…increases cardiac output, and lowers pulmonary artery pressure without increasing myocardial oxygen consumption. The inotropic effect of levosimendan is not affected by the concurrent use…

…Unstable coronary artery disease. Stable angina pectoris. Secondary prophylaxis to prevent recurrence of cerebrovascular diseases, such as: Transient ischemic attacks (TIA). Stroke Contraindications Cross reactivity…

…receptors) and parasympathetic withdrawal. Sinus tachycardia secondary to disease and medications : A wide range of diseases and medications may cause sinus tachycardia; e.g congestive…

…Before investigating secondary causes, pseudo resistance must be excluded. This includes: Poor adherence to antihypertensive treatment White coat hypertension Other contributors to apparently uncontrolled blood…

Myocardial ischemia and infarction Pharmacology & dosing Definition and pathophysiological basis Secondary prevention after myocardial infarction (MI) encompasses long term interventions intended to reduce recurrent infarction…

…effect is relatively limited compared with agents that inhibit other platelet pathways. The distinction between primary and secondary prevention is fundamental: Primary prevention refers to…

…Non HDL C and apoB are secondary targets or risk refining measures, particularly in patients with: Diabetes or other cardiometabolic risk factors Obesity Insulin resistance…

…left ventricular dysfunction, peripheral vascular disease and other manifestations of diffuse atherosclerosis. Percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are revascularization procedures…

…potassium, and resistant to suppression by sodium loading. It is the most common form of secondary hypertension. Aldosterone acts principally through the mineralocorticoid receptor (MR)…

…It identifies patients whose blood pressure remains uncontrolled despite intensive antihypertensive treatment and who therefore require assessment for pseudo resistance, secondary hypertension, treatment related contributors…

…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…

…disease The extent of jeopardized myocardium Left ventricular systolic function Diabetes and other comorbidities Anatomical complexity and completeness of possible revascularization A proximal lesion jeopardizes…

…loss of independence. Identification of PAD also provides an opportunity to recognise atherosclerosis in other arterial territories and to initiate secondary prevention. Clinical assessment should…

…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…

…cardiomyopathy Takotsubo cardiomyopathy Tachycardia induced cardiomyopathy Non compaction cardiomyopathy Peripartum cardiomyopathy Cardiomyopathy secondary to valvular heart disease Long term prognosis varies markedly across these conditions…

…predictors in prediction models. Targeting risk factors has been very successful in the primary and secondary prevention of atherosclerotic cardiovascular disease, both at the population…

…In STE ACS, on the other hand, the ST segment depressions are secondary findings and the primary findings are the ST segment elevations. As explained…

…Definition and Pathophysiology Angiotensin converting enzyme (ACE) inhibitors are foundational therapies in cardiovascular medicine, widely utilized for the management of hypertension, chronic ischemic heart disease…

…Its cardiovascular effects therefore appear to reflect modulation of vascular inflammation rather than lipid lowering. Other anti inflammatory strategies have produced less favourable results. Canakinumab…

…and other bioactive compounds from nuts; and antioxidant and antithrombotic constituents from whole grains. These combined effects may improve inflammation, insulin resistance, glucose metabolism, hypertension…

…rate or decreasing blood pressure, making it a consideration for patients with low blood pressure secondary to a low cardiac output. Its primary clinical utility…

…block causes substantial changes in left ventricular depolarization and repolarization, which result in secondary ST T changes. Such ST T changes may mimic (simulate) or…

…the signal disappears, deflate slowly (2 mmHg/s) and note the pressure at which the signal returns. Repeat on the other arm. 2. Ankle pressure…

… 2. Is there cirrhosis, or another strong suspicion of portal hypertension? Variceal and ulcer bleeding are managed differently from the first minute. Peptic ulcer remains…

…unnecessary unless the cardiac output is inadequate, hypotension is present, or secondary arrhythmias result from the slow rate. In the setting of bradyarrhythmic or asystolic…

…who were unable or unwilling to take statins. Approximately 70% were in secondary prevention and 30% in primary prevention; 23% were taking a small dose…

…or other vascular disease. A history of myocardial infarction or raised cholesterol among relatives. The presence of tendon xanthomas, corneal arcus and xanthelasma. Potential secondary…

…depression). As mentioned above there are numerous other conditions that affect the ST T segment and it is fundamental to be able to differentiate these…

…depolarization will consequently lead to abnormal repolarization. This explains the secondary ST T changes seen on premature ventricular complexes; the ST T vector will be…

…to 40 beats per minute and the rhythm is regular. There is always secondary ST T changes, meaning that the ST T segment is discordant …

…electrolyte imbalances are clinically negligible (from an electrophysiological standpoint), whereas others may be life threatening. The most common and clinically most relevant electrolyte imbalances concern…

…of ischemia (but the sensitivity is low). U wave changes always accompany other ischemic ST T changes. They may occur in both NSTEMI and STEMI…

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

…administration, warnings, precautions, and other relevant information for the drug Ticagrelor . Table 1 Summary Indications Ticagrelor, in combination with acetylsalicylic acid (ASA), is indicated for…

…heritable aortopathies, selected congenital heart diseases, pulmonary arterial hypertension and thromboembolic disorders. Most recognised heritable cardiovascular conditions demonstrate autosomal dominant transmission, in which an affected…

…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…

…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…

…drugs . The diagnosis rests on the history, a positive Dix–Hallpike test and the absence of other neurological findings. The treatment is a repositioning manoeuvre…

…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…

…or recent cerebral ischaemia; known CAD, PAD, or other atherosclerotic disease; diabetes and other cardiovascular risk factors; smoking, hypertension, hypercholesterolaemia, and sedentary behaviour; family history…

…structured around three principal diagnostic categories: Myocardial ischaemia , particularly acute coronary syndrome (ACS). Other cardiopulmonary causes , including myopericardial disease, pulmonary embolism, aortic emergencies, and pneumothorax…

…Study, which demonstrated that high blood pressure and high cholesterol levels, among other risk factors, were strongly associated with coronary artery disease and myocardial infarction…

…syndrome (ACS), DAPT is used to reduce recurrent myocardial infarction, stent thrombosis and other ischemic events after coronary angiography, percutaneous coronary intervention (PCI), or medical…

…kidneys, or other vascular beds. Malignant hypertension represents an extreme form in which acute microvascular injury occurs, classically involving fibrinoid necrosis of small arteries in…

…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…

…when recording during chest pain is not consistent with myocardial ischemia. In other words, chest pain caused by ischemia will always result in ischemic ST…

…two different sets of piezoelectric crystals; one set for sending ultrasound and the other for analyzing reflected sound waves. The cardinal difference between continuous wave…

…radiotracers emit positrons. When a positron collides with an electron, they annihilate each other, producing two gamma photons emitted in opposite directions. PET scanners detect…

…1 A ). Concave ST segment elevations, on the other hand, are much less likely to be caused by ischemia ( Figure 1 B ). This is noted…

…atrial impulses are conducted to the ventricles. The atria and the ventricles are electrically dissociated from each other. This condition is referred to as atrioventricular…

…and without compressing the skin. Ratios and other measurements Measurement Calculation Threshold : : : Waist–hip ratio Waist / hip Men 0.90, women 0.85 = abdominal…

…target Doses in venous thromboembolism Treatment doses in deep vein thrombosis and pulmonary embolism differ from the atrial fibrillation doses and include an initial high…

…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…

…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…

…margin must be included in the freeze. Contraindications Absolute: Suspected melanoma or any other pigmented lesion of uncertain diagnosis. A lesion in which histology is…

…block without pacemaker protection. Asthma and other marked obstructive airways disease — relative; the risk of bronchospasm is real. Hypotension and haemodynamic instability. Respiratory compromise during…

…then 100 mg × 1 5–7 days Epiglottitis and other severe upper airway infection cefotaxime 1–2 g × 3 IV Depends on the diagnosis Always…

…progressive acute target organ damage. Common manifestations are hypertensive encephalopathy, intracerebral haemorrhage, acute coronary syndrome, acute left ventricular failure with pulmonary oedema, acute aortic syndrome…

…alcohol, a missed meal, physical activity and any other precipitating factor. Thresholds The thresholds below are used above all in diabetes. The severity of the…