…are elevated. The syndrome is therefore defined by symptoms and signs of congestion or impaired cardiac performance rather than by ejection fraction alone. Heart failure…

…increased sweating, and muscle fatigue. Although this is a subjective measure, it provides a fairly good estimate of the actual workload. The perceived exertion may…

…and monitors, one who assesses and documents muscle function. Define the outcome measure before the test. Measure the size of the ptosis in millimetres, the…

…AV nodal refractoriness. Its electrophysiologic effects on the His Purkinje system and ventricular muscle are minimal, except in cases of toxic concentrations. In most patients…

…soreness Weakness, often perceived or functional Predominant involvement of large proximal muscle groups Symptoms commonly begin within 4–6 weeks of starting treatment. They generally…

…muscle rupture causes abrupt severe MR. Its typical presentation is: Sudden severe dyspnoea. Acute pulmonary oedema. Hypotension. Progressive heart failure. Cardiogenic shock. Complete transection of…

…determine afterwards whether a nerve injury was caused by the injury or by the treatment. Indications A clinically or radiologically confirmed dislocation of the shoulder…

ECG Troponin is a protein complex expressed in cardiac and skeletal muscle. The complex consists of troponin I (TnI) , troponin C (TnC) and troponin T…

…older people with lost muscle mass (where a normal BMI may conceal sarcopenia), in oedema and ascites, and in people under 18 years of age…

…with a low muscle mass — the elderly, the undernourished, amputees, patients with hepatic cirrhosis — creatinine based eGFR substantially overestimates renal function. Staging of chronic kidney…

…Cleviprex ® Indications Hypertension and hypertensive emergency. Treatment of postoperative hypertension. Mechanism of action Ultra short acting calcium channel blocker (CCB). Half life: 5 minutes…

…the contraction of smooth muscle cells. As compared with nitroprusside, nicardipine induces relatively greater venodilation than arteriolar dilation. Effects Nicardipine causes dilation of the coronary…

…arterial perfusion of an upper or lower limb that causes tissue metabolic requirements to exceed available blood flow. The resulting ischaemia threatens skeletal muscle and…

…of the P wave. The P wave is a small, positive and smooth wave. It is small because the atria make a relatively small muscle…

…seen in arteries throughout the circulatory system (Figure 1). The ventricular wall consists of an inner lining (endocardium), a thick muscle layer (myocardium) and an…

…typical rise and/or fall of high sensitivity cardiac troponin (hs cTn), with at least one value above the 99th percentile upper reference limit (URL…

…between the muscle fibers in these layers, which collectively produces a highly efficient pumping mechanism. Figure 1A 2C. The orientation of myocardial muscle fibers results…

…adrenergic receptors: expressed in vascular smooth muscle. Activation results in vasodilatation. D1 and D2 (dopamine receptors): activation of D1 and D2 in the kidneys and…

…does not distinguish between fat, muscle, and bone mass. It does not indicate the types or distribution of body fat. It may not be accurate…

…primarily consisting of individuals with CKD, limiting its accuracy when applied to healthy populations or those with acute kidney injury. Influence of Muscle Mass and…

…the contraction of smooth muscle cells. As compared with nitroprusside, nicardipine induces relatively greater venodilation than arteriolar dilation. Effects Nicardipine causes dilation of the coronary…

…minutes. Administer sodium thiosulfate (cyanide into thiocyanate) and terminate infusion of nitroprusside if cyanide toxicity is suspected. Adverse effects • Nausea. Vomiting. Agitation. Muscle spasm. Sweating…

…cigarette smoking, hypertension and diabetes mellitus—disturb endothelial function and favour the accumulation of fat, smooth muscle cells, fibroblasts and extracellular matrix beneath the endothelium…

…after treatment initiation or intensification necessary. Clinical evidence for cardiovascular benefit CLEAR Outcomes CLEAR Outcomes was a randomized, double blind, placebo controlled study of 13…

…may represent a more favorable profile, as the upper limit of the "healthy" range can still harbor significant metabolic risk. 3 For patients with a…

…larger (ventricular volume and muscle mass) than the right ventricle. Refer to Figure 1 . Figure 1. Cross sectional view of ventricular wall thickness in children…

Cardiology Critical care Pharmacology & dosing Definition and Pathophysiology In the management of acute heart failure and cardiogenic shock, intravenous vasoactive agents are categorised according to…

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

…Muscle strengthening exercise should additionally be performed on at least 2 days each week. Activities need not be undertaken in bouts of at least 10…

…a young age in the patient or family Hypertensive first degree relatives of patients with PA Patients with hypokalaemia may develop weakness, muscle cramps or…

…because treatment often requires urgent surgical or transcatheter intervention, with temporary mechanical circulatory support (MCS) considered as a bridge. Clinical Presentation and Symptoms Symptoms of…

…muscle cells, leading to a white, platelet rich thrombus. Myocardial vulnerability, largely driven by coronary microvascular dysfunction, also contributes to the extension and severity of…

…coronary artery spasm, coronary microvascular dysfunction (encompassing endothelial dysfunction, smooth muscle cell dysfunction, and dysregulation of sympathetic innervation), coronary embolism, and spontaneous coronary artery dissection…

…flow limitation. The mechanisms are incompletely defined. Proposed contributors include hypercontractility or hypersensitivity of coronary vascular smooth muscle to vasoconstrictor stimuli, including adrenergic agonists, leukotrienes…

…a genetic mutation in the RYR1 receptor, resulting in persistent muscle contraction upon administration of halogenated anesthetic agents. As an idiosyncratic response to substances such…

…causes constriction of the veins, which increases the venous return to the heart. Contracting muscles function as a pump that propels blood back to the…

…the contraction of smooth muscle cells. As compared with nitroprusside, nicardipine induces relatively greater venodilation than arteriolar dilation. Effects Nicardipine causes dilation of the coronary…

…the article follows: [...] Of every 10 such victims, the heart in 6 or 7 showed no recent disease in coronary arteries or in heart muscle…

…larger (ventricular volume and muscle mass) than the right ventricle. Refer to Figure 1 . Figure 1. Cross sectional view of ventricular wall thickness in children…

…syndrome), osteogenesis imperfecta typically causes prolapse of P2 (Figure 1). Myocardial ischemia affecting the papillary muscles or the connected myocardium may cause mitral prolapse, and…

…Anatomy of the mitral valve The leaflets are connected to the papillary muscles via chordae tendineae (Figure 1). The anterolateral papillary muscle receives blood supply…

…on the upper arm. Placement of chest (precordial) electrodes are not changed but additional leads may be attached in children under the age of 5…

…the pericardial cavity and/or the myocardium. Pericarditis refers to inflammation of the pericardium, and myocarditis refers to inflammation of the myocardial (muscle) tissue. However…

…coronary blood flow by relaxing vascular smooth muscle. They are contraindicated in patients with bronchospastic lung disease, or a history of significant reactive airway disease…

…the aorta. Afterload affects myocardial muscle fibers during systole and diastole. Afterload is a function of the following three variables: Aortic resistance (pressure). Left ventricular…

…which supplies the inferior wall of the left ventricle, determines the coronary artery dominance. A right dominant system implies that the PDA is supplied by…

…an acute or subacute worsening of dyspnoea, cough and sputum in particular that exceeds the patient's normal variation and requires a change of treatment…

…the underlying cause. KDIGO recommends prompt investigation of reversible causes, continuing staging, and treatment directed at both the cause and the severity [1]. Three questions…

…features or an inadequate response. First line treatment is oxygen in hypoxaemia, repeated doses of an inhaled short acting β2 agonist, ipratropium in more severe…

…according to the local protocol. Tapering after pharmacological treatment Duration and dose Risk of HPA suppression Tapering : : : < 3 weeks, at any dose Low Can…

…before revascularisation. Evaluation of treatment effect in stable angina. Exercise induced arrhythmia or exercise induced syncope. Assessment of chronotropic function and pacemaker settings. Preoperative functional…

…if possible, otherwise give IM with a fine needle and 5 minutes of compression. Anticoagulant treatment is not in itself a bar to vaccination. Relative…

…posterior approach is preferable: it passes through muscle without major vessels or nerves, and the landmark — the posterior corner of the acromion — is easy to…

…artery, which runs on the posterior aspect of the rectus muscle along its lateral border and is the commonest source of serious bleeding after paracentesis…

…widening pulse pressure are common in later life. These changes contribute to the complexity of defining an appropriate treatment target, particularly when a lower DBP…

…and appropriate pharmacological treatment. After myocardial infarction, rehabilitation aims to: Restore and improve functional capacity Reduce disability and rehospitalization Improve quality of life and self…

…are components of the myocardial contractile apparatus and are expressed predominantly in cardiac muscle. Troponin I is highly specific for myocardial injury. Interpretation of troponin…

…of femoropopliteal disease. More distal disease may cause foot symptoms, although lower extremity symptoms are much more common than upper extremity symptoms. The severity of…

…regurgitates back from the aorta into the left ventricle. This results in volume overload in the left ventricle during diastole. The hemodynamic consequences of aortic…

…Hypertrophy manifests on the ECG as increased amplitudes of the QRS complexes. The explanation is straightforward: myocardial muscle mass is increased and therefore it generates…