…heparin unless contraindicated Head of the bed 30–45° Stress ulcer prophylaxis During mechanical ventilation, in coagulopathy, or with a history of gastrointestinal bleeding Refeeding…

…Measure and trace the ulcer; photograph it with a ruler in the image. A reduction in size of 40% within four weeks predicts healing — failure…

…after vascular surgery or endovascular intervention. Assessment of healing potential in ulcers and before deciding the level of amputation. Contraindications There are no absolute contraindications…

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

…Classification of office blood pressure Category Systolic Diastolic : : : : : Optimal < 120 and < 80 Normal 120–129 and/or 80–84 High normal 130–139…

…Consequently, isolated systolic hypertension and widening pulse pressure are common in later life. These changes contribute to the complexity of defining an appropriate treatment target…

…a small increase in left ventricular pressure. This is explained by the fact that the left ventricle is capable of relaxing and expanding rapidly during…

…and with a measurement interval of no more than 30 minutes throughout the 24 hours. Phenotype Office blood pressure ABPM : : : Normotension Normal Normal White coat…

…SVR) + Central Venous Pressure (CVP) This equation illustrates that MAP is determined by the volume of blood the heart pumps and the resistance encountered in…

…can affect the blood pressure in several ways. Monoamine oxidase inhibitors can cause a hypertensive crisis through interactions, while venlafaxine and higher doses of bupropion…

…American Society of Echocardiography 30 (4), pp. 303–371. DOI: 10.1016/j.echo.2017.01.007. – Pubmed Link Tricuspid valve stenosis Mean pressure gradient…

…the functional significance of an epicardial coronary stenosis. It is defined during maximal pharmacological coronary vasodilation as the ratio of mean pressure distal to the…

…and pressure gradients using Doppler measurements Continuous wave Doppler and pulsed wave Doppler can measure the velocity of erythrocytes as they travel through the heart…

…an integrated assessment of six components: Symptoms Exercise performance (functional capacity, exercise capacity) Heart rate: maximal heart rate, heart rate response Blood pressure reaction ECG…

…Ambulatory blood pressure monitoring (ABPM): automated measurement, usually over 24 hours, at predefined intervals. Inter arm difference: a sequential systolic difference of 10 mmHg between…

…chronotropy (heart rate). Beta 2 adrenergic receptors: expressed in vascular smooth muscle. Activation results in vasodilatation. D1 and D2 (dopamine receptors): activation of D1 and…

Info Inotropes and vasopressors Vasopressors induce vasoconstriction and increase mean arterial pressure (MAP). Inotropes increase cardiac contractile force (contractility). Several endogenous and synthetic agents exist…

…permitted when assessing dietary electrolyte intake, because it can increase blood pressure and may affect interpretation of the clinical picture. A 24 hour urine collection…

…refers to a reduced partial pressure of oxygen in the blood. Asphyxia is characterized by insufficient ventilation, leading to hypoxia. Etiologies of hypoxic cardiac arrest …

Cardiology Inotropes and vasopressors Vasopressors induce vasoconstriction and increase mean arterial pressure (MAP). Inotropes increase cardiac contractile force (contractility). Several endogenous and synthetic agents exist…

…of perfusion Parameter Normal Comment : : : Heart rate 50–100/min MAP 70–105 mmHg Target ≥ 65 mmHg in shock; higher in known hypertension Pulse pressure…

…The pathophysiology reflects failure of vascular autoregulation during a rapid or severe rise in BP. This may produce acute injury in the brain, retina, heart…

…points Levosimendan alleviates heart failure symptoms, increases cardiac output, and lowers pulmonary artery pressure without increasing myocardial oxygen consumption. The inotropic effect of levosimendan is…

…The value of the exercise test lies not in ST depression alone but in the overall picture : exercise capacity, symptoms, blood pressure response, heart rate…

…heart failure. Angina pectoris. Hypertension, hypertensive crisis/emergency. Pulmonary hypertension. Blood pressure control. Mechanism of action Nitroglycerin provides nitric oxide (NO) that induces vasodilatation (of…

…a life threatening clinical syndrome in which increased intrapericardial pressure compresses the heart and impairs ventricular filling. It generally results from accumulation of pericardial fluid…

…the heart and kidneys may exert direct compressive effects and releases additional inflammatory and profibrotic mediators. Perinephric fat is associated with hypertension and blood pressure…

…responders. Left heart disease is the most common risk factor for PH. It produces postcapillary PH through elevation of left atrial and pulmonary venous pressure…

…blood pressure despite multidrug treatment rather than through specific symptoms. The clinical importance lies in its association with: Increased cardiovascular disease risk; Greater risk of…

…aphasia, hemianopia or hand paresis in a person of working age Blood pressure Measure initially in both arms if this does not delay reperfusion treatment…

…without delay, in any of the following: A systolic blood pressure < 90 mmHg caused by the arrhythmia. Ongoing myocardial ischaemia with chest pain and…

…commonest source of error is confusing them. CPAP delivers a constant pressure that recruits alveoli and unloads the heart, whereas bilevel NIV delivers pressure support…

…globe — because a perforated eye must never be instrumented, have its pressure measured, or be palpated. Indications A sensation of something in the eye, watering…

…Condition Overall strategy Common first choices : : : Acute aortic syndrome Immediate rate control and rapid reduction of the systolic blood pressure towards 100 to 120 mmHg…

…pressure lowering effect. Pain relief. Delivery IV, IM, PO, transdermal Dose Injection IV: • 150 μg in 1 ml vial. Dilute with 10 ml of…

…metabolite (ester) of enalapril, an angiotensin converting enzyme (ACE) inhibitor. Enalaprilat lowers blood pressure by inhibiting ACE. Effects • The hypotensive effect of enalaprilat depends on…

…Bolus doses of 300 μg/kg can be repeated during infusion. Adverse effects Flushing. Nausea. Bronchospasm. AV block. Caution • Avoid in acute heart failure…

…Indications Short term management of hypertension, including hypertensive emergency. Mechanism of action • Systemic Dopamine 1 (D1) receptor agonist. • Lowers blood pressure while maintaining or increasing…

…venodilation than arteriolar dilation. Effects Nicardipine causes dilation of the coronary and systemic arteries, decreases total peripheral resistance, decreases systemic blood pressure, and decreases afterload…

…blood pressure, reduces heart rate, myocardial oxygen consumption and myocardial contractility. Less pronounced blood pressure lowering effect than esmolol and labetalol. Time to onset of…

…heart failure. Angina pectoris. Hypertension, hypertensive crisis/emergency. Pulmonary hypertension. Blood pressure control. Mechanism of action Nitroprusside provides nitric oxide (NO) that induces vasodilatation of…

…Indications Hypertensive crisis. Mechanism of action Phentolamine is a non selective alpha adrenergic blocker. Phentolamine reduces blood pressure while increasing catecholamine activity. Effects Primarily causes…

…adherence. Selection should be individualized according to blood pressure, heart rate, left ventricular function, comorbidities, concomitant medications, potential drug interactions, the presumed mechanism of ischaemia…

…severity of pain also has limited discriminatory value. Features suggesting myocardial ischaemia Ischaemic discomfort commonly: Is substernal and diffuse. Is described as pressure, tightness, heaviness…

…since the 1960s. In 1948 the NHLBI initiated the Framingham Heart Study, which demonstrated that high blood pressure and high cholesterol levels, among other risk…

…1. Acute Coronary Syndrome (ACS) / Myocardial Ischemia Pain Characteristics: Typically presents as substernal discomfort, often described as pressure, tightness, or heaviness [7]. Classically, it is…

…target heart rate is reached. Its principal outputs are: Functional capacity and exercise tolerance Reproduction and characterization of symptoms Heart rate and blood pressure responses…

…be initiated concurrently. In patients with a confirmed indication for treatment but blood pressure in the range of 120–139/70–89 mmHg, concomitant indications…

…may represent a more favorable profile, as the upper limit of the "healthy" range can still harbor significant metabolic risk. 3 For patients with a…

…Alveolar Plateau) : ETCO 2 is the recorded CO 2 partial pressure just before the next inspiration. Phase 0 : Indicates the beginning of the next inspiration…

…to the heart. In instances of tension pneumothorax, the accumulated pressure can shift the entire mediastinum, manifesting externally as a laryngeal displacement. Etiologies of tension…

…systolic blood pressure increases during exercise. The increase in cardiac output during moderate exercise is the result of increased stroke volume and increased heart rate…

…study velocities, volumes, and pressure conditions in the heart. These techniques allow for the calculation of all clinically relevant hemodynamic parameters, with few exceptions. Prior…

…venodilation than arteriolar dilation. Effects Nicardipine causes dilation of the coronary and systemic arteries, decreases total peripheral resistance, decreases systemic blood pressure, and decreases afterload…

…induce myocardial electrical activity by generating adequate coronary perfusion pressure (CPP). Myocardial activity is necessary to salvage the brain, and is therefore of prime importance…

…acidic environment inactivates the anaesthetic. Place a field block in healthy skin around the abscess instead of injecting into it, and expect the procedure to…

…thing to know by heart is that an arterial line must never be confused with a venous access. Indications Continuous blood pressure monitoring in haemodynamic…

…saw, protective sheeting Hot water gives faster setting and more heat production — a risk of burns Document the distal neurovascular status before casting : sensation, motor…

…dialysis catheter, not an ordinary triple lumen catheter). Measurement of central venous pressure and central venous oxygen saturation. Repeated blood sampling during intensive care. Exhausted…

…care [1,2]. The condition is associated with falls, aspiration, pressure sores, loss of function, longer length of stay, institutional care, readmission, cognitive decline and…