…not eGFR relative to 1.73 m². Recalculate in patients who are markedly larger or smaller than average. Higher doses may be required in the…

…does not display ST segment elevations during posterior (posterolateral) transmural ischemia. On the other hand, leads V1–V3 (occasionally V4) may detect the injury currents…

…ECG and clinical examination, blood tests and other radiological examinations are most often required, in particular computed tomography (DT) and/or magnetic resonance imaging (MRI…

…sector is created using sequential activation of the piezoelectric crystals. The crystals are activated from one side to the other, as illustrated in Figure 2…

…pseudoaneurysm Surgeon, ultrasound first Other situations that argue for the operating theatre rather than the emergency room: a very large or deep abscess, a markedly…

…Previous pelvic irradiation on the intended side (yields fibrotic, unrepresentative marrow — choose the other side). A patient who cannot lie still — plan for sedation rather…

…a sufficient effect. Contraindications Absolute: Cellulitis, a skin wound or other infection over the injection site. Bacteraemia or suspected septic bursitis or arthritis. A joint…

…tamponade with a relatively small volume, whereas a slowly enlarging effusion may reach a much larger size before producing haemodynamic compromise. As intrapericardial pressure rises…

…37 Haemodynamic complications 0.26 Cardiac chamber perforation 0.03 Other complications 0.28 Total major complications 1.70 In another large diagnostic catheterization analysis…

…reduction required is greater than can reasonably be obtained with a statin alone but does not necessarily require the larger effect of a PCSK9 inhibitor…

…Other causes include acute mechanical complications—particularly ventricular septal defect (VSD) and papillary muscle rupture with acute severe mitral regurgitation—predominant right ventricular (RV) infarction…

…and increased thrombin generation. The clinical consequence of this triad is severe: cardioembolic strokes associated with AF are typically larger, present with more severe neurological…

…fascicular block, the myocardium without fascicular supply will depend on impulses spreading from other parts of the ventricle (where the fascicle is intact). Figure 1…

…QRS complex. Two artifacts are seen if both chambers are paced. The stimulation artifact is larger in unipolar pacing, as compared with bipolar pacing. The…

…stenoses in the left main stem or proximal left anterior descending artery are more likely to affect flow because they supply a larger myocardial territory…

…wave, it is still referred to as a QRS complex . In other words, if ventricular depolarization only generates a Q wave and an R wave…

…This is referred to as refraction . The larger the difference in acoustic impedance the greater the refraction. Refraction artifacts occur when ultrasound travels through tissue…

…wave Normal variants V2–V3 ≥0,02 s or QS complex None All other leads ≥0,03 s and ≥1 mm deep (or QS complex…

…lead ECG does not display ST segment elevations during posterolateral transmural ischemia. On the other hand, leads V1–V3 (occasionally V4) may detect the injury…

…Familial and genetic screening in cardiovascular medicine is the systematic assessment of relatives and other individuals who may carry an inherited predisposition to cardiovascular disease…

…anterior descending and left circumflex coronary territories. Because these vessels perfuse a large proportion of the left ventricular myocardium, left main disease carries a substantial…

…or arteries supplying the limbs. In adults over 40 years of age, atherosclerosis is the predominant cause. Other mechanisms include thrombosis, embolism, vasculitis, fibromuscular dysplasia…

…most cardiac conditions may be associated with atrial flutter. As compared with several other supraventricular tachyarrhythmias, atrial flutter does not occur among otherwise healthy individuals…

…occurs in LVH. Deep S wave in V5 or V6 ( 6 mm) Large RS complexes in multiple leads P pulmonale Figure 1. ECG changes seen…

…acute coronary syndromes. The LMCA supplies a large myocardial territory through the left anterior descending (LAD) and left circumflex (LCx) arteries (Figure 1). Acute obstruction…

…dangerous differential diagnoses [1,2]. STEMI and other ECG patterns suggesting acute coronary occlusion are time dependent conditions. The decision on immediate reperfusion is based…

…because cardiometabolic risk appears at a lower BMI. BMI is misleading in athletes with a large muscle mass, in older people with lost muscle mass…

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

…10 mm. At 50 mm/s a small square (1 mm) corresponds to 20 ms and a large square (5 mm) to 100 ms. Intervals…

…the only absolute indication, and always urgent. A large pericardial effusion with symptoms despite medical treatment. Diagnostic drainage in suspected purulent pericarditis, tuberculosis or malignancy…

…containing lipoproteins, including: LDL Intermediate density lipoprotein (IDL) Lipoprotein(a) [Lp(a)] Very low density lipoprotein (VLDL) Chylomicrons and other triglyceride rich particles Thus, non…

…injury have not generally demonstrated sufficient clinical benefit for routine use. No reflow may also occur in association with other procedural complications, including distal embolization…

…the leads. Some leads may display all waves, whereas others might only display one of the waves. Regardless of which waves are visible, the wave…

…Thus, the formula yields how large (%) the increase in heart rate was in relation to the expected increase. The cut off for chronotropic incompetence is…

…used for dosing, not the value normalised to body surface area — the difference is substantial in very small and very large people. Acute kidney injury…

…the work of breathing, the peripheral perfusion and the signs of shock 2 Two large bore peripheral cannulae. Consider an arterial line if the patient…

…LVEF), measured by echocardiography. Reduced LVEF reliably identifies a high risk group that derives a large, trial proven survival benefit from primary prevention ICDs. Its…

…Dyslipidaemia, cigarette smoking, hypertension, diabetes mellitus and other adverse influences disturb these functions. The resulting endothelial dysfunction promotes inappropriate vasoconstriction, adhesion of circulating cells, inflammatory…

…vegetables, nuts and legumes; unsaturated fatty acids and other bioactive compounds from nuts; and antioxidant and antithrombotic constituents from whole grains. These combined effects may…

…tissue prolapse, thrombus, or other acute complications; investigation of restenosis and stent thrombosis. Intravascular imaging may also clarify the mechanism of an acute coronary syndrome…

…coronary occlusion. Plaque rupture typically involves a thin, collagen poor fibrous cap overlying a large lipid core with many macrophages, resulting in a red, fibrin…

…relieve pressure on the major vessels. A large uterus exerts pressure on the descending aorta and vena cava inferior . The pressure in the vena cava…

…on the coronary arteries. The tumors can be asymptomatic for a long time and be detected randomly when investigating other conditions. More dramatic onset of…

…Medium defects : 10–20% of the myocardium. Large defects : 20% of the myocardium. Perfusion defects are further classified based on the intensity of tracer uptake…

…The ECG reaction is indeed important but several other parameters are equally important. In fact, a large body of evidence demonstrates that the strongest predictor…

…delays were at particularly high risk of death due to arrhythmias. Note that other causes of wide QRS complex must always be considered. For example…

…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…

…of these have atherosclerotic heart disease (coronary artery disease) as the underlying cause. Other common causes are cardiomyopathy (hypertrophic or dilated), arrhythmogenic right ventricular cardiomyopathy…

…CT angiography The standard investigation in acute stroke to identify large vessel occlusion, dissection or other vascular pathology CT perfusion Used with an unclear time…

…is which change can explain the pH, and whether the other variable lies within the expected range of compensation. Sample type and baseline values An…

…3 mm, long stent length Large thrombotic burdens increase procedural risk because thrombus can fragment, embolize to other coronary branches or vascular beds, propagate through…

…women, respectively, should be considered abnormal. A common cause of abnormally large T waves is hyperkalemia, which results in high, pointed and asymmetric T waves…

…myocardial oxygen supply and demand. In many cases, the initiating process is plaque disruption with thrombosis; other cases result from spasm, microvascular dysfunction, embolism, dissection…

…should only be used if other methods fail to open the airway. Figure 1. Methods to open the airway. No large study has compared oropharyngeal…

…The classical signs of cardiac tamponade are hypotension, muffled heart sounds and jugular venous distention. Other frequent symptoms are pulsus paradoxus, pericardial friction sounds, tachycardia…

…Typical appearance. Note the paper speed 50 mm/s (1 large box equals 100 ms). The impulse discharged from an ectopic focus in the ventricles…

…be classified as inappropriate sinus tachycardia. This diagnosis can only be established after all other causes have been ruled out. Inappropriate sinus tachycardia is presumably…

…ultrasound transducer contains several components. The transducer contains acoustic insulation that ensures that no other sound waves affect the transducer. The crystals are supported by…

…within about 1 hour (a liquid preparation) or 2 hours (tablets). With very large quantities of an extremely toxic preparation, lavage can be discussed later…

…atrial appendage, although competing mechanisms such as large artery atherosclerosis and small vessel disease may also contribute to stroke in patients with AF. Stroke risk…