…tunica adventitia , respectively. Figure 1. Layers of the left ventricular wall, pericardium and ventricular cavity. The endocardium The endocardium lines the atria, ventricles and the…

…gamma cameras to create tomographic images of the left ventricle. In PET (Positron Emission Tomography), radiotracers emit positrons. When a positron collides with an electron…

…are not restricted to patients with symptoms. Current guidance supports revascularisation for significant left main stenosis irrespective of symptomatic status or the documented ischaemic burden…

…with the right atrium being depolarized before the left atrium. The first half of the P wave is therefore a reflection of right atrial activation…

…to describe a reduction of blood flow to tissues and organs. A few decades later Cohnheim demonstrated that ligation of the left anterior descending artery…

…hypertension with or without left ventricular hypertrophy. Among patients with NSTE ACS undergoing angiography, approximately 10% have no critical epicardial stenosis. In some of these…

…with left ventricular systolic function. EAT = v max /time Fractional shortening (FS) Fractional shortening (FS) is calculated by measuring the change (% reduction) in left…

…left ventricle is usually considerably larger than the right ventricle, the QRS complex is actually a reflection of the electrical potentials generated by the left…

…nuances on the ultrasound image. The tissues in the ultrasound image are drawn with varying shades of one color (usually gray). This is possible because…

…the left ventricle is many times larger than the vector generated by the right ventricle, the QRS complex is actually a reflection of left ventricular…

…in the leads with the highest ST segment elevation. Figure 2. The electrocardiographic natural course in STEMI (ST elevation myocardial infarction). Inversion of T waves…

…may impair left ventricular filling and reduce systemic output. In this setting, venous congestion is generally treated initially with diuretics, whereas norepinephrine and/or inotropes…

…is associated with increased sudden death risk, particularly in individuals younger than 35 years during or after vigorous exercise. Anomalous origin of the left coronary…

…disease or excessive beta blocker or calcium channel blocker exposure. The incidence of cardiogenic shock complicating STEMI has fallen with prompt reperfusion and reduction of…

…with the right atrium being depolarized before the left atrium. The first half of the P wave is therefore a reflection of right atrial depolarization…

…initiation of ACE inhibitors, especially in patients with preexisting azotemia, hypotension, hyponatremia, diabetes mellitus, or in those taking potassium supplements. When managing albuminuria or CKD…

…the inferior wall of the left ventricle. This type of bradycardia is due to diminished automaticity (pacemaker function) in the sinoatrial node or conduction defects…

…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…

…mass. Tamponade occurs when intrapericardial pressure equals or exceeds right atrial pressure. The haemodynamic consequences are progressive impairment of right and left sided filling, reduced…

…state during treatment with an angiotensin receptor–neprilysin inhibitor. Clinical Applications Natriuretic peptides have three principal roles: Supporting or excluding the diagnosis of HF Estimating…

…or without diabetes Heart failure across the ejection fraction spectrum, according to the guideline key points Patients with renal insufficiency and cardiovascular disease, irrespective of…

…in patients with suspected or established coronary artery disease (CAD). It combines echocardiographic assessment of left ventricular (LV) structure and function with exercise or pharmacological…

…Type Angiographic appearance Diagnostic considerations Type 1 Contrast staining of the arterial wall with multiple lumens or radiolucent channels The classic appearance and usually readily…

…Prognosis in aortic stenosis according to type of stenosis. The patients with low flow (stroke volume index <35 ml/m²) and low gradient (<40 mmHg…

…of patients with pulmonary embolism or deep vein thrombosis experience a second thrombotic event within 10 years ( Goldhaber et al, Kearon et al ). Epidemiology of…

…coronary syndrome, acute left ventricular failure with pulmonary oedema, acute aortic syndrome, acute kidney injury, microangiopathic haemolysis, and severe pre eclampsia or eclampsia. The blood…

…depend on left ventricular ejection fraction (LVEF). Heart failure with reduced ejection fraction (HFrEF) is defined by the combination of symptoms, with or without physical…

…left ventricular function and together with an intravenous beta blocker Digoxin In heart failure or hypotension, or as an add on Slow onset. Dose reduction…

…tracer uptake during stress are compared with rest images or with a normally perfused reference region. A stress induced reduction in tracer uptake that improves…

…Even lesions with a visual diameter reduction of 50–70% may or may not produce ischaemia. Conversely, some lesions with apparently lesser narrowing are physiologically…

…Approximately 50% of patients with unstable angina progress to myocardial infarction within 30 days if left untreated. Moreover, the pathophysiology of NSTEMI and unstable angina…

…symptoms suggestive of myocardial ischaemia despite normal or non obstructive coronary arteries; dyspnoea; fatigue; and recurrent symptoms causing impaired quality of life. Women with suspected…

…left ventricular ejection fraction, procedural factors and anticipated outcomes. The supplied material does not describe specific physical signs of CTO or a dedicated physical examination…

…hypertension and atherosclerotic coronary disease In patients with heavy alcohol use, left ventricular dilation may precede the development of increased left ventricular hypertrophy and mass…

…negligible, and doses do not require reduction in patients with renal disease; neither amiodarone nor desethylamiodarone is dialyzable. The volume of distribution is large, averaging…

…peripheral arterial disease. More than 70% of older adults presenting with myocardial infarction, stroke, acute aortic syndromes, or heart failure have preexisting hypertension. The relationship…

…coronary syndromes HF across the spectrum of left ventricular ejection fraction AF and other arrhythmias Ischaemic stroke PAD CKD with associated cardiovascular complications Symptoms are…

…with the forehead against the band and the chin in the rest. Support your working hand against the patient's zygoma or the bridge of…

…a risk of blood contact. An alcohol or chlorhexidine swab. Let the skin dry completely before inserting the needle — alcohol carried in with the needle…

…renal insufficiency, therapeutic interventions with tamoxifen or lithium, thiazide administration, and over supplementation of calcium and vitamin D. ECG in hypercalcemia Typical ECG changes: Shortened…

…axillary nerve: sensation over the lateral part of the deltoid before and after the reduction , together with the distal pulse and sensation throughout the arm…

…shortness of breath. Dyspnea may be due to poor exercise capacity (with normal ventilatory capacity and cardiac output), diminished ventilatory capacity, diminished cardiac output or…

…partial occlusion of the artery (i.e. coronary blood flow is not completely obstructed). NSTE ACS typically presents with ST segment depressions and/or T…

…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…

…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…

…artery stenosis. Stress can be induced pharmacologically with coronary vasodilatory agents or simulated hemodynamically through exercise or the use of chronotropic and inotropic agents. Radiotracers…

…with a working diagnosis of STEMI. More than 12 hours after onset: primary PCI remains indicated when there are ongoing ischaemic symptoms, haemodynamic instability or…

…LDL C reduction required is greater than can reasonably be obtained with a statin alone but does not necessarily require the larger effect of a…

…reduction, blood pressure, lipids and smoking cessation. Weight loss was considered extremely difficult across patient categories. However, the emergence of incretin based therapies, starting with…

…of Korotkoff sounds; if sounds persist, the fourth Korotkoff sound is used. Office blood pressure: blood pressure measured in a clinical setting, manually or with…

…reduction or cessation of prolonged and heavy alcohol intake. The condition can develop despite a measurable or high blood alcohol concentration, particularly in patients with…

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…

…of hypertension is not made on a single reading. It requires repeated measurements on at least two occasions, and preferably confirmation by home measurement or…

…irrigate and never instil fluid onto a battery — the moisture drives the reaction. The battery must come out immediately, with a hook, forceps or suction…

…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…

…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 or diastolic blood pressure 80 mm Hg or higher. • Approximately 50% of all cardiovascular events attributable to hypertension occur in individual with blood…

…stimulation (can be counteracted with simultaneous administration of beta blockers). Effects Induces arteriolar vasodilation without effects on venous circulation. The reduction in systemic vascular resistance…

…the dose produces an additional reduction of approximately 6%. Clinical indications and treatment goals Established atherosclerotic cardiovascular disease Patients with established ASCVD are at very…