…taken at the next regular time. Use with caution in patients with asthma/chronic obstructive pulmonary disease (COPD). Dyspnea has been reported in patients treated…

…Pulm vasoconstriction. Increased pulmonary blood flow. Ventricular arrhythmias Severe hypertension resulting in cerebrovascular hemorrhage Cardiac ischemia Sudden cardiac death Prolonged use may be cardiotoxic. Isoproterenol…

…Pulm vasoconstriction. Increased pulmonary blood flow. Ventricular arrhythmias Severe hypertension resulting in cerebrovascular hemorrhage Cardiac ischemia Sudden cardiac death Prolonged use may be cardiotoxic. Isoproterenol…

…left ventricular failure with pulmonary oedema, acute aortic syndrome, acute kidney injury, microangiopathic haemolysis, and severe pre eclampsia or eclampsia. The blood pressure is often…

…obstructive pulmonary disease, renal insufficiency, systemic hypertension, and concomitant abdominal aortic aneurysm. Clinical Presentation and Symptoms Acute chest and/or back pain is the predominant…

…Cardiac causes Systemic causes Heart failure Sepsis Myocarditis Chronic kidney disease Cardiomyopathy Stroke or subarachnoid haemorrhage Takotsubo syndrome Pulmonary embolism Recent coronary revascularization Infiltrative disease…

…microvascular injury occurs, classically involving fibrinoid necrosis of small arteries in the kidneys, retina, and brain. Its clinical retinal signature includes flame haemorrhages, cotton wool…

CPR Hypoxia and asphyxiation Hypoxia refers to a reduced partial pressure of oxygen in the blood. Asphyxia is characterized by insufficient ventilation, leading to hypoxia…

…Immobilisation ≥ 3 days or surgery in the last 4 weeks 1.5 Previous deep vein thrombosis or pulmonary embolism 1.5 Haemoptysis 1 Active malignancy…

…1: aortic and pulmonary regurgitation (native valve disease). In European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society…

…PH. It is defined haemodynamically by precapillary PH in the absence of CTEPH, lung disease, or another explanatory cause. PAH reflects marked pulmonary arterial remodelling…

…globally every year ( Raskob et al ). The incidence of pulmonary embolism has increased in recent decades. Potential explanations for this trend include an ageing population…

…aplasia of the pulmonary valve Idiopathic pulmonary artery dilation Pulmonary regurgitation results in right ventricular volume overload, which gradually causes right ventricular failure. The ventricle…

…The PASP is an independent predictor of survival and for elevated left ventricular filling pressures (Lam et al). PASP is elevated in pulmonary arterial hypertension…

…In acute PE, obstruction of pulmonary blood flow increases RV pressure load and may impair RV filling and forward output. The resulting syndrome may progress…

…of the American Society of Echocardiography 22 (1), 1 23; quiz 101 2. DOI: 10.1016/j.echo.2008.11.029. Pulmonary valve Pulmonary valve…

…arterioles and veins via generation of cyclic GMP, which then activates calcium sensitive potassium channels in the cell membrane. Time to onset of action : 1…

…3 Important study: Milrinone as Compared with Dobutamine in the Treatment of Cardiogenic Shock (N Engl J Med 2021; 385:516 525) In a randomized…

…acute dyspnoea in a patient with COPD. Pneumonia, heart failure, pulmonary embolism, pneumothorax and acute coronary syndrome must be actively considered [1]. Do the following…

…pain and ECG changes. Acute pulmonary oedema. Impaired consciousness. Synchronised cardioversion under sedation, at an energy level according to the local protocol. An anticoagulant is…

…vascular tone or both, and the appropriate action differs fundamentally between these cases. Pressures in the heart and pulmonary circulation Flow, resistance and oxygen transport…

…is appropriate, documented before treatment begins. Procedure 1. Treat the underlying cause in parallel. Nitroglycerin and diuretics in pulmonary oedema, bronchodilators and steroids in COP

…parameter used to quantify the ratio of pulmonary blood flow (Qp) to systemic blood flow (Qs). This measurement is pivotal in diagnosing and managing congenital…

…Gonzalo; Baumgartner, Helmut et al. (2012): Guidelines on the management of valvular heart disease (version 2012). In European heart journal 33 (19), pp. 2451–2496…

…then activates calcium sensitive potassium channels in the cell membrane. Nitroglycerin is similar in action and pharmacokinetics to nitroprusside, although the latter is more potent…

…and miscellaneous conditions Definition and scope Familial and genetic screening in cardiovascular medicine is the systematic assessment of relatives and other individuals who may carry…

…establishes that the clinical evaluation must identify specific hemodynamic profiles: the presence of hypotension, end organ hypoperfusion, shock states, and pulmonary congestion. In pregnant patients…

…objective evidence of pulmonary or systemic congestion [3] . Within this spectrum, Heart Failure with Reduced Ejection Fraction (HFrEF) is specifically classified by the 2022 AHA…

…which influence cardiac function primarily by affecting ventricular function, include blood pressure, venous return, pulmonary gas exchange efficiency, the concentration of catecholamines, angiotensin, hemoglobin, etc…

…Among the causes are pulmonary embolism, pulmonary hypertension, septum defects, etc. Right ventricular load is thus an issue that is raised both in outpatient and…

…of CPR is to create large variations in intrathoracic pressure by compressing, decompressing and ventilating. These maneuvers result in arterial blood flowing through the pulmonary…

…require a higher target Doses in venous thromboembolism Treatment doses in deep vein thrombosis and pulmonary embolism differ from the atrial fibrillation doses and include…

…anticoagulation can cause a stroke hours to weeks later. Everything else in the procedure is routine. Synchronised cardioversion or unsynchronised defibrillation Synchronised cardioversion Unsynchronised defibrillation…

…blood pressure measurement. Resuscitation trolley with defibrillator, oxygen, suction and emergency drugs in the room. Staff with current CPR competence; a physician available. Patient preparation…

…activity. The investigation is diagnostic, not therapeutic. An unstable patient should be cardioverted, not investigated. Contraindications Haemodynamic instability — hypotension, shock, impaired consciousness or pulmonary oedema…

…the skull and the eyes. Postpone the test in: Condition Recommended delay : : Myocardial infarction or unstable angina 1 month Pneumothorax 1 month after resolution Pulmonary…

…80 mg tablet once daily. Warnings and precautions Use Aspirin with caution in the following cases: Concurrent anticoagulant therapy (e.g., coumarin derivatives or heparin…

…clinical factors. Provides a more personalized risk assessment. Validated in large clinical trials, including the SYNTAX trial. Limitations Requires detailed clinical and angiographic data. Calculation…

…to humans in Wuhan, China, and it has now spread to more than 170 countries and caused unprecedented damage to humans and societies. The number…

…years, compared with 15.0 per 1000 patient years in age matched controls without autoimmune disease. The greatest risks were reported with systemic sclerosis, Addison…

…or belching. Radiation to both arms or shoulders has a particularly strong association with myocardial infarction in the cited clinical data, although right arm radiation…

…than an anomalous right coronary artery. Anomalous origin of a coronary artery from the pulmonary artery can result in reduced coronary oxygen content, coronary steal…

…pulmonary congestion, systemic venous hypertension, and peripheral interstitial edema. These abnormalities produce breathlessness, orthopnea, weight gain, peripheral edema, early satiety, abdominal distension and, in some…

…Pericardial disease, including constriction Right ventricular dysfunction caused by pulmonary embolism Infiltrative cardiomyopathies, particularly cardiac amyloidosis Sepsis and other hyperdynamic states In cardiac amyloidosis, BNP…

…during the fetal period. This is explained by the configuration of the fetal circulation; pulmonary resistance is high (which means that resistance in the pulmonary…

…circulation. Improvement in left ventricular function also lowers pulmonary arterial and pulmonary capillary wedge pressures, thereby reducing the load faced by the failing right ventricle…

…treatment LV function requires evaluation in the setting of suspected ischaemia or previous infarction Dyspnoea requires assessment of dynamic LV function, valve disease, pulmonary pressure…

…Left anterior fascicular block is diagnosed if the axis is between 45° and 90° with qR complex in aVL and QRS duration is 0,12…

…output sufficiently will result in the following compilations: Pulmonary edema develops due to rising LAP and LVEDP. Cardiogenic shock develops if the cardiac output is…

…dissection Pneumothorax Pulmonary embolism Mediastinitis (rare condition) In addition to these five conditions, there are numerous other causes of chest pain, but the other causes…

…mortality in general. This is not surprising given the adverse effects of long periods of tachycardia and desynchronized atrial and ventricular activity. Fortunately, the treatment…

…resulting in fewer cardiac arrests caused by these conditions ( Jerkeman et al ). It is often difficult to determine the cause of an out of hospital…

…frequently, it may also present in individuals without identifiable cardiac disease. Contributing factors include pulmonary disorders, particularly obstructive pulmonary disease, the use of theophylline, and…

…in certain causes of cardiac arrest (e.g. pulmonary embolism) or in case of long no flow or low flow periods. Under such circumstances, the…

…sex differences in cardiovascular aging, including smaller ventricular cavities, greater age related vascular stiffening, and distinct microvascular responses to systemic inflammation [7] . The dominant risk…

…few exceptions. Prior to the Doppler era, hemodynamic assessments were performed by means of right heart catheterization (with Swan Ganz catheter [ pulmonary artery catheter ]). However…

…during the fetal period. This is explained by the configuration of the fetal circulation; pulmonary resistance is high (which means that resistance in the pulmonary…

…of the great arteries, pulmonary valve stenosis, atrial septal defect, ventricular septal defect), tricuspid valve regurgitation are the most common causes. ECG changes in right…

…myocardial ischemia/infarction, pulmonary embolism, pheochromocytoma, hyperthyroidism, hypovolemia, pharmacological substances (alcohol, amphetamine, coffee, anticholinergic drugs, beta adrenergic agonists). In all of these conditions, sinus tachycardia…

…disease. Endocarditis (common in intravenous drug addicts). Myxomatous degeneration. Rheumatic heart disease. Dilatation of the right ventricle. Dilatation of the right atrium. Pulmonary hypertension. Left…