…and releases additional inflammatory and profibrotic mediators. Perinephric fat is associated with hypertension and blood pressure variability, while obesity and hypertension together promote left ventricular…

…but their release is not specific to left ventricular systolic dysfunction. Levels may also rise with: Left ventricular diastolic dysfunction Valvular heart disease Pulmonary hypertension…

…Objective evidence of myocardial ischaemia. Absence of obstructive coronary artery disease, defined as no stenosis exceeding 50% diameter reduction and/or an FFR 0.80…

…An alcohol or chlorhexidine swab. Let the skin dry completely before inserting the needle — alcohol carried in with the needle stings. Needles of the correct…

…and 6 mm. A size 15 scalpel, a double edged razor blade or a flexible shave blade. Artery forceps, toothed surgical forceps, scissors, a needle…

…infarction (AMI), in which myocardial ischaemia is accompanied by cardiomyocyte necrosis and cardiac troponin release meeting the criteria of the universal definition of MI. Clinically…

…preparations: in practice within about 1 hour. Tablets and solid preparations: up to about 2 hours. Modified release preparations, anticholinergics, opioids and salicylate — where gastric…

…symptoms, the rate of rise, renal function and the clinical context , not by the potassium value alone. A normal ECG does not exclude dangerous hyperkalaemia…

…a fixed dose is given without assessment, when a modified release preparation is started in an opioid naive patient, or when a conversion between drugs…

…or repeated a modified release preparation or a combination product concurrent drugs, alcohol and illicit substances weight, age, pregnancy and comorbidity renal and hepatic function…

…injury is separate from MI. It refers to cardiac troponin release that does not fulfil the criteria for ischaemic myocardial infarction. It may be acute…

…is myocardial ischaemia caused by an acute coronary process. Myocardial injury leads to release of cardiac troponin, but troponin elevation is not specific for myocardial…

…recurrent narrowing within a previously implanted coronary stent. It represents a form of arterial hyperplastic disease arising after percutaneous coronary intervention (PCI). In contemporary practice…

…an atherosclerotic plaque may also release atherosclerotic debris downstream, causing microvascular embolization (i.e occluding smaller vessels downstream). The thrombosis causes occlusion of the artery…

…25–50 per cent and titrate. At a high dose, in old age or in renal failure, reduce it further. Starting doses in acute pain…

…injury. Mechanisms of troponin release Troponin I and troponin T are components of the myocardial contractile apparatus and are expressed predominantly in cardiac muscle. Troponin…

…sustained release formulation. Note: activated charcoal is ineffective against alcohols, lithium, and heavy metals. Enhance elimination Induce diuresis through urine alkalinization, contingent upon renal elimination…

…cTnI is the most cardiac specific biomarker. Troponin T (cTnT) is cardiac specific but the cTnT assays also detect proteins released from skeletal muscle. Consequently…

Cardiology Principles of myocardial perfusion imaging Myocardial perfusion imaging (MPI) is a non invasive technique for detecting and quantifying coronary artery disease (CAD). It offers…

…and Pathophysiological Basis High sensitivity cardiac troponin (hs cTn) assays detect circulating troponin released from injured cardiomyocytes at substantially lower concentrations than earlier generation assays…

…dose : 0.5 3.0 μg/kg/min + + + +++++ Low dose dopamine stimulates D1 receptors and induces vasodilation in coronary, renal, cerebral and mesenteric vessels…

…dose : 0.5 3.0 μg/kg/min + + + +++++ Low dose dopamine stimulates D1 receptors and induces vasodilation in coronary, renal, cerebral and mesenteric vessels…

…vasodilatation. D1 and D2 (dopamine receptors): activation of D1 and D2 in the kidneys and the splanchnic vascular bed leads to renal and mesenteric vasodilatation…

…pupillary reflex. Importantly, pupillary size and reactivity are influenced by factors beyond neural activity. Systemic catecholamines released or administered during resuscitation can affect pupil to