…injection is placed too high — which causes the shoulder injury known as SIRVA. Both are avoided with the right landmark and the right needle length…

…Radiation to both arms or shoulders has a particularly strong association with myocardial infarction in the cited clinical data, although right arm radiation has not…

…markers of myocardial wall stress. They are released principally by ventricular cardiomyocytes in response to increased transmural stress and ventricular stretch. Atrial natriuretic peptide is…

…effect varies tenfold between individuals, and the only way to find the right level is to give a small dose, wait until it has worked…

…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…

…a dialysis patient, in severe acute kidney injury, in treatment failure or in ongoing massive potassium release. In cardiac arrest with suspected hyperkalaemia, advanced life…

…around the clock for health care professionals. Contact the centre early in serious, unusual or unclear poisoning, with modified release preparations, mixed poisoning, pregnancy, children…

…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…

…scaffold prevents the external constriction that characterizes restenosis after balloon angioplasty. The biological response therefore occurs primarily through intimal thickening. DES release antiproliferative and anti…

…which results in thrombus formation (Figure 1). Disruption of an atherosclerotic plaque may also release atherosclerotic debris downstream, causing microvascular embolization (i.e occluding smaller…

…release tablet and an as required opioid at the same time. Opioids in abdominal pain of unclear cause do not delay the diagnosis and should…

…this pattern. Endothelial dysfunction may contribute to both microvascular and epicardial vasomotor disorders. Endothelial activation can promote the release of adhesion molecules, inflammatory cytokines, and…

…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…

…lithium, or potassium intoxication where lavage might prove beneficial, the procedure should be conducted post intubation. Avoid lavage if gastrointestinal perforation or obstruction is suspected…

…cardiac specific but the cTnT assays also detect proteins released from skeletal muscle. Consequently, skeletal muscle damage or inflammation may result in elevated cTnT levels…

…and myogenic responses, where vascular smooth muscle constricts or dilates in response to changes in intraluminal pressure. Coronary blood flow is also influenced by sympathetic…

…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…

…0 μg/kg/min. + ++++ + +++++ Medium dose dopamine activates β1, releases norepinephrine and thus increases contractility, chronotropy and mild increase in SVR. Ventricular arrhythmias Myocardial…

…0 μg/kg/min. + ++++ + +++++ Medium dose dopamine activates β1, releases norepinephrine and thus increases contractility, chronotropy and mild increase in SVR. Ventricular arrhythmias Myocardial…

…and a beta agonist without vascular effect. Catecholamine receptors Alpha 1 adrenergic receptors: expressed in vascular smooth muscle. Activation results in vasoconstriction and an increase…

…be biopsied. Hypersensitivity to local anaesthetics. Areas at high risk of unsightly or hypertrophic scars: the sternum, the shoulder, the jawline, the ears. Anatomically hazardous…

…and atherosclerosis. Ectopic fat deposited around or within the heart and kidneys may exert direct compressive effects and releases additional inflammatory and profibrotic mediators. Perinephric…

…activate the Edinger–Westphal nuclei. Parasympathetic fibers (carried by CN III) then prompt sphincter muscles in the iris to constrict the pupil. Under normal conditions…