…35, 40 or 50 % Gives a fixed, known FiO2 independently of the patient's breathing pattern. The first choice where there is a risk of…

…the left ventricle receives the depolarizing impulse from the right ventricle (where the pacemaker delivers the pulses). The depolarizing wave spreads outside the conduction system…

…Mural: flattened, fixed, and closely adherent to the endocardial surface. Protruding or mobile: extending into the ventricular cavity, sometimes with independently mobile components. Although a…

…site The left lower quadrant is the first choice : the abdominal wall is thinner there than on the right, and the descending colon is fixed…

…principle of titration is abandoned — when a fixed dose is given without assessment, when a modified release preparation is started in an opioid naive patient…

…ischaemia and to estimate prognosis in patients with suspected or established coronary artery disease (CAD). It combines echocardiographic assessment of left ventricular (LV) structure and…

…course, distribution, or termination of the coronary arteries. They include anomalous aortic origin of a coronary artery (AAOCA), coronary fistulae, and myocardial bridging. Although many…

…generally indicates a more favourable course than VA accompanied by severe fixed lesions. Nevertheless, patients who develop serious arrhythmias during spontaneous episodes represent a higher…

…mechanisms that increase myocardial oxygen demand include sustained tachyarrhythmia and severe hypertension, with or without left ventricular hypertrophy. In patients with stable known or presumed…

…with or without left ventricular hypertrophy. Among patients with NSTE ACS undergoing angiography, approximately 10% have no critical epicardial stenosis. In some of these patients…

…They are contraindicated in patients with bronchospastic lung disease, or a history of significant reactive airway disease. Contraindications also include second degree or third degree…

…pulmonic) stenosis Pulmonary stenosis is virtually always a consequence of congenital heart disease. The stenosis can be fixed or dynamic, depending on the underlying etiology…

…cardiovascular medicine. As a primary driver of sudden cardiac death (SCD) and a major cause of morbidity in patients with structural heart disease, VT necessitates…

…a fluid level in the anterior chamber, best seen with the patient sitting up. 3. Ocular movements in all directions; pain on upward gaze may…

…In order to analyze myocardial motion, the ultrasound system must filter out all sound waves reflected by other structures, notably sound waves reflected by blood…

…equations, included in all ultrasound systems, and assume that the geometry of the left ventricle is normal. Figure 1. Calculation of left ventricular mass. mass…

…studies have shown that the majority of patients inappropriately referred to the catheterization laboratory with suspicion of STEMI (STE ACS) have left bundle branch block…

…7]. Etiology and Mechanisms LBBB may result from lesser degrees of conduction delay within the left bundle system in the case of incomplete LBBB [7]…

…Patients may have: Stable angina or an anginal equivalent Exertional dyspnoea or reduced exercise tolerance Acute coronary syndrome Silent ischaemia Heart failure, particularly when left…

…patient not on digoxin treatment 3 Discordant ST T change in a patient on digoxin treatment 1 ECG signs of left atrial enlargement 3 Left…

…may be affected by patient characteristics. For example, exercising patients with ongoing myocardial ischemia may provoke life threatening ventricular arrhythmias. Patients with previous acute coronary…

…from it. AF has important consequences beyond the arrhythmia itself. It may cause symptoms and impaired quality of life, contribute to heart failure, and increase…

…principle Manage the patient, not the list of poisons. Stabilisation according to ABCDE, the plasma glucose, a blood gas and an ECG all come before…

…Extracorporeal Life Support (ECLS) encompasses several extracorporeal systems designed to assist in cases of cardiac or respiratory failure by means of an extracorporeal pump and…

Procedurer The oesophagus runs directly behind the left atrium. An electrode placed in the oesophagus at the right level therefore records atrial depolarisation with an…

…whether the treatment is safe is not the starting dose but the system around the patient : that the weekly dose is adjusted in small steps…

…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…

…contraindicated, for example in asthma Contraindicated in impaired left ventricular function and together with an intravenous beta blocker Digoxin In heart failure or hypotension, or…

…PEF or FEV1 if the patient can manage it without delaying treatment. 10. Call anaesthetics and intensive care early with life threatening features or an…

…Bradycardia in a patient with a normal circulation and no symptoms requires no pacing, only monitoring and preparedness. Asystole with no electrical activity at all —…

…speckle tracking As previously discussed, the left ventricular wall can be subdivided into three layers: the inner lining ( endocardium ), a thick muscle layer ( myocardium ) and…

…not in itself anaphylaxis. The patient must nonetheless be observed, since the reaction can progress. Practical grading There are several grading systems, and no grading…

…informed discussions between clinicians and patients. This is particularly important when considering ICD implantation, as the procedure carries both benefits (life saving therapy) and risks…

…in the fifth decade of life in several family members. Imaging studies did not reveal structural cardiac abnormalities, nor coronary artery disease. Another male patient…

…is appropriate for many patients. Long acting nitrates or ranolazine may be added when symptoms persist or when heart rate, blood pressure, left ventricular dysfunction…

…mechanisms may coexist, diagnosis and classification must integrate haemodynamics with the patient’s clinical context and the results of all relevant investigations. Haemodynamic definition At…

…Clearly, not all DCM genes have been discovered. Genetic testing for DCM Genetic testing of patients with confirmed or likely dilated cardiomyopathy can be recommended…

Echocardiography Hypertrophic cardiomyopathy (HCM): from pathophysiology to echocardiography Hypertrophic cardiomyopathy is a genetic disorder that causes left ventricular hypertrophy under normal loading conditions. Hypertrophic cardiomyopathy…

…preferably two lines in a bleeding patient. A transfusion set with a filter. Blood components must not be given through a set without a filter…

…axis, where a long half life produces more marked suppression. Stress dosing in known adrenal insufficiency A patient with primary adrenal insufficiency (Addison's disease)…

…Relative: Condition Comment : : Left main stenosis Known — perform the test only on a clear indication and with full preparedness Moderate to severe aortic stenosis without…

…Gastric lavage is considered only after a life threatening ingestion of a highly toxic substance, where the patient arrives within about 1 hour (a liquid…

…Requires detailed clinical and angiographic data. Calculation can be complex without dedicated software. May not account for all patient specific factors (e.g., frailty, comorbidities)…

…et al 1 ). Representative single beat morphs for a low risk patient (blue) and the corresponding high risk morph (red). Beyond the difference in R…

…ACE inhibitors have consistently shown benefit for patients with symptomatic LV dysfunction, and all placebo controlled chronic HFrEF trials using neurohormonal antagonists have demonstrated a…

…mm All patients Other leads Greater than or equal to 1 mm These criteria for the other leads apply in the absence of left ventricular…

…used in selected patients with suspected chronic coronary syndrome when the result is expected to influence diagnostic strategy or management. Appropriate objectives include: Measuring exercise…

…The clinical population is heterogeneous because the HFmrEF range includes both patients with recovering systolic function and those with deterioration from a previously preserved LVEF…

…and treatment goals Diabetes, left ventricular function and other comorbidities Surgical risk and contraindications to prolonged dual antiplatelet therapy Patient preferences, local expertise and operator…

…It is also recommended that leads V7, V8 and V9 be connected to the patient, as these leads may reveal the ST segment elevations on…

…underlying cause. It should be considered in every patient with newly diagnosed or referred hypertension, with particular vigilance when the clinical history includes hypokalaemia. Endocrine…

…or right ventricular involvement Pre existing abnormalities such as prior infarction, left bundle branch block, Wolff–Parkinson–White patterns or ventricular pacing STEMI and non…

…not include paradoxical embolism (discussed below) and emboli from the proximal aorta. Stroke and TIA (Transient Ischemic Attack) Ischemic stroke constitutes 87% of all stroke…

…fraction <55%. This implies that left ventricular pumping capacity is reduced and it is synonymous with heart failure with reduced ejection fraction (HFREF ). Average ejection…

…the heart. Therefore, most images in adult TTE are obtained with the patient positioned in the left lateral decubitus position. In this position, the heart…

…during ongoing ventilation (DBD). An intensive care patient in whom a decision has been made to withdraw life sustaining treatment, in whom total brain infarction…

…cannula bridges the gap until conditions are controlled. Contraindications In life threatening conditions all contraindications are relative — but they govern which site is chosen. Infection…

…latter. The treatment is also time limited by its very nature: a patient who has not responded within a couple of hours should be intubated…

…dialysis patient, in severe acute kidney injury, in treatment failure or in ongoing massive potassium release. In cardiac arrest with suspected hyperkalaemia, advanced life support…

…needle itself. It is the decision whether to perform it now or after imaging, how the patient is positioned, which needle is chosen, and that…