…raised outside it — associated with the same risk as manifest hypertension. Non dipping: a nocturnal fall in pressure of < 10% of the daytime value…

…are two different treatments with different physiology, and the commonest source of error is confusing them. CPAP delivers a constant pressure that recruits alveoli and…

…renal function further increases blood pressure. Non traditional cardiovascular mechanisms include: Uraemia associated inflammation Oxidative stress Vascular dysfunction Promotion of vascular calcification Albuminuria and proteinuria…

…altitude sickness Aspiration Chronic obstructive pulmonary disease (COPD) Bronchospasm (asthma) Other : Coma Central hypoventilation syndromes Neuromuscular diseases Anemia The natural course of asphyxia Should ventilation…

…induce vasoconstriction and raise the mean arterial pressure (MAP). Inotropes increase myocardial contractility. There are several synthetic and endogenous agents with inotropic and vasopressor effects…

…most common risk factor for PH. It produces postcapillary PH through elevation of left atrial and pulmonary venous pressure. In some patients, chronic postcapillary pr

…competing risk of death from non cardiovascular causes, an important consideration in older populations. Risk prediction is particularly relevant in adults with elevated blood pressure …

…with tamponade has an exceptionally poor prognosis. In the vast majority of these cases, the tamponade develops acutely or subacutely. It is uncommon for chronic…

…for pain). An opioid is rarely the right choice in nociplastic or neuropathic pain, in chronic non cancer pain, or in headache. A failure to…

…with previous myocardial infarction and residual inflammation, defined by hsCRP ≥2 mg/L, it produced a modest reduction in a composite of cardiovascular death, non…

…a greater burden of cardiovascular and non cardiovascular comorbidity than patients with reduced EF. Pathophysiology Abnormal ventricular relaxation and increased filling pressures The central hemodynamic…

…evidence of ischaemia represents acute myocardial injury rather than MI. Persistent elevation without a significant dynamic change is consistent with chronic myocardial injury. Non ischaemic…

…threatening; reported in hospital mortality was 42.4% for STEMI associated mechanical complications and 18% for those associated with NSTEMI. The timing of VSR, free…

…The absence of symptoms indicates that the bradycardia is compensated by an increase in stroke volume. Symptomatic bradycardia may present with chronic or acute symptoms…

…from selected populations, frequently with low or intermediate ischemic risk and under representation of patients with STEMI or other very high risk features. Noninferiority studies…

…when other therapeutic options cannot be pursued. Patients receiving digoxin may present with symptoms of digitalis toxicity, which manifests across multiple organ systems. Non cardiac…

…Coronary pressure assessment is consequently recommended to complement ICA, particularly for intermediate non left main coronary stenoses. Myocardial ischaemia may occur despite the absence of…

…the heart cannot provide blood flow commensurate with the body’s requirements, or can do so only at the expense of abnormally high filling pressures…

…presentation and other findings. A reduced CFR may occur with angiographically insignificant epicardial disease because of abnormalities in the coronary resistance vessels. Left ventricular hypertrophy…

…and with a measurement interval of no more than 30 minutes throughout the 24 hours. Phenotype Office blood pressure ABPM : : : Normotension Normal Normal White coat…

…risk of cardiovascular diseases, such as stroke, and mortality. Stability : MAP readings tend to be more accurate than systolic blood pressure when using non invasive…

…conventional hypertension threshold. The traditional diagnostic threshold of 140/90 mmHg derives from epidemiological observations associating pressures above this level with increased mortality. Contemporary management…

…all adults with confirmed hypertension, defined in the cited recommendation as blood pressure ≥140/90 mmHg. Screening is particularly pertinent in the presence of hypokalaemia…

…Indications Hypertensive crisis. Mechanism of action Phentolamine is a non selective alpha adrenergic blocker. Phentolamine reduces blood pressure while increasing catecholamine activity. Effects Primarily causes…

…blood pressure elevation accompanied by acute hypertension mediated target organ damage (HMOD). The European definition uses BP ≥180/110 mmHg with acute HMOD, although other…

…clinical encounters improves detection of risk factors such as elevated blood pressure and lipid abnormalities. CAC should therefore be integrated with clinical assessment and established…

…rate response, blood pressure changes, ECG changes, arrhythmias, and exercise (functional) capacity. Functional capacity is a strong predictor of both cardiovascular and overall mortality, offering…

…distal pressure × hyperemic mean transit time — isolates microvascular resistance. Only indices that detect microvascular disease as an independent cause of ischemia, including with non obstructive…

…acute stroke to identify large vessel occlusion, dissection or other vascular pathology CT perfusion Used with an unclear time of onset, a late time window…

…major surgery and intensive care [1,2]. The condition is associated with falls, aspiration, pressure sores, loss of function, longer length of stay, institutional care…

…before producing haemodynamic compromise. As intrapericardial pressure rises, the right atrium and right ventricle are compressed, with elevation of their diastolic pressures. Right sided filling…

…The emergency evaluation of non traumatic chest discomfort is structured around three principal diagnostic categories: Myocardial ischaemia , particularly acute coronary syndrome (ACS). Other cardiopulmonary causes…

…of multiple modest dietary changes. Mediterranean type diets provide polyphenols from extra virgin olive oil, fruits, vegetables, nuts and legumes; unsaturated fatty acids and other…

…with palpation is often indicative of a noncardiac source [4]. 3. Pneumonia with Pleurisy Pain Characteristics: Pleuritic pain is a common presentation [2]. 4. Other…

…oxidative stress. Metabolic dysfunction associated fatty liver disease affects approximately 10% of non obese individuals and up to 65% of patients with metabolic syndrome. A…

…systolic blood pressure, non HDL cholesterol, diabetes, body mass index, and current smoking—account for more than half of the population attributable risk of cardiovascular…

…the other arm. 2. Ankle pressure. Place the cuff just above the malleoli, with its lower edge about 2 cm above the tip of the…

…chance of success by counteracting vascular spasm. Pressure monitoring set: stiff, short tubing, a transducer, and a flush system with physiological saline in a pressure…

…before shunt surgery. Contraindications Clinical signs of herniation — deep unconsciousness with unreactive pupils, an altered breathing pattern, a rising blood pressure with bradycardia. A known…

…immediately available as a precaution. Dosage of vernakalant Vernakalant is dosed by body weight, with the maximum dose based upon 113 kg. Normal dilution: 4…

…unexplained drop in arterial pressure. Silent or unrecognized infarction occurs more often in patients without antecedent angina and in those with diabetes and hypertension. Of

…R. Open chest versus closed chest cardiopulmonary resuscitation in trauma patients with signs of life of life hospital arrival upon arrival: a retrospective multicenter study…

…remain consistent with those used for non pregnant adults. The fetus is not harmed by defibrillation, amiodarone, or adrenaline (epinephrine). In the event of a…

…normal blood pressure (normotension). Combination therapy with multiple antihypertensives is often necessary to normalize blood pressure. Management of hypertension requires careful consideration of other cardiovascular…

…of increasing coronary blood flow. In circumstances with non shockable rhythm or with prolonged periods of VF (fine VF resistant to defibrillations), the purpose of…

…plasmapheresis or other extracorporeal therapy (requires a large bore dialysis catheter, not an ordinary triple lumen catheter). Measurement of central venous pressure and central venous…

…maximal oxygen or non invasive ventilation. Inadequate ventilation with a rising pCO₂ and respiratory acidosis, or a markedly increased work of breathing with impending exhaustion…

…completely. Relative contraindications: A high risk of aspiration: a non fasted patient, ileus, third trimester pregnancy, marked reflux. A need for high airway pressures, for…

…an exact estimate of blood loss [1]. Strong indications for activation Ongoing bleeding with haemodynamic instability, for example a systolic blood pressure below 90 mmHg…

…the first instance. Give small boluses, for example 250 to 500 mL, with immediate reassessment of the blood pressure, pulse, peripheral perfusion, mental state and…

…table below shows a systematic history taking in patients presenting with chest pain (chest discomfort) or other symptoms suggestive of the five conditions listed above…

…Coimbra R. Open chest versus closed chest cardiopulmonary resuscitation in trauma patients with signs of life upon hospital arrival: a retrospective multicenter study. Crit Care…

…capacity, stress testing also provides information on electrocardiographic (ECG) reaction, the occurrence of arrhythmias, symptoms, physiological reactions (blood pressure, heart rate) during and after exercise…

…of synchronized electric shock (i.e. a shock synchronized to the QRS complex). Typically used to treat atrial fibrillation, ventricular tachycardia, and other tachyarrhythmias with…

…without a definite diagnosis. Choice of technique Diagnostic question Method Comment : : : Pigmented lesion, suspected melanoma Excision with a 1–3 mm margin, down into the…

…with carotid stenosis have no focal neurological symptoms. Asymptomatic disease may be discovered during targeted duplex ultrasound (DUS), pre operative assessment, or evaluation of other…

…is associated with increased sudden death risk, particularly in individuals younger than 35 years during or after vigorous exercise. Anomalous origin of the left coronary…

…of dynamic LV function, valve disease, pulmonary pressure, or haemodynamics Stress imaging is not recommended in patients undergoing urgent non cardiac surgery or those with…

…gradient. Pathophysiology of aortic stenosis As aortic stenosis progresses, pressure conditions on the left side change dramatically, including in the left ventricle, left atrium, aorta…

…pressure (manifests with sinus bradycardia and hypertension). Hypothyroidism . Hypothermia . Hyperkalemia . ECG example of sinus bradycardia Figure 1 shows sinus bradycardia at a paper speed of…