…years) : No dose adjustments are necessary. Contraindications to vernakalant Severe aortic stenosis Systolic blood pressure < 100 mm Hg. Heart failure with NYHA class III…

…and neurohormonal factors. These factors, which influence cardiac function primarily by affecting ventricular function, include blood pressure, venous return, pulmonary gas exchange efficiency, the concentration…

…bilateral brachial blood pressure measurement; cardiac auscultation; inspection of the legs and feet. A systolic blood pressure difference between the arms exceeding 15 mmHg is…

…term hypertensive urgency is best avoided. It implies that an asymptomatic rise in blood pressure must be treated urgently, which is not supported by evidence…

…most common sustained cardiac arrhythmia and a profound driver of global cardiovascular morbidity and mortality, primarily due to its association with ischemic stroke and systemic…

…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…

…has remained stable. New data suggest that the incidence of heart failure among young adults has increased in recent years ( Nabel et al, Savarese et…

…has remained stable. New data suggest that the incidence of heart failure among young adults has increased in recent years ( Nabel et al, Savarese et…

…acute condition. Much research has been devoted to it in recent years. Most cases (70%) of takotsubo cardiomyopathy occur in situations with extreme stress, such…

…Other mechanisms capable of obstructing coronary arteries include embolism, dissection, coronary arteritis associated with systemic vasculitis, extrinsic compression, myocardial bridging and radiation induced coronary disease…

…Systemic inflammation results in increased levels of circulating pro inflammatory cytokines that may cause plaque rupture (i.e the risk of atherosclerotic plaque rupture is…

…studies of the urinary tract. Wound healing with a sacral pressure sore or extensive perineal wounds where urinary leakage prevents healing. Voiding problems in neurogenic…

…recent years ( Figure 2 ). The chain of survival is only as strong as its weakest link, which means that all components of the chain must…

…evidence of peripheral embolism, or an unexplained drop in arterial pressure. Silent or unrecognized infarction occurs more often in patients without antecedent angina and in…

…in most textbooks in the field. However, contemporary data suggest that the current figure is approximately 60%. The discrepancy between traditional figures and recent studies…

…guidelines. Hence, this chapter will present the most recent evidence and recommendations for the evaluation and treatment of chronic coronary syndromes (CCS). Ischemic heart disease…

…guidelines. Hence, this chapter will present the most recent evidence and recommendations for the evaluation and treatment of chronic coronary syndromes (CCS). Ischemic heart disease…

…Most of these adverse events are related to the suppression of the renin angiotensin aldosterone system (RAAS), such as decreases in blood pressure and mild…

…and Internet connected devices. Additional breakthroughs have been achieved in recent years, with the leadless pacemaker being the most promising improvement. 1 Given the wide…

…Every seven years HPV, with reflex cytology if HPV positive The interval is counted from the most recent sample analysed for HPV. Invitations are sent…

…of attending a lecture given by professor Salim Yusuf of McMaster University. Professor Yusuf is the most cited researcher in cardiovascular medicine, a real giant…

…T2DM) and obesity was siloed, with clinicians focusing primarily on hemoglobin A1c (HbA1c) reduction, blood pressure, lipids and smoking cessation. Weight loss was considered extremely…

…Of every 10 such victims, the heart in 6 or 7 showed no recent disease in coronary arteries or in heart muscle. In other words…

…cardiac arrest is the most lethal manifestation of cardiovascular disease, accounting for 50% of all cardiovascular deaths ( Tsao et al ). A recent meta analysis showed…

…blood pressure and saturation throughout the investigation. Explain to the patient what is going to happen and that the most important thing is to swallow…

…driven atherothrombosis, while interruption of antiplatelet therapy after recent stenting is associated with increased risk of major adverse cardiovascular events (MACE) and stent thrombosis. Premature…

…branch block. The most widely recognized criteria to date were developed by Sgarbossa and colleagues and are therefore referred to as the Sgarbossa criteria. However…

…detail. The clinical definitions and recommendations presented in this chapter are in line with recent guidelines (2020) issued by the American Heart Association (AHA), American…

…and unstable presentations, the critical entity of electrical storm, and the long term management strategies informed by recent sub group analyses, registry data, and ongoing…

…be discussed later. Lavage must never be performed routinely in poisoning — it rarely alters the course and adds a risk of aspiration. Repeated doses of…

…neurological impairment Respiratory failure or respiratory arrest Clinical signs of raised intracranial pressure or impending herniation Moderately severe symptoms New confusion Severe headache Persistent nausea…

…an apron, a visor. Suction must be out and working before you begin. Inform the patient and agree a hand signal for a pause. Position…

…coagulopathy. Severe uncontrolled hypertension. Recent intracranial haemorrhage without a fresh assessment of benefit and risk. An inability to attend for sampling and follow up — relative…

…volume matters more than the fluid; irrigate under pressure through a 20 mL syringe and a large bore needle. Chlorhexidine in alcohol to the skin…

…involves the atria, atrioventricular node, accessory pathway and the ventricles. In most cases, the re entry is induced by a premature atrial beat. Atrioventricular reent

…A transfusion set with a filter. Blood components must not be given through a set without a filter. Sodium chloride 9 mg/mL for flushing

…s sign, an irregular pupil, a soft globe — because a perforated eye must never be instrumented, have its pressure measured, or be palpated. Indications A…

…threatening attack. 6. Give a systemic steroid early. 7. Insert intravenous access, but do not let blood sampling or cannulation delay inhaled treatment. 8. Reassess…

…ileus, third trimester pregnancy, marked reflux. A need for high airway pressures, for example severe ARDS, marked obesity or a stiff chest wall. Glottic or…

Info Brugada's algorithm is the most used algorithm for distinguishing ventricular tachycardia (VT) and supraventricular tachycardia (SVT) with wide QRS complex. The algorithm entails…

…therapy. I C Symptom relief Symptom Management Recommendation Level of evidence Hypoxia Oxygen is indicated if SaO2 < 90% or PaO2 < 60 mmHg. I…

…mmHg is insufficient to generate cardiac electrical activity. CPP = P aortic P right atrium Cerebral perfusion pressure (CerPP) : The pressure that drives cerebral blood…

…orthostatic hypotension Dix Hallpike, supine roll test, orthostatic blood pressure Episodic spontaneous vestibular syndrome Attacks lasting minutes to hours, sometimes days, without an obligatory trigger…

…ultrasound gel, a blood pressure cuff of the correct size (the width should correspond to about 40 % of the circumference of the limb), a manual…

…examination include: Unexplained systolic blood pressure < 90 mmHg Suggestion of gastrointestinal hemorrhage Persistent bradycardia (< 40 beats/min) Undiagnosed systolic murmur Carotid sinus massage…

Arrhythmias and arrhythmology ECG Atrial flutter Atrial flutter is the second most common pathological tachyarrhythmia. Only atrial fibrillation is more common. Atrial flutter occurs almost…

…LAP (left atrial pressure). However, left ventricular end diastolic pressure (LVEDP) also rises; the left ventricle becomes volume overloaded since less blood is ejected into…

Echocardiography Echocardiography in 2D Two dimensional (2D) ultrasound is the most commonly used modality in echocardiography. The two dimensions presented are width (x axis) and…

…and arrhythmology Critical care Definition and pathophysiology Atrial fibrillation (AF) is the most frequent supraventricular arrhythmia in patients with acute coronary syndromes (ACS) and is…

…occluding smaller vessels downstream). The thrombosis causes occlusion of the artery; blood flow may be partially or completely obstructed. Consequently, the myocardium supplied by the…

…abdominal aortic diameter exceeds 3 cm. Most AAAs are located below the renal arteries and are related to atherosclerotic disease. At least 90% of AAAs…

…tamponade, and sudden: Loss of pulse. Loss of blood pressure. Loss of consciousness. Electromechanical dissociation or pulseless electrical activity despite ongoing sinus rhythm on the…

…response of the jugular venous pressure, looking for Kussmaul’s sign Hepatomegaly as evidence of systemic venous congestion Blood pressure and evidence of hypotension Clinical…

…a period of) stress? Symptoms related to body position or respiration? Ischemic chest pain is usually described as pressure, squeezing, or a crushing sensation across…

…risk factors, ECG diagnosis and management Atrial fibrillation is the most common abnormal tachyarrhythmia (only sinus tachycardia is more common). The prevalence of atrial fibrillation…

…and careful analysis of ECG tracings. Most modern devices are capable of transmitting ECG tracings continuously to cloud based platforms, which enables the clinician to…

…It is typically described as a diffuse pain over the anterior chest wall. The pain may be experienced as a pressure, cramp or crushing sensation…

Arrhythmias and arrhythmology ECG Mechanisms of cardiac arrhythmias: from automaticity to re entry This section introduces the most common arrhythmias encountered in clinical practice, beginning…

…ECG and clinical examination, blood tests and other radiological examinations are most often required, in particular computed tomography (DT) and/or magnetic resonance imaging (MRI…

…ECG, normal variants & pathological variants Sinus tachycardia is the most common tachyarrhythmia (tachycardia). Sinus tachycardia is the result of an increased rate of depolarization (i…