…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…

…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…

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…

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

Cardiology Introduction Since its initial description in 1992 as a syndrome of right bundle branch block, ST segment elevation, and sudden cardiac death (SCD), Brugada…

…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

…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…

…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…

…left to right shunt, tamponade, or sudden loss of effective cardiac output. Their recognition is essential because treatment often requires urgent surgical or transcatheter intervention…

…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…

…of titration is abandoned — when a fixed dose is given without assessment, when a modified release preparation is started in an opioid naive patient, or…

…It generally results from accumulation of pericardial fluid, blood, or, less commonly, a mass. Tamponade occurs when intrapericardial pressure equals or exceeds right atrial pressure…

…Clinical Applications Natriuretic peptides have three principal roles: Supporting or excluding the diagnosis of HF Estimating disease severity and prognosis Contributing to longitudinal assessment and…

…due to diminished automaticity (pacemaker function) in the sinoatrial node or conduction defects (e.g. second degree AV block) as a result of ischemia/infarction…

…Preparation and equipment Hand disinfection; gloves where there is a risk of blood contact. An alcohol or chlorhexidine swab. Let the skin dry completely before…

…the right coronary cusp (RCC), and the left main coronary artery (LMCA) departs from the left coronary cusp (LCC). NCC = non coronary cusp. Natural…

…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…

…haemorrhage control) planned in advance. A history of a severe transfusion reaction: contact transfusion medicine before transfusing again. Preparation and equipment Compatibility testing Test What…

…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…

…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…

…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…

…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…

…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…

…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…

…in arteries throughout the circulatory system (Figure 1). The ventricular wall consists of an inner lining (endocardium), a thick muscle layer (myocardium) and an outer…

…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…

…Inter arm difference: a sequential systolic difference of 10 mmHg between the arms. Orthostatic hypotension: a fall of ≥20 mmHg in SBP and/or ≥10…

…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…

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…

…body in the ear canal or the nasal cavity must be removed. The urgency varies: Object Urgency : : Button battery Immediately — leakage of fluid causes a…

…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 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…

… 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…

…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…

…a drop in blood pressure, and finally a reduction in heart rate. This sequence is characteristic of neurally mediated hypotension. Clinical Presentation and Symptoms Vasovagal…

…initiation of an ACE inhibitor to prevent symptomatic hypotension. Diagnostics The source material does not cover specific diagnostic modalities such as ECG, imaging, or electrophysiology…

…patients with ASCVD or at least one ASCVD risk equivalent who were receiving statins, inclisiran produced a further reduction in LDL C of approximately 50…

…to patients with symptoms. Current guidance supports revascularisation for significant left main stenosis irrespective of symptomatic status or the documented ischaemic burden. In chronic coronary…

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

…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…

…1: Myocardial and ECG reaction in various settings with ischemia or increased workload STATUS OF CORONARY ARTERY SETTING EFFECT ECG REACTION Normal coronary artery (no…

…to moderate heart failure, kidney or liver disease, especially when combined with diuretics (risk of fluid retention and impaired kidney function). Patients with bronchial asthma…

…therefore appropriate. Drug interactions are particularly important. Inhibition of cytochrome P 450 3A4 or 2C9 can increase statin concentrations. Relevant interacting agents include amiodarone, macrolide…

…why, or the patient at risk of carbon dioxide retention is given 15 litres on a reservoir mask and drifts off into a respiratory acidosis…