…years, compared with 15.0 per 1000 patient years in age matched controls without autoimmune disease. The greatest risks were reported with systemic sclerosis, Addison…

…and in patients with diabetes or renal failure the index may be falsely normal because of medial sclerosis — in that case add toe pressure measurement…

…or associated with conditions such as systemic sclerosis, HIV infection, cirrhosis, and sickle cell disease. The classification also recognizes vasoreactivity subgroups among patients with idiopathic…

…Episodes of headache, palpitations, sweating and pallor that may suggest phaeochromocytoma. Systemic sclerosis, kidney disease, autoimmune disease or previous thrombotic microangiopathy. Antidepressants can affect the…

…grading There are several grading systems, and no grading replaces immediate clinical assessment. The updated international grading comprises five levels, with mild skin and mucosal…

…condition characterized by systemic inflammatory response syndrome (SIRS), disseminated intravascular coagulation (DIC), and hypoperfusion manifesting as hypotension. The high mortality associated with sepsis underscores the…

…action • Systemic Dopamine 1 (D1) receptor agonist. • Lowers blood pressure while maintaining or increasing kidney perfusion. Effects Dopamine 1 receptor agonists lower systemic blood pressure…

…The shunt fraction (Qp/Qs) is a critical hemodynamic parameter used to quantify the ratio of pulmonary blood flow (Qp) to systemic blood flow (Qs)…

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

…and incompletely absorbed after oral administration, with systemic bioavailability ranging from 25% to 65% and minimal hepatic first pass extraction. Following a single oral dose…

…Although epicardial coronary arteries are a major site of disease, atherosclerosis is systemic and may affect multiple arterial territories. The arterial wall is biologically active…

…of systemic atherosclerosis. The principal clinical concern is cerebral embolism or haemodynamic compromise leading to transient ischaemic attack (TIA) or stroke. The risk associated with…

…Purkinje system, such as isoproterenol and/or procainamide. EPS with isoproterenol is also recommended for risk stratification in specific populations, such as asymptomatic patients with…

…these patients exhibit hypotension—often with a systolic blood pressure less than 90 mmHg—accompanied by signs of poor vital organ perfusion or frank shock…

…adventitial disease and trauma. Atherosclerotic PAD is a manifestation of systemic arterial disease rather than an isolated disorder of the lower limbs. Patients frequently have…

…driver of global cardiovascular morbidity and mortality, primarily due to its association with ischemic stroke and systemic embolism. The contemporary understanding of AF has evolved…

…while simultaneously affecting systemic perfusion. Aortic stenosis is a serious condition with poor long term outcomes. Patients with low flow low gradient aortic stenosis (discussed…

…body's capacity for heat elimination. Hyperthermia can induce an inflammatory state similar to the Systemic Inflammatory Response Syndrome (SIRS). Body temperatures surpassing 40°C (104°F…

…abnormal amount of fluid in the pericardial space. It can be caused by numerous local and systemic disorders. Accumulation of fluid in the pericardial space…

…peptide levels and/or objective evidence of pulmonary or systemic congestion [3] . Within this spectrum, Heart Failure with Reduced Ejection Fraction (HFrEF) is specifically classified…

…confused with hypertrophy caused by increased loading conditions. Increased ventricular load is mostly caused by systemic hypertension or aortic stenosis. In hypertension, the increased systemic…

…the same time, exacerbation is a clinical syndromic diagnosis, not a sufficient explanation for all acute dyspnoea in a patient with COPD. Pneumonia, heart failure…

…5. Add ipratropium in a severe or life threatening attack. 6. Give a systemic steroid early. 7. Insert intravenous access, but do not let blood…

…instrumental removal: Suspected penetrating injury or an intraocular foreign body — shield the eye with a rigid shield, give systemic antibiotics and contact an ophthalmologist urgently …

…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…

…unstable patient Hypotension (systolic < 90 mmHg for 15 minutes, or a need for a vasopressor), obstructive shock or cardiac arrest with suspected pulmonary embolism…

…of disease progression. Assessment of pulmonary involvement in systemic disease, for example rheumatoid arthritis or scleroderma, and during treatment with pulmonary toxic drugs. Contraindications Forced…

…effect on myocardial contractility or conduction. Clevidipine reduces mean arterial blood pressure (MAP) by decreasing systemic vascular resistance (SVR). Clevidipine does not reduce cardiac filling…

…is defined as significantly elevated blood pressure (systolic pressure ≥180 mmHg and/or diastolic pressure ≥120 mmHg) with concurrent signs of acute organ damage or…

…of blood flow to vital organs than systolic blood pressure alone. Predictive Value : Elevated MAP has been associated with an increased risk of cardiovascular diseases…

…muscle cells. As compared with nitroprusside, nicardipine induces relatively greater venodilation than arteriolar dilation. Effects Nicardipine causes dilation of the coronary and systemic arteries, decreases…

…with worse outcomes. Unprotected Left Main Disease : Increases complexity and risk. Peripheral Vascular Disease (PVD) : Indicates systemic atherosclerosis. Chronic Obstructive Pulmonary Disease (COPD) : Associated with…

…CKD). These agents interfere with the renin angiotensin aldosterone system (RAAS) by inhibiting the enzyme responsible for the conversion of angiotensin I to angiotensin II…

…the extent of circulatory compromise. Features associated with an unfavourable short term prognosis include: Tachycardia Low systolic blood pressure Respiratory insufficiency, manifested by tachypnoea and…

…free wall rupture after infarction Anticoagulant associated bleeding Renal failure Systemic inflammatory disease Catheter based electrophysiological and structural cardiac procedures In patients with acute pericarditis…

…Dietary composition may influence blood pressure, glucose–insulin homeostasis, lipids and apolipoproteins, endothelial function, systemic inflammation, liver fat synthesis, adiposity, thrombosis and coagulation, cardiac function…

…therapeutic options cannot be pursued. Patients receiving digoxin may present with symptoms of digitalis toxicity, which manifests across multiple organ systems. Non cardiac symptoms include…

…of systemic venous congestion include: Peripheral edema Rapid weight gain Increasing abdominal girth Early satiety Bendopnea Abdominal ascites Older patients may present atypically, with fatigue…

…changes occur during the first year of life. The electrocardiogram (ECG) evolves in parallel with the changing anatomy and physiology of the heart. ECG amplitudes…

…causes, and extracardiac or systemic causes producing myocardial oxygen supply–demand imbalance. Coronary mechanisms Coronary mechanisms include: Plaque rupture or plaque erosion with thrombosis, despite…

…or fall. A stable elevation indicates chronic myocardial injury . Myocardial injury is not synonymous with myocardial infarction. Cardiac troponin identifies injury to myocardial cells, but…

…normal or only slightly elevated. This combination—systemic venous hypertension with relatively modest left sided congestion—is an important clinical clue. Haemodynamic severity The presentation…

…FMD was identified in 86% of patients with SCAD. SCAD should therefore prompt consideration of systemic arteriopathy rather than being regarded solely as an isolated…

…environmental factors and genetic background. Thrombotic susceptibility is likewise affected by inflammation and other systemic influences. The severity of myocardial injury is determined not only…

…hours. The extent and tempo of injury are influenced by collateral flow, myocardial oxygen consumption, and intermittent occlusion with reperfusion. Prompt reperfusion, when appropriate, reduces…

…with atherosclerosis or may be the dominant cause of ischaemia. Other mechanisms capable of obstructing coronary arteries include embolism, dissection, coronary arteritis associated with systemic…

…reflects atherothrombosis: disruption of an atherosclerotic plaque followed by platelet activation and coagulation, with formation of an intraluminal thrombus. The clinical spectrum includes unstable angina…

…change or degeneration. Endocarditis with alpha streptococcus is most often subacute and can develop gradually over several days to weeks. More acute endocarditis is often…

…is defined as significantly elevated blood pressure (systolic pressure ≥180 mmHg and/or diastolic pressure ≥120 mmHg) with concurrent signs of acute organ damage or…

…changes occur during the first year of life. The electrocardiogram (ECG) evolves in parallel with the changing anatomy and physiology of the heart. ECG amplitudes…

…immune mediated fibroproliferative response to endothelial injury [2] . The process initiates with endothelial dysfunction, a state provoked by systemic risk factors such as hypertension, hyperglycemia…

…the cases. As compared with the right ventricle, the left ventricle contracts against much greater resistance (i.e. the pressure in the systemic circulation), and…

…rather than the emergency room: a very large or deep abscess, a markedly unwell patient with fever and systemic upset, suspected necrotising soft tissue infection…

…life produces more marked suppression. Stress dosing in known adrenal insufficiency A patient with primary adrenal insufficiency (Addison's disease), secondary adrenal insufficiency or long…

…TIA, systemic thromboembolism) in the next 12 months and the calculations apply to untreated patients with non valvular atrial fibrillation ( Table 1 ). CHADS VASc Score…

…min Safe for peripheral use +++++ +++ ++ 0 Potent vasoconstrictor with mild inotropic effect. Increases systolic pressure, diastolic pressure and pulse pressure with minimal effect on CO…

…and its variants are associated with conditions that cause medial degeneration or increase aortic wall stress. Relevant associations include: Systemic hypertension Marfan syndrome Loeys–Dietz…

…ergotism, hypercoagulable states or iatrogenic vascular injury. Acute occlusion may also occur in an artery with established collateral circulation, particularly an occluded bypass graft; in…

…sex , and genetically influenced effects on the cardiovascular system. Acute exposure produces transient haemodynamic and myocardial effects, whereas sustained heavy consumption is associated with hypertension…

…antihypertensives, should prompt clinical suspicion [1]. Cardiac Signs and Symptoms Patients often present with symptoms of predominant right heart failure, including lower extremity edema, ascites…