…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…

…BMI of 23 and obesity from 27.5, because cardiometabolic risk appears at a lower BMI. BMI is misleading in athletes with a large muscle…

…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…

…subendothelial accumulation of apolipoprotein B containing lipoproteins, macrophage infiltration, smooth muscle cell proliferation, and extracellular matrix deposition, ultimately leading to the formation of atherosclerotic plaques…

…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…

…utility is frequently limited by its inability to distinguish between muscle mass and various fat depots, or to identify the precise location of excess adiposity…

…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…

…monophosphate (cAMP) and calcium, as well as through the direct activation of voltage sensitive calcium channels. At lower doses, dobutamine stimulates beta2 and alpha receptors…

…or 80 cm in women is considered indicative of obesity or excess abdominal adiposity. Ethnic specific thresholds are lower or otherwise modified in some populations…

…central component of cardiovascular prevention and treatment. It is associated with lower cardiovascular and all cause mortality and with reduced incidence or burden of hypertension…

…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…

…central chest or epigastrium, may radiate to the arms, and less often to the abdomen, back, lower jaw, neck, or occipital region. It typically occurs…

…central portion of the chest or the epigastrium and occasionally radiates to the arms. Less common sites of radiation include the abdomen, back, lower jaw…

…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…

…Heat stroke ( 40°C) Neurological symptoms, confusion, convulsion, tachycardia, hypotension, coma. As above but with lower temperatures. Electrolyte replacement. Large infusions of fluids are typically needed…

…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…

…The ECG grid. The x axis represents time and y axis represents amplitude of the electrical signals generated in the myocardium. The same ECG grid…

…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…

…acromion and the lower tip of the muscle insertion. 3. Stretch the skin with the thumb and index finger, or compress the muscle in a…

…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…

…first. Procedure Choice of insertion site The left lower quadrant is the first choice : the abdominal wall is thinner there than on the right, and…

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

…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…