…venous system, resulting in dilation of vena cava inferior ( 2.1 cm). Severe tricuspid regurgitation may lead to systolic reversal in the hepatic veins. This…

…displayed per second. High frame rate (i.e many frames per second) is desirable because it provides better temporal resolution. Frame rate depends on several…

…stricture or a known diverticulum Relative Recent nasal or pharyngeal surgery Signs that should raise the suspicion of a base of skull fracture: periorbital bruising…

…misplaced stimulation artifacts, irregular pacing, etc. Most cases of malfunction are associated with the electronics in the pulse generator or dislodgement or fracture of the…

…pathological Q waves, which means that these ECGs were recorded several hours after symptom onset or those are signs of old infarction. Pathological R waves…

…Moderate regurgitation Severe regurgitation Pulmonary valve morphology normal normal/abnormal abnormal Density CW Doppler weak, slow deceleration variable dense, steep deceleration, early termination of diastolic…

…size and volume Women Men Normal range Mildly abnormal Moderately abnormal Severely abnormal Normal range Mildly abnormal Moderately abnormal Severely abnormal ATRIAL DIMENSIONS LA diameter…

…Staging of chronic kidney disease Stage eGFR Description : : : G1 ≥ 90 Normal or high G2 60–89 Mildly reduced G3a 45–59 Mildly to moderately reduced…

…54 30–44 <30 2D, Two dimensional. Ejection fraction (EF) Normal Mildly abnormal Moderately abnormal Severely abnormal Ejection fraction (%), biplan, males 52 72 41 51…

…attack (TIA). Severely impaired liver function classified as Child Pugh Class C. Dosage Adults Initial dose : A single loading dose of 60 mg. Maintenance dose…

…flow is severely compromised. Clinical Presentation No reflow may become apparent during or immediately after PCI. The clinical presentation depends on the extent of microvascular…

…measurement of coronary blood flow, providing absolute quantification. The resting myocardium rarely reveals evidence of significant coronary artery stenosis unless the stenosis is severely critical…

…brain is severely compromised or absent, leading to rapid brainstem hypoxia. As a result, pupils often dilate widely within 30–120 seconds of cardiac arrest…

…after the onset of myocardial infarction. This is utilized in clinical practice by detecting troponins in patients with suspected acute coronary syndromes. Several manufacturers have…

…seizures and temperature management. The ICU is the preferred level of care for the absolute majority. The CCU may be suitable for stable (hemodynamically and…

…atrial and ventricular filling, such that stroke volumes are severely reduced. Commotio cordis Commotio cordis occurs as a result of a blunt, non penetrating blow…

…plugging. Expiratory flow limitation causes air trapping and dynamic hyperinflation. The consequences are increased work of breathing, exhaustion and, in the most severe cases, hypotension…

…Contraindications Ongoing respiratory depression, or untreated severe respiratory failure without the possibility of monitoring. Paralytic ileus and suspected obstructive ileus (an opioid can be given…

…stenosis severity is a poor surrogate for the hemodynamic significance of a coronary lesion, with anatomic and functional assessment discordant in a substantial minority of…

…Moderate regurgitation Severe regurgitation Pulmonary valve morphology normal normal/abnormal abnormal Density CW Doppler weak, slow deceleration variable dense, steep deceleration, early termination of diastolic…

…despite manifest heart failure and severe symptoms. These individuals exhibit pronounced hypertrophy, resulting in a reduction of ventricular volume and subsequently an increase in ejection…

…Warfarin has a narrow therapeutic index, a half life of several days and more than a hundred clinically relevant interactions. What determines whether the treatment…

…of Echocardiography 30 (4), pp. 303–371. DOI: 10.1016/j.echo.2017.01.007. Mitral valve stenosis Primary parameters Mild stenosis Moderate stenosis Severe…

…Moderate regurgitation Severe regurgitation Pulmonary valve morphology normal normal/abnormal abnormal Density CW Doppler weak, slow deceleration variable dense, steep deceleration, early termination of diastolic…

…abrupt deterioration in renal function. By contrast, hypertensive urgency describes severe hypertension without clinical evidence of acute, ongoing target organ damage. Although BP reduction is…

…This functional definition encompasses several physiological states. Brief coronary occlusion or relatively prolonged moderate ischemia may produce post ischemic stunning. In the absence of infarction…

…function (contractile function) Several echocardiographic measurements are available to assess left ventricular systolic function. These methods elucidate slightly different aspects of systolic function and their…

CPR Data sources for monitoring cardiac arrest and resuscitation There are currently several large registries monitoring resuscitation practices. Some data sources also monitor sudden cardiac…

…can be repeated, usually up to a total of three boluses, if severe symptoms persist and the initial rise is insufficient [3,6]. European protocols…

…Inotropes increase myocardial contractility. There are several synthetic and endogenous agents with inotropic and vasopressor effects, and they often need to be combined in order…

…cardiac contractile force (contractility). Several endogenous and synthetic agents exist and are frequently combined to achieve the desired hemodynamic outcome. Most agents exhibit both vasopressor…

…an emergency management pathway. Patients without haemodynamic instability require more detailed prognostic evaluation using two complementary domains: Indicators of acute PE severity , including clinical findings…

…Acute myocardial infarction is the most severe complication of coronary artery disease. The most common initiating mechanism is rupture or erosion of a vulnerable (unstable)…

…cardiac contractile force (contractility). Several endogenous and synthetic agents exist and are frequently combined to achieve the desired hemodynamic outcome. Most agents exhibit both vasopressor…

…subdivided into several layers. These layers are similar to those seen in arteries throughout the circulatory system (Figure 1). The ventricular wall consists of an…

Echocardiography Principles of image optimization in echocardiography In order to obtain optimal ultrasound images, it is necessary to adjust several parameters continuously during the examination…

…early in severe, progressive or diagnostically unclear AKI. Definition and staging according to KDIGO Acute kidney injury is present when at least one of the…

…generalised tonic clonic and sometimes several within a short period 24 to 72 hours Increasing autonomic hyperactivity and risk of complicated withdrawal 48 to 96…

…poisoning, withdrawal or several factors Inattention is central. A simple check is to ask the patient to recite the months of the year backwards. A…

…Active Ingredient(s) Cardiotoxicity Label Section DICT Concern Cardiac side effects Severity of cardiotoxicity Hyaluronic Acid HYALURONIC ACID HYALURONIC ACID NA no no ZYPREXA Relprevv…

…from sudden cardiac death. Atrial fibrillation and ventricular arrhythmias were observed in the fifth decade of life in several family members. Imaging studies did not…

…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…

…atherosclerotic plaque, and the severity and distribution of coronary stenosis. Modern cardiac CT can acquire a three dimensional cardiac dataset within approximately 5–15 seconds…

…The relationship between LDL C exposure and ASCVD risk is characterized by several principles: Lower LDL C is associated with lower ASCVD risk across the…

…establish: The severity and functional impact of angina or anginal equivalent symptoms. The response to GDMT. The extent of myocardial ischaemia. The presence of viable…

…transection of a papillary muscle may cause immediately overwhelming MR. Partial rupture, often involving the tip or head of the muscle, more commonly produces severe…

…two temporally and clinically distinct complications of acute myocardial infarction (AMI): Early infarct associated pericarditis , which develops from several hours to approximately 4 days after…

…range of miscellaneous conditions. Because several mechanisms may coexist, diagnosis and classification must integrate haemodynamics with the patient’s clinical context and the results of…

…with temporary mechanical circulatory support (MCS) considered as a bridge. Clinical Presentation and Symptoms Symptoms of STEMI The usual symptom is severe, prolonged ischemic discomfort…

…severe hypertension with or without left ventricular hypertrophy. Among patients with NSTE ACS undergoing angiography, approximately 10% have no critical epicardial stenosis. In some of…

…therapeutic decisions in the presence or absence of an acute coronary occlusion, rather than rigid ECG thresholds. Several machine learning models for ECG interpretation have…

…common type of atrial flutter, the re entry loops around the tricuspid valve in a counter clockwise direction. This yields negative flutter waves in II…

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

Echocardiography Color Doppler Velocities recorded in a sample volume of the pulsed wave Doppler can be presented with a color. A color scale from blue…

…Dilation of the left ventricle is virtually always accompanied by impaired left ventricular systolic function. It should be noted that several types of cardiomyopathies ( e…

…to grow new vessels into the ischemic zone. Newly formed vessels, which may originate from other branches of the same coronary artery or another coronary…

…Hypotension can be counteracted with simultaneous administration of norepinephrine. All patients with severe acute heart failure who receive levosimendan should be monitored invasively (e.g…

…exercise due to physical limitations. Contraindications to exercise, such as unstable angina, severe aortic stenosis, decompensated heart failure, or aortic aneurysm. Baseline ECG abnormalities rendering…

…just proximal to the orifice. The change in flow profile results in the formation of a hemisphere with several layers. Flow velocity is equal within…

…with oxygen demands. Depending on several factors– including the severity of the stenosis/occlusion, microvascular function, myocardial oxygen extraction, presence of collateral circulation, etc –ischemia…