…the tissue — even when they lie in separate nostrils, or one in the nose and one in the ear — and compress the mucosa and cartilage…

…of polyvinyl chloride for decompression and evacuation; a fine, soft tube (Ch 8–12) of polyurethane or silicone for nutrition, since it causes less mucosal…

…target — the nasal cannula stays in place for days without anyone asking why, or the patient at risk of carbon dioxide retention is given 15…

…risk of fluid retention and impaired kidney function). Patients with bronchial asthma, chronic obstructive pulmonary disease, hay fever, or nasal polyps (increased risk of hypersensitivity…

… nasal masks and total face masks are alternatives in intolerance. A hydrocolloid dressing for the bridge of the nose applied before the mask goes on…

…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…

…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…

…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…

…progressive reduction of coronary blood flow sufficient to produce myocardial ischaemia and, when prolonged or severe, myocardial necrosis. It most commonly reflects atherothrombosis: disruption of…

…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…

…failure, and heart failure have been identified as important risk factors. Severe atherosclerosis of the axillary or subclavian arteries may increase the risk of embolization…

…exhibits high extraction from blood to tissue and high retention, with a linear relationship between myocardial blood flow and measured tracer activity over a wide…

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

…and the start of the QRS complex is called the PR segment. The PR segment is the baseline (also referred to as reference line or…

…ceiling of care and the decision on intubation early. Initial assessment Confirm that the presentation fits an exacerbation A COPD exacerbation is an acute or…

…data beyond perfusion imaging and ECG reaction. Coronary blood flow and coronary flow reserve (CFR) Coronary blood flow is the volume of blood flowing through…

…image of the tissue, the ultrasound machine must overcome the following technical obstacles. The ultrasound machine must know which sound waves are reflected and from…

…Definition and Pathophysiology ST segment elevation myocardial infarction (STEMI) is an acute myocardial infarction associated with a working diagnosis of persistent ST segment elevation or…

…Approximately 60% reduction Inclisiran, with or without statin therapy Approximately 50% reduction The absolute reduction depends on the pretreatment LDL C concentration and the accompanying…

…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…

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

…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…

…independent of baseline HbA1c or the magnitude of HbA1c reduction. 7 Instead, these agents exert multifaceted effects through direct activation of receptors in target tissues…

…and treatment thresholds. The 2024 European guideline defines hypertension as an office systolic blood pressure (SBP) of ≥140 mmHg or diastolic blood pressure (DBP) of…

…occurs after an abrupt reduction or cessation of prolonged and heavy alcohol intake. The condition can develop despite a measurable or high blood alcohol concentration…

…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

…allergic reaction Skin or mucosa only, stable breathing and circulation Observation, a non sedating antihistamine for symptoms Anaphylaxis Objective airway, respiratory or circulatory compromise, or…

…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…

…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…

…medicine Definition and pathophysiology Acute limb ischaemia (ALI) is an abrupt reduction in arterial perfusion of an upper or lower limb that causes tissue metabolic…

…can refine interpretation. Coronary plaque and future events Angiographic stenosis severity is an imperfect predictor of future myocardial infarction or sudden death. Lesions causing only…

…sinus rhythm and a heart rate above 70 beats/min. The reduction in the combined outcome of cardiovascular death or heart failure hospitalisation was related…

…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…

…SVR) is rapid and may cause reflex sympathetic stimulation, including tachycardia. May therefore induce or worsen angina pectoris. The rapid reduction of afterload is desired…

… and A reduction of at least 50% from baseline. In patients who experience a recurrent atherothrombotic or cardiovascular event within 2 years while receiving maximally…

…C) and other apoB containing lipoproteins in atherosclerotic cardiovascular disease (ASCVD). Atherosclerosis develops through the progressive deposition and retention of LDL C and other apoB…

…therefore focuses principally on ASCVD prevention and reduction of LDL C, non HDL C and apolipoprotein B. Causes and secondary contributors A search for secondary…

…The first half of the P wave is therefore a reflection of right atrial depolarization and the second half is a reflection of left atrial…

…a state of inadequate tissue and end organ perfusion caused by cardiac insufficiency. Sustained hypoperfusion reduces oxygen and nutrient delivery and, when severe or prolonged…

…of foods habitually consumed rather than isolated nutrients considered independently. For cardiometabolic health, the most favourable patterns generally contain more minimally processed, fibre rich and…

…setting or outcome Reported benefit of cessation Cardiovascular disease overall Substantial reduction in cardiovascular events and mortality Established coronary disease Approximately 36% lower risk of…

…of a central reflex produces a stereotypic response: an initial increase in heart rate, followed by a drop in blood pressure, and finally a reduction…

…Loss of function (LOF) mutations in SCN5A lead to a reduction in the inward sodium current ($I {Na}$) and are identified in 20% to…

…reversible causes are absent and the patient is symptomatic or at risk of developing symptoms. The most common non reversible causes of sinus bradycardia are…

…of systemic arterial pressure. This renoprotective effect involves a reduction in intraglomerular hyperfiltration and hypertension by disproportionately reducing glomerular efferent arteriolar vasoconstriction. Clinical Presentation and…

…patients with and without diabetes. A pooled analysis of studies involving patients with heterozygous familial hypercholesterolaemia or ASCVD found an LDL C reduction of approximately…

…to BNP and NT proBNP in heart failure (HF). The biologically active natriuretic peptides promote vasodilation, renal sodium and water excretion, and reduction of cardiac…

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

…and A reduction of at least 50% from baseline . The treatment sequence is generally: High intensity statin therapy at the highest tolerated dose. Addition of…

…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…

…ischemia or increased workload STATUS OF CORONARY ARTERY SETTING EFFECT ECG REACTION Normal coronary artery (no atherosclerosis) At rest Oxygen supply is adequate and ischemia…

…important. Inhibition of cytochrome P 450 3A4 or 2C9 can increase statin concentrations. Relevant interacting agents include amiodarone, macrolide antibiotics such as erythromycin and clarithromycin…

…inflammatory disease of the arterial wall in which lipid accumulation, vascular cell dysfunction, immune cell recruitment, extracellular matrix remodelling, and thrombosis interact to produce focal…

…intensity and duration of exposure to cardiovascular risk factors. Primary prevention Primary prevention targets people without clinical CVD who nevertheless have established risk factors or…

…Diagnostic considerations Type 1 Contrast staining of the arterial wall with multiple lumens or radiolucent channels The classic appearance and usually readily recognized Type 2…

…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…

…Condition Overall strategy Common first choices : : : Acute aortic syndrome Immediate rate control and rapid reduction of the systolic blood pressure towards 100 to 120 mmHg…

…diameter stenosis and haemodynamic significance is weak, particularly for intermediate lesions. Even lesions with a visual diameter reduction of 50–70% may or may not…

…Reduction of Sympathetic Drive Modulating autonomic tone is a pivotal therapeutic target [4]: Beta Blockers : Administered to reduce adrenergic stimulation [4]. Sedation and Intubation : Along…

…The first half of the P wave is therefore a reflection of right atrial activation and the second half is a reflection of left atrial…