…phase. Severe breathlessness in the palliative phase (at lower doses than for pain). An opioid is rarely the right choice in nociplastic or neuropathic pain…

…blocker exposure. The incidence of cardiogenic shock complicating STEMI has fallen with prompt reperfusion and reduction of infarct size. Earlier estimates approached 20%, whereas contemporary…

…renal sodium and water excretion, and reduction of cardiac fibrosis through activation of the natriuretic peptide A receptor. NT proBNP is an inactive cleavage product…

…lower border of the acromion , in the middle of the muscle belly, within the inverted triangle formed between the acromion and the lower tip 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 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…

…impaired renal venous outflow and persistent right sided congestion may be important mechanisms. Diuretics relieve the hemodynamic consequences of congestion by producing a negative sodium…

…visual diameter reduction. Relevant determinants include: Lesion eccentricity Vessel tortuosity Calcification Plaque rupture or asymmetric filling defects Serial lesions Vessel size The relationship of 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…

…Pathophysiology of pulmonary embolism (PE). Hemodynamic effects Pulmonary embolism leads to increased resistance in the main pulmonary artery, and thereby increased afterload on the right…

…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…

…bradycardia. Click to zoom. Treatment of sinus bradycardia Benign causes of sinus bradycardia (e.g. vasovagal reaction, well trained athletes) do not require treatment. When…

…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…

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

…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…

…hours duration): Due to cellular adaptations, rapid correction carries the risk of inducing osmotic demyelination syndrome (ODS). It is therefore recommended to raise serum sodium…

…an orthopaedic surgeon before attempting reduction. Posterior shoulder dislocation, which is often associated with fracture and requires an orthopaedic surgeon. Dislocation of a native hip …

…integrated assessment of six components: Symptoms Exercise performance (functional capacity, exercise capacity) Heart rate: maximal heart rate, heart rate response Blood pressure reaction ECG reaction:…

…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…

…on the size of the thrombus and the plaque. The patient will experience severe chest pain due to the abrupt reduction of coronary blood flow…

…radial access. Radial access has also been associated with lower overall major adverse cardiac events and mortality in pooled analyses of randomized trials. Femoral access…

…of the tracers is fixed immediately after administration. Radiotracers with higher levels of redistribution can move from areas of higher concentration to regions with lower…

…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…

…92 percent until the risk of hypercapnia has been assessed. 3. Take an arterial blood gas in respiratory compromise, low saturation, suspected carbon dioxide retention…

…functional) capacity. Functional capacity is a strong predictor of both cardiovascular and overall mortality, offering incremental prognostic data beyond perfusion imaging and ECG reaction. Coronary…

…sex, Black race, lower socioeconomic or uninsured status, a history of angina or diabetes, and consultation with relatives or physicians before contacting emergency services. These…

…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…

…by about 13% of their length, but the sum of all contractions results in a reduction of the diameter and length of the ventricle by…

…reduction of the ST segment elevation by 50%) within 60 minutes after administration of thrombolysis. Otherwise, one must consider rescue PCI. For the purpose of…

…A1c (HbA1c) reduction, blood pressure, lipids and smoking cessation. Weight loss was considered extremely difficult across patient categories. However, the emergence of incretin based therapies…

…category of elevated blood pressure, defined as office SBP 120–139 mmHg or DBP 70–89 mmHg. This distinction supports a risk based approach because…

Psykiatri Akutsjukvård Lathundar Rapid summary Alcohol withdrawal occurs after an abrupt reduction or cessation of prolonged and heavy alcohol intake. The condition can develop despite…

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…

…by home measurement or 24 hour recording — the thresholds for which are lower than for office measurement. Classification of office blood pressure Category Systolic Diastolic : : : …

…The urgency varies: Object Urgency : : Button battery Immediately — leakage of fluid causes a chemical burn Two or more magnets (including in different nostrils) Immediately — pressure…

…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…

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

…slope of diastolic depolarisation and produces a dose dependent reduction in sinus rate. Its principal therapeutic distinction from beta blockers is that it lowers heart…

…and there may be individual benefits of initiating treatment at lower blood pressure levels. KEY POINTS • The risk of cardiovascular disease increases gradually at blood…

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

…dose dependent reduction in triglycerides. The benefit of statins extends beyond angiographic reduction of coronary obstruction. Intensive lipid lowering improves endothelial function, lowers circulating high…

…dioxide retention for the latter. The treatment is also time limited by its very nature: a patient who has not responded within a couple of…

…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…

Procedurer The insertion itself is rarely the difficult part — it is the confirmation of the position that determines whether the tube is safe. A misplaced…

…products and sweets. An umbrella review incorporating observational studies and randomized trials reported associations between greater adherence to a Mediterranean diet and lower risks of

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

…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…

…Discharge Management The STRONG HF trial demonstrated the safety and efficacy of an approach based on starting and titrating oral medical therapy for heart failure…

…heterozygous familial hypercholesterolaemia. The broader therapeutic principle is that LDL C reduction is associated with cardiovascular benefit regardless of the pharmacological route used. In patients…

…a lesion proximal to the first septal perforator of the left anterior descending artery was associated with lower five year survival than a more distal…

…It promotes degradation of the messenger RNA encoding PCSK9, thereby suppressing hepatic PCSK9 synthesis. The resulting increase in LDL receptor availability lowers circulating LDL C…

…insufficiency and cardiovascular disease, irrespective of diabetes status The clearest and most consistent cardiovascular signal is reduction in hospitalization for heart failure. Benefits also include…

…manifest at rest because of the severe reduction of coronary flow caused by acute atherothrombosis. Table 1: Myocardial and ECG reaction in various settings with…

…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…

…increase the risk of simvastatin related myopathy. Some Asian populations, including Japanese, Chinese and Malay patients, may have higher statin blood levels; lower starting doses…

…the lower part of the target range. Paraquat poisoning — oxygen worsens the lung injury. Discuss with your national or regional poison control centre. An open…