Cardiology Myocardial ischemia and infarction Definition and Pathophysiology Refractory angina is a chronic syndrome of persistent ischaemic symptoms despite the exhaustion of conventional therapeutic options…

…myocarditis, arrhythmias, thyroid disease, iron deficiency and anaemia, kidney dysfunction, sleep disordered breathing, cancer related disease and cardiac amyloidosis among the relevant clinical settings or…

…paracentesis: Tense ascites with abdominal discomfort, early satiety or respiratory compromise. Diuretic refractory or diuretic intolerant ascites, as recurrent treatment. Contraindications There are in practice…

…Give a full loading dose of an intravenous antiseizure drug If the seizure continues after adequate step 1 and step 2 Refractory status: contact anaesthesia…

…syndrome" has emerged, emphasizing the putative role of sensitized sensory nerve endings and afferent neural pathways in causing chronic refractory cough, akin to chronic neuropathic…

…no imaging evidence of RV dysfunction. Catastrophic or “supermassive” PE refers to refractory cardiogenic shock or the need for ongoing cardiopulmonary resuscitation. Mechanical circulatory support…

…10]. Refractory atrial arrhythmias resistant to antiarrhythmic drugs or repeated ablation procedures should raise suspicion, especially in patients in their mid 60s or older [10…

…will be blocked at that point. The length of the refractory period (see Basic Cardiac Electrophysiology) varies with heart rate. The length is shortened as…

…Figure 4. Intermittent failure to capture. Figure 5. Failure to capture during the refractory period. Figure 6. Tachyarrhythmia with ventricular pacing. Failure to capture Definition…

…intravenous access, fluid and early contact with anaesthesia or intensive care Refractory anaphylaxis Persisting airway, respiratory or circulatory compromise despite two adequate intramuscular doses of…

…relative contraindication to elective cardioversion. It does not apply in haemodynamic instability. Digitalis toxicity — a risk of refractory ventricular arrhythmias. Therapeutic digoxin levels, by contrast…

…on confusion for the management of delirium in intensive care. Renal replacement therapy Absolute indications: refractory hyperkalaemia, refractory acidosis, refractory fluid overload, uraemic symptoms (pericarditis…

…cause — warm the patient instead. Refractory shock in which the bradycardia and reduced contractility of hypothermia are not tolerated. A decision to withhold further life…

…criteria present: haemodynamic instability or cardiogenic shock recurrent or ongoing chest pain refractory to medical treatment life threatening arrhythmias or cardiac arrest mechanical complications of…

…renal replacement therapy Hypoperfusion with persistent organ injury Consider mechanical circulatory support Refractory advanced disease Consider palliative care Right ventricular failure is characterized by increased…

…paraplegia or paraparesis, rapid aortic expansion, refractory pain and hypertension despite treatment. A related entity is non A non B dissection , which involves the arch…

…disease, the principal symptomatic indication for revascularization is angina that remains refractory despite medical therapy when significant stenoses are anatomically or physiologically suitable for treatment…

…angiography may be appropriate, particularly when symptoms are severe, refractory to guideline directed medical therapy, occur at a low level of exertion, or are associated…

…controlled with four or more medications, and “refractory hypertension,” referring to uncontrolled blood pressure despite five or more medications, are not included in the European…

…resistant hypertension” for blood pressure at target on four or more drugs or “refractory hypertension” for blood pressure above target despite five or more drugs…

…days to attain a steady state concentration before further adjusting the dose. Electrophysiology Sotalol prolongs the effective refractory periods of the atrium, atrioventricular (AV) node…

…some fibers are still refractory. If an atrial impulse reaches the atrioventricular node when there are two pathways, one being refractory and the other capable…

…dispersion in the refractoriness. This means that some myocardial regions will be refractory while others will be excitable at the same time. As previously discussed…

…of ECMO initiation. Efficacy of ECMO (ECPR) in refractory out of hospital cardiac arrest Several studies have investigated the efficacy of ECMO (ECPR). The results…

…interval (because more fibers will be refractory). If the premature atrial impulse reaches the atrioventricular node (or bundle of His) while it is completely refractory…

…AV node becomes more and more exhausted (i.e more and more refractory) each time until it is completely refractory and blocks the atrial impulse…