Cardiology Clinical medicine Definition and pathophysiology Peripheral artery disease (PAD) is a clinical disorder caused by stenosis or occlusion of the aorta or arteries supplying…

…arteries. It frequently coexists with left main coronary artery disease, diabetes mellitus, left ventricular dysfunction, peripheral vascular disease and other manifestations of diffuse atherosclerosis. Percutaneous…

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

…peripheral vasoconstriction, impaired consciousness, a rising lactate or a worsening acidosis. An assessed need for at least 4 units of red cells within 1 hour…

…of long term outcomes after revascularization. It incorporates both anatomical (from the original SYNTAX Score) and clinical variables (e.g., age, sex, renal function, left…

…risk of rapid deterioration. Intraosseous access: Cardiac arrest where venous access is not immediately available. Shock, severe trauma, burns or status epilepticus when peripheral access…

Procedurer The ankle brachial index is the cheapest and most accessible method of objectively demonstrating peripheral arterial disease, and it is needed more often than…

…decreases total peripheral resistance, decreases systemic blood pressure, and decreases afterload. Nicardipine has antianginal and antihypertensive effects. Time to onset of action 5 to 15…

…a medical emergency in which prompt recognition, specialist assessment and restoration of perfusion are essential. The abrupt arterial obstruction may result from progression of peripheral…

…hypercholesterolaemia, and sedentary behaviour; family history, particularly in the broader assessment of peripheral arterial and aortic disease; planned surgery, especially carotid endarterectomy (CEA), coronary artery…

…advanced from a peripheral artery to the aortic root and coronary ostia. It remains the reference standard for defining the extent of coronary artery disease…

…CCS), peripheral artery disease (PAD), and acute coronary syndromes (ACS). Its principal therapeutic objective is reduction of low density lipoprotein cholesterol (LDL C), the primary…

…aortic disease, and peripheral artery disease (PAD). Diabetes also substantially increases the risk of chronic kidney disease (CKD), which itself promotes cardiovascular disease and amplifies…

Echocardiography Cardiac thromboembolism Thromboembolism is a leading cause of death worldwide (1). Emboli originating in the atria, left atrial appendage (LAA), ventricles, valves, and proximal…

…of fluid management. Contraindications Infection, burn or trauma over the insertion site. Insufficient collateral circulation to the hand. Vascular disease in the limb: marked peripheral…

…catheter). Measurement of central venous pressure and central venous oxygen saturation. Repeated blood sampling during intensive care. Exhausted peripheral venous access during prolonged intravenous therapy…

…absolute contraindications, but be cautious and consider referral in: Diabetes with neuropathy or peripheral arterial disease — a risk of osteomyelitis and poor healing. Check the…

…what was expected. The poison control centre is the authoritative local source for the current indication, dosing, sampling and duration of treatment. International guidelines must…

…oxygen if hypoxaemic, two large bore peripheral cannulae 0 to 10 min A blood gas with lactate, two sets of blood cultures, and a culture…

…pulse, and active movement of every tendon crossing the wound. A tendon injury can be painless and gives normal passive movement — test actively against resistance…

…are associated with increasing likelihood of symptoms, complications and rupture. Aneurysmal sacs may contain mural thrombus, which can contribute to peripheral embolization and may reduce…

…Thromboxane A2 promotes vasoconstriction and platelet aggregation. Because aspirin affects only one pathway of platelet activation, its antiplatelet effect is relatively limited compared with agents…

…as three times higher than in individuals without comparable renal impairment. The cardiovascular burden of CKD extends beyond CAD to peripheral arterial disease, cerebrovascular disease…

…or both. The clinical consequences of extracellular volume expansion include elevated cardiac filling pressures, pulmonary congestion, systemic venous hypertension, and peripheral interstitial edema. These abnormalities…

…High intensity statin therapy remains the foundation of lipid lowering treatment for patients with chronic coronary syndrome, acute coronary syndrome (ACS), atherosclerotic peripheral arterial disease…

…establish: The triglyceride concentration and whether the sample was fasting or non fasting. The presence of ASCVD, peripheral arterial disease or aortic disease. Secondary causes…

…CKD), and peripheral artery disease (PAD). Figure 1 (below) shows weight loss effects of novel multi agonists in recent clinical trials (Rawshani et al). Recommended…

…support a causal relationship between Lp(a) associated genetic variants and coronary artery disease. Associations have also been extended to peripheral arterial disease, ischaemic stroke…

…right atrial pressure. Levosimendan represents a distinct class of inodilator. It enhances myocardial contractility and induces peripheral vasodilation through cardiac myofilament calcium sensitisation. This process…

…peripheral arterial disease, heart failure, depression, dementia and osteoporosis. It also improves functional capacity, skeletal health, muscular strength, quality of life and psychological well being…

…coronary syndrome Reinfarction reduced by approximately 30–40%; death reduced by approximately 35–45% Peripheral artery disease Lower risk of progression to chronic limb threat

…of myocardial infarction. Cardiac troponin T and troponin I have emerged as the preferred biomarkers because they are extremely sensitive and specific for myocardial injury…

…as ECPR [extracorporeal CPR] ) requires the immediate establishment of veno arterial ECMO (VA ECMO) . A peripheral artery (typically femoral artery) and vein (typically femoral vein…

…with the use of the ejection fraction is that it only assesses systolic function . Research in recent years has demonstrated that left ventricular diastolic function…

…gain and peripheral oedema. Previous hypercapnia, NIV or invasive ventilation. Home oxygen and the patient's usual saturation. Previous exacerbations and hospital admissions. Current inhaled…

…and supplemental oxygen [1]. Distinguish between: Acidaemia and alkalaemia , which describe the current pH of the blood. Acidosis and alkalosis , which describe processes that lower…

…negative blood (always RhD negative to women of childbearing age) while awaiting the result. Equipment A large bore peripheral cannula — at least 1.3 mm…

…be small — a few tenths of a millilitre, at most about 0.5 mL. A larger volume draws in peripheral blood and dilutes the specimen…

…Dark skin: a risk of permanent hypopigmentation. Areas with poor circulation, above all the lower leg in a patient with peripheral arterial disease or diabetes…

…have selected an objectively measurable finding in advance — usually ptosis or fatigable gaze palsy — that can be assessed before and during the window of effect…

…compression. The reason compression nevertheless so often fails is that it is done wrongly: the patient pinches the nasal bone instead of the soft part…

…and level of consciousness. 2. Attach ECG, pulse oximetry and repeated blood pressure measurement when a hypertensive emergency is suspected. 3. Insert a peripheral venous…

Endokrinologi & metabolism Akutsjukvård Lathundar Emergency overview Measure the plasma glucose immediately in everyone with a reduced level of consciousness, seizures, confusion, a change in behaviour…

…closer monitoring — the patient cannot feel pressure injury Peripheral neuropathy of other cause As above Severe pain Titrate the pressure up gradually Rheumatoid arthritis with…

…septic shock, or a need for high dependency or intensive care 3 Take at least two sets of blood cultures from separate peripheral punctures. Also…

…the day of the test can therefore be given dexamethasone. That is the practical key: the patient does not have to be left unprotected for…

…marked elevation of CK and threatened kidney injury, as an adjunct to the decisive measure: early and generous fluid administration. The benefit of alkalinisation over…

…decreases total peripheral resistance, decreases systemic blood pressure, and decreases afterload. Nicardipine has antianginal and antihypertensive effects. Time to onset of action 5 to 15…

…with ECG, central vein catheter and intra arterial catheter (A line) is warranted. Overview of vasopressors and inotropes Inotropes and vasopressors. Table 1. Drug manual…

…binding to the A1, A2B, and A3 receptors is responsible for the side effects of heart block, wheezing, and peripheral vasodilation, respectively. Pharmacokinetics and Administration…

…and atherosclerotic coronary disease In patients with heavy alcohol use, left ventricular dilation may precede the development of increased left ventricular hypertrophy and mass. Initially…

…patients with left ventricular dysfunction, though those with depressed ejection fraction should receive it with great caution due to the risk of hypotension. Peripheral IV

…cardiovascular death, and progression of atherosclerotic disease in patients with established coronary or other atherosclerotic vascular disease. Antiplatelet therapy is a central component because platelet…

…injury, accelerates atherosclerosis, increases myocardial oxygen demand, and may worsen ischemia in patients with obstructive coronary disease. It is also the most prevalent antecedent of…

Cardiology Definition and purpose Cardiovascular risk assessment estimates an individual’s probability of experiencing cardiovascular disease (CVD) over a defined period. SCORE2 and SCORE2 Older…

…The resulting haemodynamic congestion produces a characteristic clinical phenotype of breathlessness, fatigue and oedema. This definition does not depend on left ventricular ejection fraction (LVEF)…

…develop premature CAD. Symptoms therefore depend on the vascular territory involved and may include manifestations of coronary, cerebral or peripheral arterial disease, although the source…

…a therapeutic objective. LDL C as the primary treatment target Current lipid management frameworks place LDL C at the centre of treatment. Lifestyle intervention is…

…daytime symptoms suggestive of sleep disordered breathing Hypoventilation Peripheral oedema or venous disease Reduced mobility Osteoarthritis and low back pain Symptoms of type 2 diabetes…

…Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a hepatic protein that regulates the availability of the low density lipoprotein receptor (LDL receptor) on hepatocytes…