…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…

…and apoB are secondary targets or risk refining measures, particularly in patients with: Diabetes or other cardiometabolic risk factors Obesity Insulin resistance or metabolic syndrome…

…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…

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…

…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…

…pulmonary oedema and other conditions with a high risk of fluid overload — a relative contraindication requiring invasive monitoring and slower administration. Significant metabolic alkalosis or…

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

…Seizures later than this, focal seizures or status epilepticus should raise strong suspicion of another or an additional cause [1]. Delirium tremens most often begins…

…including chronic coronary syndromes and acute coronary syndromes HF across the spectrum of left ventricular ejection fraction AF and other arrhythmias Ischaemic stroke PAD CKD…

…of foamy macrophages. The occurrence of neoatherosclerosis helps explain why ISR and other stent related events may arise well after the initial intervention. Mechanical mechanisms…

…Parkinson White Syndrome]); blocking AV node conduction may result in accelerated transmission of atrial impulses to the ventricles and thus ventricular fibrillation and cardiac arrest…

…survival. It includes diagnosis of post cardiac arrest syndrome (PCAS), optimization of ventilation, oxygenation, hemodynamics, antiischemic treatment, temperature treatment, treatment of seizures, and infections. However…

…These two measures – i.e switching to anaerobic metabolism and discontinuing the contractions – enables the myocardium to endure 20 to 30 minutes of severe ischemia…

…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…

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

…and reliable screening tool for body composition, risk of type 2 diabetes, metabolic syndrome and specific cancers. BMI and cardiovascular outcomes High BMI is associated…

…Cardiometabolic mechanisms Visceral and ectopic fat are particularly relevant to cardiovascular risk. Excess adipose tissue promotes: Chronic, low grade systemic inflammation Insulin resistance Abnormal adipokine…

…or metabolic equivalents, is among the strongest predictors of mortality in patients with cardiovascular disease after accounting for age. Chronotropic response, blood pressure behaviour and…

…and metabolic syndrome [58] . Hypertension and coronary artery disease (CAD) remain the most potent population attributable risk factors. Furthermore, the "obesity paradox"—whereby overweight and…

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…

…entity typically associated with drug induced long QT syndrome (DI LQTS) [1]. The condition arises in the setting of both modifiable and nonmodifiable risk factors…

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

…dose of 10 mg is not recommended due to higher exposure to the active metabolite and increased bleeding risk compared to patients weighing ≥ 60 kg…

…the oxygen supply. However, experimental and clinical studies have shown that myocardial metabolism, and thus contractility, is tightly coupled to oxygen supply. The myocardium is…

…Definition and pathophysiology Acute limb ischaemia (ALI) is an abrupt reduction in arterial perfusion of an upper or lower limb that causes tissue metabolic requirements…

…tip also lies in the lumen. 5. Hold the needle still and advance the catheter over the needle. It should slide in without resistance. 6.

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

…immediately with DKA dose insulin, while the osmolality is corrected cautiously [1,3]. Euglycaemic DKA Euglycaemic DKA means ketosis and metabolic acidosis despite a normal…

…acids and other bioactive compounds from nuts; and antioxidant and antithrombotic constituents from whole grains. These combined effects may improve inflammation, insulin resistance, glucose metabolism…

…magnitude of untreated LDL C elevation. The presence and age of onset of premature CAD or other vascular disease. A history of myocardial infarction or…

…risk of cardiovascular mortality and approximately one fifth of the risk of all cause mortality in the cited international cohort evidence. Metabolic risk factors make…

…the leads. External causes are less common and include electrolyte disorders, metabolic disorders, hypoxemia, antiarrhythmic drugs, or electromagnetic disturbance caused by other machines/devices. Below…

…sole determinant for terminating CPR or initiating ECMO ( Paiva et al ). If both ETCO 2 and other indicators suggest ROSC, compressions may be temporarily paused.

…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 0 to 4 minutes Defibrillation Circulatory phase 4 to 10 minutes Compressions and ventilation, followed by defibrillation Metabolic phase 10 minutes Unknown Table 1 …

…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…

…health care exposure and the risk of resistant organisms 0 to 60 min Empirical intravenous antibiotics in septic shock or in certain or highly likely…

…Is there cirrhosis, or another strong suspicion of portal hypertension? Variceal and ulcer bleeding are managed differently from the first minute. Peptic ulcer remains the…

…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…

…blog Endocrinology & metabolism Cardiovascular medicine is currently witnessing a paradigm shift. For decades, the management of type 2 diabetes mellitus (T2DM) and obesity was siloed…

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

…120 mmHg. This process is primarily mediated by local metabolic mechanisms, which adjust vascular tone in response to myocardial oxygen demand, and myogenic responses, where…

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…

…No defined threshold The patient has cognitive or physical impairment and needs help from another person Level 3 can occur even when the glucose has…

…scale), gives poorer control and is not recommended as the sole regimen. Common situations Situation Management : : Fasting before an investigation, type 1 Continue basal insulin…

…remnant lipoproteins and insulin resistance are associated with atherosclerotic cardiovascular disease (ASCVD), particularly in peripheral arterial disease. The relationship between triglyceride concentrations and aortic disease…

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…

…Brand names Vasotec IV ® Indications Hypertension and hypertensive emergency. Acute left ventricular failure. Mechanism of action Enalaprilat is the active metabolite (ester) of enalapril…

…Early metallic stents reduced acute closure but introduced the risk of thrombosis related to the intravascular foreign body. First generation DES, particularly sirolimus and paclitaxel…

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

…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…

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

…a small dose of a statin, defined as atorvastatin less than 10 mg daily or an equivalent dose of another statin. Approximately 45% of participants…

…pass hepatic metabolism through CYP3A4. Dose adjustment is required in severe hepatic or renal impairment, and clinically relevant interactions occur with CYP3A4 inhibitors and inducers…

…systemic and pulmonary vascular resistance, and restore adequate end organ perfusion. Dobutamine is a synthetic catecholamine that functions as an agonist of both beta1 and…

…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…

…muscle cells and has little or no effect on myocardial contractility or conduction. Clevidipine reduces mean arterial blood pressure (MAP) by decreasing systemic vascular resistance …

…originate from other branches of the same coronary artery or another coronary artery, will alleviate the ischemia, improve myocardial function and increase resistance to episodes…