…LAD) Causes of right axis deviation Normal in newborns. Right ventricular hypertrophy. Acute cor pulmonale (pulmonary embolism). Chronic cor pulmonale (COPD, pulmonary hypertension, pulmonary valve…

…LAD) Causes of right axis deviation Normal in newborns. Right ventricular hypertrophy. Acute cor pulmonale (pulmonary embolism). Chronic cor pulmonale (COPD, pulmonary hypertension, pulmonary valve…

…threshold of ≤15 mmHg remains the recommended criterion for precapillary PH, partly because this value has been used in therapeutic studies of pulmonary arterial hypertension…

…causes of pulmonary regurgitation. Mild pulmonary regurgitation is a normal echocardiographic finding that requires no further investigation. Table 1. Causes of pulmonary regurgitation Pulmonary hypertension…

…in pulmonary arterial hypertension (PAH). Valve area The continuity equation can be used to calculate the valve area. The equation claims that the volume of…

…pulmonary disease, advanced age, smoking, diabetes, hypertension, cancer, etc – are the most important risk factors for poor outcomes. The vast majority of infections with COVID…

…of pain exacerbation with inspiration, along with a pleural friction rub, helps differentiate it from angina pectoris [5]. 5. Pulmonary Hypertension Pain Characteristics: Severe pulmonary…

Referensvärden A diagnosis of hypertension is not made on a single reading. It requires repeated measurements on at least two occasions, and preferably confirmation by…

…minute. Duration of action : <10 minutes. Effects Potent blood pressure lowering. Antianginal effect. Reduces afterload and preload. Effective in pulmonary edema. Can produce severe hypotension…

…becomes prolonged. However, most often the cause of the load is the primary problem. Among the causes are pulmonary embolism, pulmonary hypertension, septum defects, etc…

…antenatal hypertensive disorders, but it may also arise de novo after delivery. New onset postpartum preeclampsia is increasingly recognized as a significant cause of maternal…

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

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

…with increased risk of hypotension in patients with autonomic dysfunction, hypovolemia, or severe coronary or valvular disease Recent (<48 hours) use of dipyridamole or dipyridamole…

…Trinipatch ® Indications Pulmonary edema, congestive heart failure. Angina pectoris. Hypertension, hypertensive crisis/emergency. Pulmonary hypertension. Blood pressure control. Mechanism of action Nitroglycerin provides nitric…

…heritable aortopathies, selected congenital heart diseases, pulmonary arterial hypertension and thromboembolic disorders. Most recognised heritable cardiovascular conditions demonstrate autosomal dominant transmission, in which an affected…

…diastolic dysfunction Valvular heart disease Pulmonary hypertension Ischaemic heart disease Atrial arrhythmias Pericardial disease, including constriction Right ventricular dysfunction caused by pulmonary embolism Infiltrative cardiomyopathies…

…Pulmonary hypertension. Left to right shunt. Right ventricular dysfunction due to pressure/volume overload is the most common cause. Ebstein's anomaly The prevalence of…

…septal rupture VSR typically causes: Recurrent chest pain. Dyspnoea. Hypotension. Rapid development of biventricular failure. Pulmonary oedema. Cardiogenic shock. The shunt may initially be tolerated…

…In patients with HFpEF, acute hypertension is a frequent trigger of decompensation and may produce abrupt pulmonary oedema, sometimes requiring non invasive ventilation or intubation…

…cardiovascular societies, defines HF as a clinical syndrome corroborated by elevated natriuretic peptide levels and/or objective evidence of pulmonary or systemic congestion [3] . Within…

…unexplained drop in arterial pressure. Silent or unrecognized infarction occurs more often in patients without antecedent angina and in those with diabetes and hypertension. Of

…Valve function and stress related haemodynamic changes Diastolic function Pulmonary hypertension Coronary flow velocity reserve (CFVR) Pulmonary congestion detected by B lines on lung ultrasound…

…is loss of contractile myocardium, with reduced cardiac output and systemic hypoperfusion. LV failure may produce elevated filling pressures, pulmonary venous hypertension, and pulmonary congestion…

…QUESTIONS COMMENTS Risk factors for the 5 serious etiologies Family history (focus on ischemic heart disease, aortic dissection, pulmonary embolism, pneumothorax). Hypertension. Smoking. Dyslipidemia (hyperlipidemia)…

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

…progressive acute target organ damage. Common manifestations are hypertensive encephalopathy, intracerebral haemorrhage, acute coronary syndrome, acute left ventricular failure with pulmonary oedema, acute aortic syndrome…

…acute myocardial infarction, pericarditis/myocarditis or pulmonary embolism is often a reversible arrhythmia with low risk of recurrence. Atrial fibrillation in other circumstances (particularly those…

…vascular stiffening, and distinct microvascular responses to systemic inflammation [7] . The dominant risk factors for HFpEF include hypertension (present in 80% of cases), obesity, type…

…2] Causes of Left Axis Deviation: Left ventricular hypertrophy [11] Left heart disease, which may be suspected in the differential diagnosis of pulmonary hypertension [16…

…Behçet disease can cause both arterial and venous thrombosis. In SLE, renal artery involvement may contribute to difficult to control hypertension. The cardiovascular consequences of

…pulmonary hypertension and pulmonary edema. Table 1. Causes of aortic regurgitation Bicuspid aortic valve Rheumatic heart disease Calcified aortic valves Idiopathic aortic dilatation (aneurysm) Hypertension…

…pulmonary hypertension, etc). Ischemic heart disease (coronary artery disease). Structural heart disease, any. Treatment of atrial tachycardia Discontinuation of digoxin is typically sufficient in patients…

…of life. The underlying aetiology is heterogeneous. Chronic heart failure evaluation should therefore seek reversible or treatable causes. The source material identifies coronary disease, hypertension…

…including abnormalities of LV relaxation and filling. Hypertension and diabetes can contribute to the development of heart failure in the preserved and mildly reduced EF…

…Hypotension, which may or may not be present Markedly reduced cardiac output in severe cases Cardiogenic shock in the most advanced presentations The symptoms of…

…Increasing severity of mitral regurgitation is associated with worse outcomes. Pulmonary hypertension secondary to left heart disease may occur because elevated left sided filling pressures…

…risk of atrial fibrillation. The increase in left atrial pressure may also propagate backward to the pulmonary circulation, causing pulmonary hypertension (PH). Additionally, pulmonary hypertension…

…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…

…Systemic hypertension coexists in approximately 70% of patients with aortic dissection. PAU is particularly associated with advanced age, smoking, coronary artery disease, chronic obstructive pulmonary…

…Endocarditis – due to risk of embolization Deep venous thrombosis – due to risk of embolization Relative contraindications for exercise ECG Severe hypertension (systolic blood pressure 200…

…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…

…P pulmonale. P mitrale: left atrial enlargement (hypertrophy, dilatation) If the left atrium encounters increased resistance (due to mitral valve stenosis, mitral valve regurgitation, hypertension…

…or pulmonary disease, a pulse ≥ 110/min, a systolic blood pressure < 100 mmHg and a saturation < 90 per cent. An sPESI of 0…

Cardiology Emergency medicine Definition and pathophysiology Acute pulmonary embolism (PE) is classified according to haemodynamic status, clinical severity, evidence of right ventricular (RV) dysfunction, and…

…pulmonary embolism, pneumothorax and acute coronary syndrome must be actively considered [1]. Do the following early: 1. Assess airway, work of breathing, level of consciousness…

…PDA) in a left dominant circulation (i.e. 10 15% of cases). Clinically, patients present with severe chest pain, diaphoresis, hypotension, pulmonary edema, malignant arrhythmias…

…The drugs can also be given sequentially. Hypotension can be counteracted with simultaneous administration of norepinephrine. All patients with severe acute heart failure who receive…

…will rapidly propagate to the pulmonary circulation and cause pulmonary edema. Also, left ventricular exhaustion results in diminished cardiac output, potential hypotension and cardiogenic shock…

…of the following: A systolic blood pressure < 90 mmHg caused by the arrhythmia. Ongoing myocardial ischaemia with chest pain and ECG changes. Acute pulmonary…

…effects, and the condition is classified as cardiac tamponade. The classical signs of cardiac tamponade are hypotension, muffled heart sounds and jugular venous distention. Other…

…Indications Emergency, irrespective of duration and anticoagulation status: Tachyarrhythmia with haemodynamic compromise: hypotension, shock, pulmonary oedema, myocardial ischaemia or a falling level of consciousness. Unstable…

…not investigated. Contraindications Haemodynamic instability — hypotension, shock, impaired consciousness or pulmonary oedema. Treat the arrhythmia first. Known stricture or tumour of the nose, pharynx or…

…Weakness Presyncope or syncope Exercise intolerance Symptoms of shock in advanced cases The presentation may be abrupt or subacute. Acute haemopericardium may cause sudden hypotension…

…associated with acute haemodynamic compromise, pulmonary oedema, or evidence of coronary ischaemia. These findings determine the urgency and type of intervention. The assessment should also…

…regurgitation Severe regurgitation Pulmonary valve morphology normal normal/abnormal abnormal Density CW Doppler weak, slow deceleration variable dense, steep deceleration, early termination of diastolic flow…

…pulmonary embolism overlap with risk factors for DVT; immobilisation, surgery, hypercoagulability, and pregnancy are common risk factors (see Risk factors below). A significant proportion of…

…regurgitation Severe regurgitation Pulmonary valve morphology normal normal/abnormal abnormal Density CW Doppler weak, slow deceleration variable dense, steep deceleration, early termination of diastolic flow…

…of care and on whether intubation is appropriate, documented before treatment begins. Procedure 1. Treat the underlying cause in parallel. Nitroglycerin and diuretics in pulmonary…

…The shunt fraction (Qp/Qs) is a critical hemodynamic parameter used to quantify the ratio of pulmonary blood flow (Qp) to systemic blood flow (Qs)…