…stockings. Avoid measuring the arm pressure on the side with a dialysis fistula, lymphoedema after axillary clearance or a recently inserted venous port. Procedure 1…

Echocardiography Myocardial ischemia and infarction Definition and pathophysiology Post infarction mechanical complications are structural disruptions of acutely infarcted myocardium occurring most often during the first…

Cardiology Myocardial ischemia and infarction Definition and pathophysiology Post infarction pericarditis encompasses two temporally and clinically distinct complications of acute myocardial infarction (AMI): Early infarct…

CPR Post resuscitation care Victims of out of hospital cardiac arrest (OHCA) who achieve ROSC in the emergency room (ER) are transferred to the intensive…

Procedurer The insertion itself is rarely the difficult part — it is the confirmation of the position that determines whether the tube is safe. A misplaced…

…stenosis is an atherosclerotic narrowing of the carotid arteries. It forms part of multisite artery disease, defined as atherosclerosis affecting at least two vascular beds…

…the past century. Initial post mortem observations in the late 19th century first linked thrombotic occlusion of a coronary artery with myocardial necrosis. Although early…

…axis of the heart Although often ignored, assessment of the electrical axis is an integral part of ECG interpretation. The electrical axis reflects the average…

ECG Introduction to ECG interpretation The normal T wave Assessment of the T wave represents a difficult but fundamental part of ECG interpretation. The normal…

…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…

…aphasia and radiological changes resembling ischaemic stroke. Glucose measurement is therefore always part of the initial stroke assessment [1]. Treat immediately when there are symptoms…

…Non surgery patients: atrial fibrillation ≤7 days duration. Post cardiac surgery: atrial fibrillation ≤3 days duration. Vernakalant does not convert atrial flutter to sinus rhythm…

…ischemic heart disease, heart failure with reduced ejection fraction (HFrEF), and post myocardial infarction (MI) care. Despite their proven morbidity and mortality benefits, their use…

…PCI), or medical management. The standard post ACS regimen is DAPT for 12 months, generally consisting of low dose aspirin and a potent P2Y12 inhibitor…

…by hyperpolarisation and contributes to spontaneous diastolic depolarisation. By inhibiting the intracellular portion of its transmembrane pore, ivabradine reduces the slope of diastolic depolarisation and…

…involving the posterior region of the left ventricle, usually as part of an inferoposterior or posterolateral infarction. Its recognition is clinically important because posterior infarction…

…heart (heart axis) Although often ignored, assessment of the electrical axis is an integral part of ECG interpretation. The electrical axis reflects the average direction…

…In summary, while the absence of a pupillary reflex upon hospital admission post cardiac arrest serves as an unfavorable prognostic indicator, its standalone utility in…

…ventricles or atria. ECG 2. The initial part shows QRS complexes with similar morphology as ECG 1, likely presenting a supraventricular rhythm. Three short bursts…

…vasoconstriction, arrhythmia, intra aortic balloon pump. Assessment of stroke volume variation as part of fluid management. Contraindications Infection, burn or trauma over the insertion site…

…transfusion protocol. Plasma and platelets: in ongoing bleeding with coagulopathy, or as part of balanced transfusion in massive haemorrhage. Transfusion thresholds in the stable, non…

…is the standard site for both aspiration and biopsy in adults. Here the posterior part of the iliac crest is thick, red marrow is abundant…

…gynaecological examination of asymptomatic women has not been shown to improve outcomes and is not part of the screening programme — screening consists of the smear…

…important indication and an emergency procedure . An unclear arthritis, as part of the diagnostic work up. Haemarthrosis after trauma. A symptomatic effusion causing pain or…

…Prevention of recurrence after a healed venous ulcer. After deep vein thrombosis with post thrombotic syndrome. Differential diagnosis Feature Venous ulcer Arterial ulcer Diabetic foot…

…replacement is not the management of a side effect; it is part of the treatment itself. Indications Salicylate poisoning with symptoms or a rising serum…

…of Echocardiography recommendations for the assessment of valvular regurgitation. Part 1: aortic and pulmonary regurgitation (native valve disease). In European journal of echocardiography : the journal…

…segment depression in the inverted lead aVR). A notch is evident in the ascending part of the ST segment. A male patient (Figure 1) presented…

…and mortality The modern concept of rehabilitation has evolved from early post infarction physical activity programmes into a structured centre of secondary cardiovascular prevention in…

…angina, angina or ischaemia with non obstructive coronary arteries (ANOCA/INOCA), post ACS or post revascularization states, and heart failure of ischaemic or cardiometabolic origin…

…In this post I would like to discuss hot topics related to coronary artery disease and I will emphasize on issues that are typically raised…

…of other forms of acute tubular necrosis, although the complication remains associated with post procedural morbidity and mortality. Pathophysiology The precise mechanism of contrast induced…

…Restenosis was more likely with: Small reference vessel diameter A small post procedural lumen Substantial residual stenosis Long lesions Diabetes mellitus Untreated edge dissection Components…

…In patients with acute coronary syndromes (ACS), the early post event period is particularly vulnerable, and delayed intensification of lipid lowering therapy may leave patients…

…therapeutic consequences are likely to outweigh procedural risks. This balance forms part of shared clinical decision making. Pathophysiological and Diagnostic Considerations Angiographic severity and physiological…

…scar formation Diffuse myocardial fibrosis Reversible ischemic dysfunction Chronic hypoperfusion with hibernating myocardium Post ischemic stunning Adverse left ventricular (LV) remodeling Ischemic cardiomyopathy is the…

…side). This article is part of the comprehensive chapter: How to interpret the ECG The P wave vector is slightly curved in the horizontal plane…

…and routine clinical practice report muscle symptoms. This discrepancy reflects, at least in part, the nocebo effect : negative expectations, contextual cues and attribution of pre…

…availability of atropine, isoproterenol, or transcutaneous pacing for post shock bradycardia, and use of biphasic defibrillators , which are standard due to superior efficacy over monophasic…

…Frequently, overt signs of life are absent, and the patient's coldness can mimic post mortem conditions. Therefore, a meticulous assessment of vital signs is…

…injuries to the mediastinum can cause tamponade. Post operative Complications : Post surgical complications following thoracic procedures can cause tamponade. Tamponade with swinging heart of the…

…2019/2020 ), in which stable coronary artery disease is part of the broader syndrome of chronic coronary syndromes (CCS) . This syndrome includes six clinical manifestations…

…such as viral, bacterial, and tuberculous infections. Post pericardiotomy syndrome. Acute transmural myocardial infarction. Rupture of the free ventricular wall. Neoplasms (particularly breast and lung…

…implantable cardioverter defibrillator; CRT, cardiac resynchronization therapy) are discussed in subsequent chapters. The first part consists of a brief rehearsal of the basics of cardiac…

…. . formed a constituent part of the character of Angina Pectoris. Atherosclerosis: the cause of coronary artery disease The underlying cause is atherosclerosis, which is a…

…P wave may be slightly biphasic (diphasic) in lead V1, implying that the terminal part of the P wave is negative (Figure 1, upper panel)…

…usually thickened and during systole leaflet doming appears. The proximal part of the pulmonary artery is frequently dilated. The maximum and mean pressure gradient is…

…Figure 1. The sinoatrial (SA) node and atrioventricular (AV) node are located in the atria and are not part of the ventricular conduction system. The…

…ventricle in the thorax. It is localized immediately behind the sternum and thus is the most anteriorly located part of the heart. The right ventricle…

…2019/2020 ), in which stable coronary artery disease is part of the broader syndrome of chronic coronary syndromes (CCS) . This syndrome includes six clinical manifestations…

…Thus, with regards to measuring ventricular dimensions, trabeculae and papillary muscles are considered part of the left ventricular cavity. Other dimensions– including atrial dimensions, mitral…

…tachycardia (AVNRT) AV re entrant tachycardia (AVRT) Permanent junctional reciprocating tachycardia (PJRT) Junctional Ectopic Tachycardia (JET) VENTRICULAR ARRHYTHMIAS Ventricular tachycardia Fascicular tachycardia FREQUENT ECTOPY Premature…

…Moreover, the first part of the formula (0.5 • D blood ) can be approximated to 4, meaning that Formula 2 can be rewritten as follows…

…available. Recall that ST segment elevations also become normalized as a part of the natural course of myocardial infarction (refer to Figure 2 below). However…

…and inhibits excitatory glutamate signalling, in part via NMDA receptors. With prolonged alcohol exposure the nervous system adapts through reduced GABA mediated inhibition and increased…

…and is the only tissue that produces new nail. Its visible distal part is the lunula. The matrix horns are the lateral extensions of the…

…tragus and the area behind the pinna before the otoscope is inserted — mastoid erythema and a protruding ear are not part of the tympanic membrane…

…treatment — hyperoxia increases the risk of pulmonary toxicity. Keep the saturation in the lower part of the target range. Paraquat poisoning — oxygen worsens the lung…

…patient resists internal rotation. Check the axillary nerve: sensation over the lateral part of the deltoid before and after the reduction , together with the distal…

…ferric subsulfate, electrocoagulation. A pot of 4 % formalin, and for immunofluorescence Michel's medium or saline according to local procedure. Photograph and draw in the…