Cardiology Respiratory medicine Definition and Pathophysiology Pulmonary hypertension (PH) is a heterogeneous pathophysiological disorder characterized primarily by elevation of pulmonary arterial pressure. It may arise…

…below 7.35 with raised pCO₂ Acute or acute on chronic hypercapnic respiratory failure Rapidly falling pH An urgent ventilatory problem Focal chest pain or…

…the preparation Avoid in renal failure, heart failure, a history of peptic ulcer, and old age Titrate according to the effect and the respiratory rate…

…often lacks abdominal pain and peritonism and instead presents as encephalopathy, renal failure or simply deterioration. The procedure itself is straightforward: ultrasound to find the…

…the management of hypertension, chronic ischemic heart disease, heart failure with reduced ejection fraction (HFrEF), and post myocardial infarction (MI) care. Despite their proven morbidity…

…pH and bicarbonate. An arterial blood gas is needed mainly when concomitant respiratory failure or an exact assessment of oxygenation requires it [3]. Calculation of…

…asthma. Severity in COPD Arterial blood gas Type 1 respiratory failure: PaO₂ < 8 kPa with a normal or low PaCO₂ — a problem of oxygenation…

…morphine Morphine has an active renally excreted metabolite that causes late sedation and respiratory depression Marked liver failure A reduced dose of all of them…

…especially in young women. Non coronary mechanisms that reduce oxygen supply include severe bradyarrhythmia, respiratory failure with severe hypoxaemia, severe anaemia, and hypotension or shock…

…Life Support (ECLS) encompasses several extracorporeal systems designed to assist in cases of cardiac or respiratory failure by means of an extracorporeal pump and oxygenator…

…antidote. Intubation is recommended for neurological, respiratory or haemodynamic failure that cannot be corrected quickly. Rapid sequence induction is used when intubation is required [1]…

…Post resuscitation care requires expertise and resources to diagnose, monitor and manage neurological injuries, hemodynamic and respiratory instability, multiorgan failure, infections, seizures and temperature management…

…hypoxaemia. Hypoxaemic failure where high flow nasal oxygen is insufficient and the carbon dioxide is normal. Bilevel NIV: Acute exacerbation of COPD with respiratory acidosis …

…evidence of hypotension Heart rate and tachycardia Respiratory rate and oxygenation Evidence of systemic congestion or acute RV failure Syncope or altered clinical status Comorbid…

…ischemia or infarction, acute heart failure, or pulmonary oedema. Patients may present with chest pain, severe breathlessness, hypoxaemia, rales, or respiratory distress. In patients with…

…dyslipidaemia, coronary artery disease (CAD), atherosclerosis, heart failure (HF), atrial fibrillation and cardiovascular events. In clinical practice, obesity is conventionally defined by a body mass…

…gas is the reference method when the question concerns oxygenation, precise ventilation or severe respiratory failure. A peripheral venous blood gas is easier to obtain…

…crisis. Contraindications There are no absolute contraindications in hypoxaemia. Take particular care in: A risk of hypercapnic respiratory failure — COPD, severe obesity with hypoventilation, neuromuscular…

…and, in the most severe cases, hypotension, pneumothorax and respiratory arrest [1]. The first few minutes 1. Sit the patient up and minimise physical exertion…

…aspiration: a new pleural effusion of unclear cause. An effusion not confidently explained by heart failure must be aspirated. Suspected empyema or complicated parapneumonic effusion…

…The vast majority of infections with COVID 19 result in mild disease, with symptoms similar to seasonal flu (influenza) and other viral respiratory infections. However…

…sided heart failure, which is explained by the fact that high pressure in the right atrium leads to a decrease in atrial filling. Respiratory variations…

…Parameter Assessment A Airway Voice Breath sounds B Breathing Respiratory rate (12–20 / min) Chest wall movements Chest percussion Lung auscultation Pulse oximetry ( 95%) C…

…Glasgow Coma Scale below 8 Vomiting together with clear neurological impairment Respiratory failure or respiratory arrest Clinical signs of raised intracranial pressure or impending herniation…

…intervention Within 60 min Contact intensive care in shock, rapidly progressive organ dysfunction, respiratory failure, impaired consciousness, or a need for a vasopressor After initial…

…Respiratory complications occur, but untreated convulsive status itself carries a considerable risk of hypoxia and respiratory failure. In placebo controlled trials, respiratory depression was no…

…level of consciousness with inadequate protective reflexes active major haematemesis severe agitation respiratory failure an anticipated difficult or prolonged endoscopic intervention a need for general…

…microvascular dysfunction, coronary embolism, coronary dissection, hypotension, shock, respiratory failure, severe anaemia, sustained bradyarrhythmia Increased myocardial oxygen demand Sustained tachyarrhythmia, severe hypertension, hypertensive crisis, critical…

…spasm, microvascular dysfunction, embolism, dissection, hypotension or shock, respiratory failure, severe anaemia, sustained bradyarrhythmia, tachyarrhythmia, or severe hypertension with or without left ventricular hypertrophy. Among…

…often not true in other circumstances (e.g. pulmonary embolism, trauma, respiratory causes, drug overdoses, etc.). Among victims in whom the cardiac arrest was caused…

…confusion, impaired reflexes. Severe <115 mmol/L Seizures, coma, respiratory arrest, brainstem herniation and death. Table 2. Grading of hyponatremia. Hypernatremia Hypernatremia does not cause…

…Left ventricular function affects right ventricular function via afterload. In the case of left ventricular failure, the pressure in the pulmonary vessels rises and the…

…is warranted. Figure 1. Sinus arrhythmia (respiratory sinus arrhythmia). Treatment of sinus arrhythmia Sinus arrhythmia is a normal finding among young and healthy individuals. It…

…end tidal carbon dioxide, ETCO2) Capnography refers to the measurement of end tidal carbon dioxide (ETCO 2 ) in the respiratory system. ETCO 2 is the…

…Respiratory conditions : Tension pneumothorax Drowning Airway obstruction Hanging Pneumonia High altitude sickness Aspiration Chronic obstructive pulmonary disease (COPD) Bronchospasm (asthma) Other : Coma Central hypoventilation syndromes…

…disturbance. 4. Monitoring at the appropriate level of care , with readiness for respiratory support. 5. Treatment of the alcohol use disorder and planned follow up …

…reactions in the lower grades and marked airway, respiratory or circulatory compromise in the higher ones [5]. For acute clinical use the following simplification can…

…the separate quick reference for dosing in impaired renal function. Respiratory tract Diagnosis Agent Dose Duration : : : : Pneumonia, non severe (DS CRB65 0–1) phenoxymethylpenicillin 1…

…oxygenation despite maximal oxygen or non invasive ventilation. Inadequate ventilation with a rising pCO₂ and respiratory acidosis, or a markedly increased work of breathing with…

…echocardiographic finding A dilated inferior vena cava without respiratory variation Strongly suggests a raised filling pressure Marked respiratory variation in mitral and tricuspid inflow The…

…capacity. Suspected asthma or COPD — diagnosis and follow up. Risk groups: current or former smokers over 40 with respiratory symptoms, and occupational exposure to dust…

…Ebo et al ). Clinical manifestations of anaphylaxis Nervousness, anxiety. Dermatological: Pruritus Urticaria Respiratory: Dyspnea Bronchospasm, stridor, wheezing Hypoxia Life threatening edema involving the lips, tongue…

…It is based on the subjective physical sensations experienced during exercise, including increased heart rate, increased respiratory rate and depth, increased sweating, and muscle fatigue…

…bronchospasm is real. Hypotension and haemodynamic instability. Respiratory compromise during an ongoing crisis. Distinguish the conditions instead by temporarily withdrawing the cholinesterase inhibitor, under monitoring…

…investigations. The emergency differential also reflects distinct mechanisms of acute cardiopulmonary disease: Pulmonary embolism and spontaneous pneumothorax may produce abrupt chest pain and respiratory distress…

…the coronary lumen. Coronary imaging is technically demanding because the vessels are small and are subject to both cardiac and respiratory motion. Image quality is…

…threatening conditions or injuries, including cardiac arrest, drowning, trauma, asphyxia and respiratory arrest. BLS can be provided by laymen, EMTs (emergency medical technicians), nurses, paramedics…

…electrode). Lead III occasionally displays a large isolated Q wave; this is called a respiratory Q wave, because its amplitude varies with respiration. Lead III…

…blood back to the heart. The respiratory depth (volume) increases and this reduces the intrathoracic pressure by increasing the intrathoracic volume. Reduced intrathoracic pressure will…

…tachycardia. Sinus arrhythmia Sinus arrhythmia (respiratory sinus arrhythmia) fulfills all criteria for sinus rhythm except for the fact that the rhythm is slightly irregular. The…