…imbalance Hypercalcemia Definition : P/S Ca 2+ 2.6 mmol/L In approximately 90% of cases, hypercalcemia is attributed to primary hyperparathyroidism or neoplastic etiologies…

…reflection of the electrical potentials generated by the left ventricle. QRS duration QRS duration is the time duration from the start to the end of…

…risk of hypercapnia has been assessed. 3. Take an arterial blood gas in respiratory compromise, low saturation, suspected carbon dioxide retention, reduced consciousness, or when…

…this chapter, you will learn the physiological basis of all ECG waves and how to determine whether the ECG is normal or abnormal. Although heart…

…and several syndromes can overlap [1,4]. Time after a clear reduction or the last intake Common clinical picture : : 4 to 12 hours Tremor, sweating…

…the most common form of neurally mediated syncope (NMS), a disorder of autonomic reflexes. It typically occurs after attaining an upright posture or following painful…

…Refraction artifact Reflection and refraction occur when ultrasound passes tissue boundaries. Tissue boundaries represent acoustic reflectors at which some of the ultrasound energy is reflected…

…or ≥ 110 Isolated systolic hypertension ≥ 140 and < 90 Thresholds for different measurement methods Measurement technique Faulty measurement technique is the most common cause of…

…generally results from abrupt reduction in coronary blood flow caused by thrombotic occlusion of a previously atherosclerotic artery. Plaque erosion or rupture exposes thrombogenic material…

…is symptomatic or at risk of developing symptoms. The most common non reversible causes of sinus bradycardia are sinus node dysfunction, side effects of medications…

…Important exceptions Condition Overall strategy Common first choices : : : Acute aortic syndrome Immediate rate control and rapid reduction of the systolic blood pressure towards 100 to…

…valve disease is a common cause ( Figure 25, P mitrale ). If the atria are depolarized by impulses generated by cells outside of the sinoatrial node…

…mutations in SCN5A lead to a reduction in the inward sodium current ($I {Na}$) and are identified in 20% to 30% of probands [7] …

…deep veins of the legs or pelvis. Thrombi formed in the deep veins in the legs or pelvis can detach and flow via inferior vena…

…which is synonymous with ischemic heart disease, is the most common form of cardiovascular disease. It has been the number one killer in Western and…

…However, randomized evidence has not shown a reduction in mortality or myocardial infarction with routine CTO PCI compared with medical therapy. Clinical presentation and symptoms…

…stress testing It is a common misunderstanding that the ECG is the main parameter of the stress test. The ECG reaction is indeed important but…

…The population impact of a risk factor depends not only on the relative risk associated with exposure but also on how common the exposure is…

…that compresses the true lumen. The resulting reduction in coronary blood flow may produce myocardial ischaemia, acute coronary syndrome (ACS), myocardial infarction (MI), or, rarely…

…4.0 cm 2 . Aortic stenosis is a progressive disease that leads to a gradual reduction in the orifice area. As the area is reduced…

…mitrale, because mitral valve disease is a common cause (Figure 1). The duration of the P wave will exceed 120 milliseconds in lead II. Biatrial…

…occlusions; a partial occlusion results in a reduction of coronary blood flow and this causes subendocardial ischemia (i.e ischemia that only affects the subendocardium)…

…therefore the beginning of the investigation, not the end. In a frail older patient an apparently small insult — sleep deprivation, urinary retention or a new…

…perfusion. • Dose dependent elevation of intracranial pressure (ICP) and reduction in cerebral blood flow. Caution • Used cautiously in patients with high intracranial pressure or azotemia…

…An undisplaced or reduced fracture to be treated conservatively. Immobilisation after reduction of a dislocation. Immobilisation of a ligament injury, a tendon injury, or after…

…or supranormal ejection fraction , despite manifest heart failure and severe symptoms. These individuals exhibit pronounced hypertrophy, resulting in a reduction of ventricular volume and subsequently…

…age related reduction in cardiovascular reserve, and the increasing burden of comorbid disease. Heart failure with preserved ejection fraction becomes particularly common among the very…

…risk of terminating drug therapy as compared with implementing an artificial pacemaker in order to be able to continue drug therapy. It is very common…

…Glycaemic control is important for prevention of microvascular complications, but intensive glucose lowering alone has shown little or no consistent effect on cardiovascular complications in…

…compromise or skin tenting — reduce promptly, before radiography. The longer a joint remains dislocated, the harder the reduction becomes and the greater the risk of…

…a fairly good estimate of the actual workload. The perceived exertion may be graded from 0 (none) to 10 (maximal exertion) or according to the…

…conceptual framework Acute coronary occlusion is the abrupt or progressive reduction of coronary blood flow sufficient to produce myocardial ischaemia and, when prolonged or severe…

…or partial, depending on the size of the thrombus and the plaque. The patient will experience severe chest pain due to the abrupt reduction of…

…emergency or urgent procedures, chronic kidney disease, ST segment elevation myocardial infarction, and cardiogenic shock. Patient related and procedural risk factors The risk of adverse…

…designed to identify ischemic areas of the myocardium by highlighting regions with reduced blood flow. Radiotracers for SPECT Technetium 99m (Sestamibi or Tetrofosmin): With a…

…or even reduce infarct size, which is generally attributed to its reduction of heart rate and contractility. But as it turns out, [2] the reduction…

…and parasympathetic influences; sympathetic stimulation leads to vasoconstriction through the release of norepinephrine, while parasympathetic activation can cause vasodilation via acetylcholine release. These mechanisms collectively…

Echocardiography Generating the ultrasound image The ultrasound transducer generates short bursts (pulses) of ultrasound waves. Reflected ultrasound waves are analyzed by the machine during the…

…are complementary objectives of initial STEMI management. The principal acute complications fall into two broad categories: Electrical complications , particularly ventricular arrhythmias. Mechanical or pump failure…

…Its principal clinical effect is therefore reduction of LDL cholesterol (LDL C), through a mechanism complementary to that of statins. Statins reduce hepatic cholesterol synthesis…

…apex (which is fixed to the diaphragm via the pericardial sack), while the myocardium travels towards the center of the cavity and the entire ventricle…

…inversion of the T waves. These T waves are called post ischemic T waves and they indicate that the infarction process is more or less…

…lowering alone. Meta analyses have shown that the risk reduction in MACE is largely independent of baseline HbA1c or the magnitude of HbA1c reduction. 7…

…blood pressure reduction may also occur in selected people whose pressure is elevated but below the conventional hypertension threshold. The traditional diagnostic threshold of 140…

…Assessment should integrate the history, physical examination, laboratory data and diagnostic testing. Examination for congestion Useful bedside indicators of persistent or improving congestion include: J

Akutsjukvård Lathundar Basic principle Anaphylaxis is a rapidly developing systemic hypersensitivity reaction that can cause life threatening compromise of the airway, breathing or circulation. Skin…

…a cerumen loop. Suction with Frazier tips of various sizes. A balloon catheter (a 5–6 Fr Fogarty or a Katz extractor). A local anaesthetic…

…crisis. Mechanism of action Phentolamine is a non selective alpha adrenergic blocker. Phentolamine reduces blood pressure while increasing catecholamine activity. Effects Primarily causes afterload reduction…

…pathophysiology Acute limb ischaemia (ALI) is an abrupt reduction in arterial perfusion of an upper or lower limb that causes tissue metabolic requirements to exceed…

…effect of a coronary lesion depends on more than its visual diameter reduction. Relevant determinants include: Lesion eccentricity Vessel tortuosity Calcification Plaque rupture or asymmetric…

…was related to the magnitude of heart rate reduction. Ivabradine is also a reasonable consideration when a beta blocker cannot be tolerated or is contraindicated…

…mm Hg systolic or 90 mm Hg diastolic (140/90 mm Hg). The discordance between optimal blood pressure and the definition of hypertension is explained…

…May therefore induce or worsen angina pectoris. The rapid reduction of afterload is desired in conditions requiring afterload reduction. Time to onset of action 10…

…therapeutic objective is reduction of low density lipoprotein cholesterol (LDL C), the primary lipid target in contemporary secondary prevention. Statins inhibit hepatic 3 hydroxy 3…

…the unit. Preparation and equipment A device capable of both CPAP and bilevel ventilation, or alternatively flow generated CPAP with a PEEP valve. Masks in…

…disease (ASCVD). Atherosclerosis develops through the progressive deposition and retention of LDL C and other apoB containing lipoproteins within the arterial wall. This initiates inflammatory…

…associated with increased ASCVD risk. Management in this range therefore focuses principally on ASCVD prevention and reduction of LDL C, non HDL C and apolipoprotein…

…Indications Decompression in ileus, subacute obstruction or gastric retention — the commonest indication on a surgical ward. Decompression in severe vomiting where the stomach does not…

…cardiovascular risk reported a 30% reduction in major cardiovascular events with a Mediterranean diet supplemented with either nuts or extra virgin olive oil compared with…

…benefits of cessation The principal benefits relevant to clinical cardiology include: Clinical setting or outcome Reported benefit of cessation Cardiovascular disease overall Substantial reduction in…