…together with rest angina and ST segment elevation caused by spasm. The absence of obstructive disease generally indicates a more favourable course than VA accompanied…

…coronary atherosclerosis without plaque rupture, coronary artery spasm, coronary microvascular dysfunction (encompassing endothelial dysfunction, smooth muscle cell dysfunction, and dysregulation of sympathetic innervation), coronary embolism…

…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…

…of myocardial injury Important causes include: Mechanism or clinical setting Examples Acute coronary atherothrombosis Plaque disruption or erosion with thrombosis Reduced myocardial perfusion Coronary spasm…

…clinical practice report muscle symptoms. This discrepancy reflects, at least in part, the nocebo effect : negative expectations, contextual cues and attribution of pre existing symptoms…

…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…

…guidelines of the Swedish Society of Anaesthesiology and Intensive Care Medicine (SFAI), together with the antidotes. Material for immobilisation: a shoulder sling, a dorsal backslab…

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…

…calcium channel blocker. Clevidipine is highly selective for vascular smooth muscle cells and has little or no effect on myocardial contractility or conduction. Clevidipine reduces…

…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…

…and venous filling may be reduced. Other possible findings include muscle stiffening and loss of deep tendon reflexes. Pulses are absent distal to the obstruction…

…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…

…contraction is called circumferential shortening (Figure 2C). Figure 2A 2C. The orientation of myocardial muscle fibers results in longitudinal, radial and circumferential shortening (contraction). Longitudinal…

…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…

…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…

…38% Pooled analyses across different background therapies 17%–25% In patients with atherosclerotic vascular disease or familial hypercholesterolaemia, addition of bempedoic acid to statin therapy…

…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…

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…

…accounting for approximately 80% of cases. Other causes include acute mechanical complications—particularly ventricular septal defect (VSD) and papillary muscle rupture with acute severe mitral…

…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…

…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…

…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…

…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…

…dilation. Atrial dilation causes a significantly increased risk of atrial fibrillation. The increase in left atrial pressure may also propagate backward to the pulmonary circulation…

…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…

…are common in myocardial ischemia and infarction. These conditions may be seen as signs of ischemia, which is why one must be familiar with them…

…in particular that exceeds the patient's normal variation and requires a change of treatment. Common precipitants are viral infection, bacterial infection and air pollution…

…Creatinine is a late marker of function and may rise only after a substantial fall in glomerular filtration. The value is affected by muscle mass…

…of breathing Accessory muscle use Cyanosis, exhaustion, hypotension or collapse The classification is based on a combination of clinical findings, oxygenation and objective measurement of…

…apply to the anti inflammatory effect. They say nothing about the mineralocorticoid effect or about suppression of the HPA axis, where a long half life…

…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…

Procedurer The value of the exercise test lies not in ST depression alone but in the overall picture : exercise capacity, symptoms, blood pressure response, heart…

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

…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…

…discontinuation of medication may become appropriate. Frailty is potentially reversible. Management should therefore include consideration of treatable contributors, such as underlying comorbidities, supervised muscle strengthening…

…anxiety Depression or psychological distress Loss of confidence in resuming normal activity Difficulty returning to work or recreational exercise Frailty or loss of muscle mass…

…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…

…develop through papillary muscle displacement, annular dilatation, or both; progressive ventricular remodeling may also occur in primary valvular disease. Increasing severity of mitral regurgitation is…

…promote atherosclerosis. The principal anatomical distributions are: Abdominal aorta and iliac arteries, involved in approximately 30% of symptomatic patients. Femoral and popliteal arteries, involved in…

…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…