…s outcome: Neurological injury Myocardial dysfunction Systemic response to reperfusion and ischemia Effects of the underlying cause of cardiac arrest Neurological injuries may cause coma…

…pulmonary disease (COPD) Bronchospasm (asthma) Other : Coma Central hypoventilation syndromes Neuromuscular diseases Anemia The natural course of asphyxia Should ventilation be entirely inhibited (as seen…

…pronounced symptoms and other therapies have failed. Patients with structural heart disease or reduced left ventricular function are not eligible. Effects of propafenone and flecainide…

…therapies in cardiovascular medicine, widely utilized for the management of hypertension, chronic ischemic heart disease, heart failure with reduced ejection fraction (HFrEF), and post myocardial…

…drinking in either sex. Other definitions of unhealthy drinking include at least two drinks daily in women or three in men, or at least four…

…methods may also contribute. The cardioprotective effect is therefore likely to result from the cumulative influence of multiple modest dietary changes. Mediterranean type diets provide…

…durability of the response is central to its clinical use. After the initial treatment phase, administration is required only twice annually. This may reduce the…

…with avoidance of second hand smoke and, where possible, other inhaled nicotine products. In cardiovascular medicine, the objective is not merely to reduce cigarette consumption…

…conventional risk factors have sex dependent effects: Blood pressure rises more steeply in women from young adulthood, resulting in a greater lifetime burden of hypertension…

…Interactions Pharmacodynamic interactions Anticoagulants, thrombolytics, or other platelet aggregation inhibitors: Salicylates inhibit platelet function and enhance the effect of anticoagulants, increasing bleeding risk. Monitor coagulation…

…not developed for routine coronary prevention because of fatal infections and high cost. Low dose methotrexate did not reduce cardiovascular outcomes, and several other agents…

…the duration of the tachyarrhythmia, the greater the risk of cardiomyopathy. Pathophysiology Prolonged tachyarrhythmias lead to the following hemodynamic effects: Tachyarrhythmia results in reduced preload…

…these direct effects, adenosine antagonizes catecholamine stimulated adenylate cyclase. This inhibition decreases the accumulation of cyclic adenosine monophosphate (cAMP), which in turn reduces the L…

…all cause mortality. The excess risk is mediated by the combined effects of hyperglycaemia, hypertension, dyslipidaemia, obesity, smoking and other conventional risk factors, together with…

…characterized by reduced physiological reserve and increased vulnerability to adverse outcomes. It is dynamic and may improve or worsen with illness, treatment, or other interventions…

…Lathundar Key messages Two things set the COPD exacerbation apart from many other causes of acute dyspnoea: oxygen must be titrated cautiously and the blood…

Echocardiography The Doppler effect When sound waves hit objects some of the sound waves are reflected back to the sound source. If the reflector (i…

…pacemaker therapy. Treatment of AV block in the acute setting Treatment in the acute setting is directed at managing bradycardia and reduced cardiac output. Bradycardia…

…tracer uptake plateaus. This saturation effect can lead to an underestimation of blood flow in regions affected by significant coronary artery disease, potentially resulting in…

…dose , titrated against clinical effect. 2. Parenteral thiamine early , preferably before or at the same time as carbohydrate administration. 3. Rapid identification of seizures, delirium…

…aggregation. Because aspirin affects only one pathway of platelet activation, its antiplatelet effect is relatively limited compared with agents that inhibit other platelet pathways. The…

…of revascularization Expected effects on death, myocardial infarction and stroke Likelihood of repeat revascularization Symptom burden and treatment goals Diabetes, left ventricular function and other…

…Hemodynamic effects of cardiac tumors The hemodynamic effect of the tumor depends on its size and location. Tumors can reduce cardiac output by causing obstruction…

…the bleeding risk of the procedure and by renal function. In markedly reduced renal function (dabigatran at eGFR <30 mL/min, the other DOACs at…

…myocardial contractility and heart rate. Coronary compression and a Venturi or “suction” effect have been proposed as mechanisms of inducible ischaemia. The functional impact depends…

…of premature atherosclerotic cardiovascular disease (ASCVD), particularly coronary artery disease (CAD). FH results from pathogenic variants affecting proteins in the hepatic LDL receptor pathway. Reduced…

…patients with impaired renal function, reflecting both reduced clearance and the high prevalence of structural heart disease in this population. Obesity is associated with lower…

…Other mechanisms include thrombosis, embolism, vasculitis, fibromuscular dysplasia, arterial entrapment, cystic adventitial disease and trauma. Atherosclerotic PAD is a manifestation of systemic arterial disease rather…

…the concurrent use of beta blockers. The vasodilating effect reduces preload and afterload, further reducing myocardial workload. 1 The pharmacokinetic profile of levosimendan is modulated…

…interventions intended to reduce recurrent infarction, ischaemic stroke, cardiovascular death, and progression of atherosclerotic disease in patients with established coronary or other atherosclerotic vascular disease…

…in the context of the clinical presentation and other findings. A reduced CFR may occur with angiographically insignificant epicardial disease because of abnormalities in the…

…arrhythmic effect as well), which is why clinicians mostly choose rate control. Both rate and rhythm control reduce morbidity, and mortality and improve quality of…

…gaze palsy — that can be assessed before and during the window of effect. The muscarinic effect may at the same time produce marked bradycardia and…

…Only clinical signs of herniation halt the puncture, and antibiotics and a corticosteroid are then given immediately after blood cultures. For questions other than acute…

…regards to their effects and hazards. For example, high HDL cholesterol levels appears to be beneficial, whereas triglyceride levels seem to be of little or…

…have hemodynamically significant right ventricular infarction. Hemodynamic effects of right ventricular infarction include low cardiac output, hypotension, sensitivity to drugs that reduce preload (nitrates, morphine…

…acid reduced this composite outcome by approximately 13%: Hazard ratio: 0.87 95% confidence interval: 0.79–0.96 P = .004 Other summaries of…

…eGFR of 30 40 mL/min for lower urinary tract infection. At an eGFR <30 mL/min the antibacterial effect is lost. Dosed independently of…

…serum concentration. Alkalinisation increases renal elimination several fold and at the same time reduces the passage of salicylate into the central nervous system. Contact your…

…and infarction Myocardial ischemia: cellular changes, ECG signs and development of infarction Like all other cells in the human body, cardiac myocytes use ATP (adenosine…

…treatment — modification of loading, eccentric exercise, an NSAID, an orthosis — has not given a sufficient effect. Contraindications Absolute: Cellulitis, a skin wound or other infection…

…Its principal clinical effect is therefore reduction of LDL cholesterol (LDL C), through a mechanism complementary to that of statins. Statins reduce hepatic cholesterol synthesis…

…repeated cycles of transient ischemia induce the protective effect. Some studies (including randomized clinical trials) have suggested the benefit of ischemic preconditioning, while other studies…

Cardiology Continous medical discussion: the ECG blog Infectious diseases Cardiovascular effects of COVID 19 Coronavirus disease 2019 (COVID 19) has caused a global public health…

…often necessary to normalize blood pressure. Management of hypertension requires careful consideration of other cardiovascular risk factors and coexisting conditions. Therapy must be tailored to…

…is not an established drug interaction. The half life of adenosine is 8 seconds. Adverse effects are therefore very brief. Indications Paroxysmal supraventricular tachycardia (PSVT…

…This is also a normal finding. Abnormal (pathological) causes of sinus bradycardia In all other situations, sinus bradycardia should be regarded as a pathological finding…

…effects, and the condition is classified as cardiac tamponade. The classical signs of cardiac tamponade are hypotension, muffled heart sounds and jugular venous distention. Other…

…hypertensive emergency. It summarises the mechanism of action, the onset, the duration of effect, the dosing, the adverse effects and the important precautions. A hypertensive…

…true bradyarrhythmic or asystolic arrest from other tachyarrhythmic events. On the surface electrocardiogram, sinus bradycardia may appear at rates of 40 to 48 beats per…

…macrophages, neurons and other tissues. This distribution helps explain why PA produces cardiovascular injury beyond its effects on blood pressure and potassium balance. The principal…

…from the combined effects of contrast exposure and other ischaemic or nephrotoxic stresses. The kidney is particularly vulnerable to toxic injury because of its high…

…These sympatho inhibitory effects decrease serum norepinephrine levels, plasma renin levels, and potentially aldosterone levels. Clinical Presentation and Symptoms In the management of heart failure…

…in the myocardium. The electrical potential difference exists between ischemic and normal myocardium and it results in displacement of the ST segment. The ST segment…

…all other situations, sinus arrest/pause should be considered abnormal, and the following differential diagnoses are at hand: Sinus node dysfunction. Side effects of drugs…

…S Ca 2+ 2.6 mmol/L In approximately 90% of cases, hypercalcemia is attributed to primary hyperparathyroidism or neoplastic etiologies. Other causes include immobilization…

…TdP is well defined for many of these agents, many are classified as QT prolonging solely based on their drug class or presumed pharmacodynamic effects…

…of blood flow. However, the Doppler effect can also be used to study myocardial motion. Myocardial motion during systole and diastole alter the frequency of…

…less than 80% diagnoses chronotropic incompetence) Management of chronotropic incompetence Treatment of chronotropic incompetence and other bradyarrhythmias are discussed in the chapter Treatment of bradyarrhythmias.

…Ultimately, the specificity of exercise stress testing is lower in the elderly, as compared to younger individuals. Sensitivity, on the other hand, appears to be…