…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 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…

…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…

…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…

…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…

…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…

…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…