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…

…commensurate with the body’s requirements, or can do so only at the expense of abnormally high filling pressures. The resulting haemodynamic congestion produces a…

…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…

…seizure lasting at least 5 minutes, or repeated generalised tonic clonic seizures without the patient regaining consciousness between them. Five minutes is the practical threshold…

…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…

…A history of increasing frequency of hospitalizations and visits for heart failure without disease recognition in the 3 years preceding diagnosis is also a notable…

…long refractory periods and short RR intervals have shorter refractory periods. Aberrant conduction occurs when the length of the cardiac cycle is changed without a…

…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…

…Isolated urticaria, localised angio oedema or itching without compromise of the airway, breathing or circulation is usually an allergic reaction but not in itself anaphylaxis…

…can precipitate ventricular fibrillation, and cardioversion of fibrillation of unknown duration without anticoagulation can cause a stroke hours to weeks later. Everything else in the…

…replacement therapy Absolute indications: refractory hyperkalaemia, refractory acidosis, refractory fluid overload, uraemic symptoms (pericarditis, encephalopathy) and certain poisonings. Early initiation without an absolute indication has…

…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…

…C Blood samples Management Recommendation Level of evidence Serum biomarkers of myocardial infarction (troponin) should be sampled as early as possible without delaying reperfusion therapy…

…provides a practical framework for selecting treatment: Clinical state Principal management approach Congestion without hypoperfusion Intravenous loop diuretic therapy Congestion with hypoperfusion Loop diuretic therapy…

…refractory pain and hypertension despite treatment. A related entity is non A non B dissection , which involves the arch without involvement of the ascending aorta…

…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…

…but symptom characteristics and clinical judgement must be incorporated. In symptomatic individuals without known CAD, newer clinical prediction algorithms are preferred over older approaches based…

…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…

…risk may seem very much, it only amounts to one extra case. So, even if the relative risk is high, the absolute risk can be…

…with refractory out of hospital cardiac arrest. Patients aged 18 to 70, who received bystander CPR and initially presented with a ventricular arrhythmia without return…

…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…

…degree AV block Mobitz type II is characterized by sporadically occurring blocks, without the Wenckebach phenomenon. Second degree AV block Mobitz type I (Wenckebach block)…