Cardiology Coronary Atherosclerosis Coronary atherosclerosis is a chronic, progressive, and highly complex lipid driven inflammatory disease of the arterial intima that serves as the fundamental…

…to separate pericarditis from ST elevation myocardial infarction (STEMI). This may not always be simple, because both conditions bring about severe chest pain and ST…

…greater ventricular wall stress, probably because of suppression of natriuretic peptide production or post translational modification rather than a simple clearance effect. Treatment also affects…

Cardiology Myocardial ischemia and infarction Definition and pathophysiology Atherosclerosis is a chronic, inflammatory disease of the arterial wall in which lipid accumulation, vascular cell dysfunction…

…and record an ECG. 2. Confirm the potassium with a repeat sample, but do not delay treatment when there are ECG changes, circulatory compromise or…

…process: acute, evolving or chronic The severity of ischaemia and whether infarction has occurred The extent and degree of myocardial involvement The anatomical territory, including…

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

…Reduction in plasma volume, preload and afterload Lower left ventricular wall stress Reduced sympathetic nervous system activity Improvement in cardiac metabolic efficiency, including increased oxygen…

…fluid. The aspiration is technically simple — what determines the outcome is that it is done early and sterilely and that the samples are sent correctly…

…discussion: the ECG blog ECG The best ECG book is not the one making it simple In the thrilling and ever evolving field of medicine…

…majority of cases, and the great majority of objects can be removed in general practice or in the emergency department with simple equipment. Two principles…

…only one that will go in. The rule that saves time is simple: two attempts or 90 seconds — then go intraosseous. Indications Peripheral venous cannula:…

…The treatment looks simple — bicarbonate and a look at the urine dipstick — but it fails routinely for one single reason: without normal potassium the urine…

…been the dominating method for assessing left ventricular systolic function. Ejection fraction is simple to calculate; if the left ventricle contains 100 ml of blood…

…are simple mathematical equations, included in all ultrasound systems, and assume that the geometry of the left ventricle is normal. Figure 1. Calculation of left…

…or more anatomically contiguous leads, which implies leads that are anatomically juxtaposed. The reason for this is simple. For example, if there is acute ischemia…

…pressure suggests a low stroke volume Capillary refill < 3 s A simple and validated marker of perfusion Lactate < 1.6 mmol/L Clearance…

…exophytic lesion (fibroma, seborrhoeic keratosis) Shave Simple, with a good cosmetic result Suspected cutaneous lymphoma Several 4–6 mm punches Broad sampling increases the yield…

…severity of stenoses and regurgitations, etc . These calculations are based on simple mathematical equations, which are based on hemodynamic principles. It is fundamental to be…

…an intuitive basis. Consider the fact that the left ventricle contracts and ejects blood into the aorta roughly 100,000 times daily, each time overcoming…

…speed , and direction . The underlying mathematical principles are simple and important to understand. Figure 2 illustrates the wavelength and amplitude of sine curves. Figure 2…

…The explanation for this is simple: transmural ischemia is due to a complete and proximal artery occlusion and such occlusions must be managed with immediate…

…the principle of ultrasound imaging is simple: sound waves are sent into the tissue and the reflected waves are used to create an image of…

…disturbance? Calculate the delta gap or delta ratio 6 Does the result fit the patient? If not, check the sample type, supplemental oxygen, sampling technique…

…resolved Inattention The patient loses the thread, is easily distracted or cannot follow a simple instruction Altered awareness The patient is drowsy, difficult to rouse…

…at high flows and during prolonged treatment. A nasal cannula, a simple mask, a mask with a reservoir, a Venturi mask with a set of…

…catheter . Both are controlled by feedback from the core temperature. Simple measures that are often enough: undressing the patient, lowering the room temperature, a fan…

…the back. In clinical practice, this is often performed by simply placing the electrodes to lead V4, V5 and V6 on the back. One might…

…Pupillary Reflex in Cardiac Arrest The pupillary light reflex is controlled by a simple neural circuit: light signals travel from the retina via the optic…

…Brugada syndrome. This disorder is easy to diagnose with a simple blood test and the ST segment elevations resolve after normalization of potassium levels. Brugada…

…and Mobitz type 2. A very simple rule of thumb can be applied to do this: whenever there are varying PR intervals, the diagnosis is…

…left shows many sample volumes within a Doppler sector. The picture on the right shows color Doppler located across the mitral valve and the left…

…renal failure or simply deterioration. The procedure itself is straightforward: ultrasound to find the fluid, an insertion site in the left lower quadrant lateral to…

…presented in the parenthesis). Values without confidence interval are simply the 98 th percentile (i.e the upper reference limit). Age <1 day 1–3…

…practice guidelines for emergency medicine (and prehospital medicine). This is high quality medical education simply. Life in the Fast Lane Australian site with one of…

…etc . The purpose of such changes is simply to enable the cardiopulmonary system to increase its delivery of oxygen to skeletal muscle and myocardium. The…

…presented in the parenthesis). Values without confidence interval are simply the 98 th percentile (i.e the upper reference limit). Age <1 day 1–3…

…automaticity) in the sinoatrial node. This simply means that the sinoatrial node discharges electrical impulses at a higher frequency than normal. Similar to sinus rhythm…

…in properly selected patients. Tenecteplase 0.25 mg/kg is a safe and effective alternative to alteplase and is simpler to administer, since the whole…

…Sampling for a suspected sexually transmitted infection — although chlamydia and gonorrhoea can be tested on urine or a self taken vaginal sample without a speculum…

…and anxiety related disorders. The immediate objective is not simply to establish whether the patient has ACS. It is to determine whether the patient is…

…more than one pathophysiological pathway, combinations generally lower blood pressure more effectively than simply increasing the dose of a single drug. They may also permit…

…Figure 6 , panel A. These calculations are approximated simply by eyeballing. Panel B in Figure 6 shows a net negative QRS complex, because the negative…

…causing aberrant ventricular conduction. A premature atrial beat is simply an extra (unexpected) beat discharged by an ectopic focus in the atria. The impulse from…

…is derived by measuring flow velocities across the mitral valve using pulsed Doppler. Estimating left ventricular filling pressure via e' . Measurement of deceleration time (DT) …

…the resulting QT interval is referred to as corrected QT interval, or simply QTc interval. The primary hazard lies in long QTc intervals because they…

…specific region of the image, whereas shifting focus simply adjusts the location (along the ultrasound beam) with the best resolution. If the ultrasound image is…

…continuously. Sample volume (SV) The major advantage of pulsed wave Doppler is the ability to specify where (along the Doppler line) to measure velocities. This…

…Pulsed tissue Doppler uses a sample volume where the velocity is recorded (Figure 1). Figure 1. Pulsed tissue doppler with sample volume in the mitral…

…seconds). The QRS complex is wide simply because the ectopic impulses that cause these rhythms spread partially or entirely outside of the ventricular conduction system…

…measured value does not fit the clinical picture, repeat the sample and send a venous plasma glucose, but do not delay treatment of a neurologically…

…three way tap when the opening pressure is to be measured. Four numbered sample tubes, and a light protected tube if spectrophotometry is to be…

…a guidewire, a dilator and a 5–8 F pigtail catheter , plus a drainage bag. Sample tubes for cell count, chemistry, culture and cytology, and…

…suture material, a size 11 scalpel, artery forceps. Sample tubes according to the table below, and blood culture bottles. Suction and oxygen to hand. The…

…often the very question at issue A patient who needs steroid cover simply to get through the day of the test can therefore be given…

…with acute pancreatitis. Evaluation and physical examination Evaluation should establish: The triglyceride concentration and whether the sample was fasting or non fasting. The presence of…

…T wave changes. The term ST T segment changes (or simply ST T changes) is used to refer to such ECG changes. It must also…

…the conduction cells. The terms contractile myocardium , myocardium, or simply myocardial cell, refer to this cell type, and these terms are used interchangeably. Cardiac cell…

…WCT) or a narrow complex tachycardia (NCT). This is done by simply judging the QRS duration. If the QRS duration is normal (<0.12 seconds…

…absolute risk of an event (such as sudden cardiac arrest) is simply the number of individuals that experience the event divided by the number of…