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

…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…

…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…

…G, 25 mm 90° 1–2 mL Deltoid, BMI 35 or a large arm 23 G, 38 mm 90° 1–2 mL Vastus lateralis, infant…

…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…

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

…artery. Depending on the size and form of the thrombus, it will occlude the main pulmonary artery or its branches. The larger the thrombus, the…

…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…

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…

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…

…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…

…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…

…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…

…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…

…angiography or PCI; cardiogenic shock; ST segment elevation myocardial infarction; extensive vascular calcification; female sex; low body mass index; larger arterial sheaths; greater intensity of…

…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…

…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…

…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…

…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…

…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…

…many studies, although the relative advantage of apoB over non HDL C or standard lipid testing remains unsettled. In a large population study, LDL C…

…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…

…a one quarter reduction in major cardiovascular events over 7 years compared with a low fat diet. In primary prevention, a large randomized trial involving…

…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…

…symptoms Typical SAMS consists of: Symmetric muscle pain Muscle aching or soreness Weakness, often perceived or functional Predominant involvement of large proximal muscle groups Symptoms…

…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…