…hip or thigh symptoms suggest aortoiliac disease. Calf symptoms are typical of femoropopliteal disease. More distal disease may cause foot symptoms, although lower extremity symptoms…

Cardiology Continous medical discussion: the ECG blog Endocrinology & metabolism Cardiovascular medicine is currently witnessing a paradigm shift. For decades, the management of type 2 diabetes…

…An ECG must be performed on all patients seeking medical attention due to chest discomfort or other symptoms that may be caused by myocardial ischemia…

…cTnI and cTnT are specific to cardiac muscle cells. Cardiac troponin levels are extremely low in healthy subjects; the 99 th percentile is less than…

…severe complication of coronary artery disease. The most common initiating mechanism is rupture or erosion of a vulnerable (unstable) atherosclerotic coronary plaque. Upon such damage…

…2]. Upper gastrointestinal bleeding can present as haematemesis, coffee ground vomiting or melaena. Haematochezia can occur in massive upper bleeding with rapid intestinal transit. Coffee…

…female Normal <440 ms <430 ms <450 ms Upper limit 440–460 ms 430–450 ms 450–470 ms Prolonged 460 ms 450 ms 470…

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

…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…

…tightness, heaviness, burning, or discomfort in the chest and may extend to the arms, shoulders, neck, jaw, upper back, abdomen, or epigastrium. Dyspnoea, nausea, vomiting…

…arms, neck, jaw, upper back, and abdomen, as well as dyspnea and nausea (anginal equivalents) [7]. Clinicians must consider both cardiac and non cardiac etiologies…

…troponin value above the assay specific 99th percentile upper reference limit. It is classified as acute when serial measurements demonstrate a rise and/or fall…

…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…

…there are visible QRS complexes. The signal in the lower lead shows that the rhythm is a polymorphic ventricular tachycardia (or even flutter). ECG 3 …

…appropriate specialty: Location Risk Management : : : Medial triangle of the face (nasal root, alae nasi, upper lip) Venous drainage towards the cavernous sinus Surgeon or ENT…

…and in people under 18 years of age, where iso BMI or percentile charts should be used. Waist circumference Measure the waist between the lowest…

…least two occasions, and preferably confirmation by home measurement or 24 hour recording — the thresholds for which are lower than for office measurement. Classification of…

…wrong patient — a mislabelled tube, or an identity check performed at the nurses' station instead of at the bedside. The check against the patient's…

…5–7 days or doxycycline 200 mg × 1 on day 1, then 100 mg × 1 5–7 days Epiglottitis and other severe upper airway infection…

…when time allows. There is complete upper airway obstruction where laryngoscopy will not succeed; plan for a surgical airway or awake fibreoptic intubation. A difficult…

…Orders of magnitude that direct the work up ALT 50 × the upper limit of normal: paracetamol poisoning, ischaemic hepatitis ("shock liver") or acute viral hepatitis…

…upper border of the rib, never at the lower border where the neurovascular bundle lies, and the drainage is stopped for coughing, chest pain, or…

…groups: current or former smokers over 40 with respiratory symptoms, and occupational exposure to dust, gas or fumes. Preoperative assessment before thoracic or upper abdominal…

…setting, manually or with an automated device. Home blood pressure monitoring (HBPM): self measurement at home, generally with a validated upper arm oscillometric device. Ambulatory…

…atrium is activated passively. The upper boundary of this circuit may be located either anterior or posterior to the superior vena cava. A critical area…

…above the 99th percentile upper reference limit (URL). The injury is considered acute if there is a documented rise and/or fall of cTn values…

…myocardial injury, demonstrated by a rising and/or falling troponin pattern with at least one value above the assay specific 99th percentile upper reference limit;…

…heart disease from pulmonary vascular disease. Although a PAWP of 12 mmHg represents the upper limit of normal in some assessments, a threshold of ≤15…

…above the assay specific 99th percentile upper reference limit (URL). It is considered acute when there is a rise and/or fall in cTn values…

…tongue, and uvula causing airway obstruction Cardiovascular: Hypotension Circulatory collapse culminating in cardiac arrest Anaphylaxis can develop without dermatological or upper airway manifestations. Anaphylactic cardiac…

…dilatation Atrial enlargement: left atrial enlargement (P mitrale) and right atrial enlargement (P pulmonale) The atria may become dilated and/or hypertrophic during pathological circumstances…

…adults, the x axis represents time (the paper speed is typically 25 mm/s or 50 mm/s) and the y axis represents amplitude (millivolts…

…to the ventricles is normal. The PR interval must not be shorter than 120 msec or longer than 220 msec. The PR segment is the…

…4. Posterior tibial artery — behind the medial malleolus. Measure. 5. Repeat on the other leg. If the signal is uncertain or borderline, the fibular artery…

…not eGFR relative to 1.73 m². Recalculate in patients who are markedly larger or smaller than average. Higher doses may be required in the…

…seal impossible. Recent surgery on the oesophagus or upper gastrointestinal tract, ileus and ongoing upper gastrointestinal bleeding. Marked agitation or inability to cooperate. Copious secretions…

…of medical suitability is made by the transplant team. Never rule out a possible donor on your own on grounds of age or medical history…

…when perforation is suspected). A tonometer: an applanation tonometer on the slit lamp, or a hand held device (iCare, Tono Pen). Procedure Systematic examination 1…

…technique). The patient lies supine or sits. The upper arm is held adducted against the trunk and the elbow is flexed to 90 degrees. The…

… it is part of the treatment itself. Indications Salicylate poisoning with symptoms or a rising serum concentration. Alkalinisation increases renal elimination several fold and at…

…subcutaneous or submucosal tissues, most frequently involving the face, lips, tongue, and upper airway. Due to the risk of airway compromise, it represents a medical…

…of TdP are frequently pause dependent, initiated by either a slowing of the heart rate or a PVC induced pause. The subsequent sinus beat typically…

…sex Previous upper gastrointestinal disease Hepatic or renal disease Multiple cardiovascular risk factors Concomitant nonsteroidal anti inflammatory drugs Corticosteroid therapy Other antiplatelet or antithrombotic drugs…

…neck, or upper back. Chest discomfort triggered by emotional stress. Palpitations associated with physical activity, a large meal, emotional upset, or cold exposure. The absence…

…Meanwhile, deoxygenated blood in the superior vena cava (which returns blood from the head and upper limbs) also enters the right atrium. Oxygenated and deoxygenated…

…second half is a reflection of left atrial depolarization. This is shown in Figure 3 (upper panel). Recall that the P wave in V1 is…

…If the preprocedural concentration is above the 99th percentile upper reference limit, it must be stable or falling before a subsequent rise can reliably be…

…therefore appropriate. Drug interactions are particularly important. Inhibition of cytochrome P 450 3A4 or 2C9 can increase statin concentrations. Relevant interacting agents include amiodarone, macrolide…

…squeezing, or a crushing sensation across the precordium and may radiate to the neck, shoulder, jaw, back, upper abdomen, and left or right arm. Onset…

…artery disease has been classified into the following three syndromes: Stable angina pectoris : Symptoms appear primarily during exercise or other situations with increased myocardial load…

…also I and aVF). Arrhythmias Sinus tachycardia Sinus tachycardia exists if the heart rate is higher than the upper normal limit. Sinus tachycardia can exceed…

…Meanwhile, deoxygenated blood in the superior vena cava (which returns blood from the head and upper limbs) also enters the right atrium. Oxygenated and deoxygenated…

…during physical exertion). Therefore, to judge whether the QT interval is normal or not, one must adjust for the current heart rate. This is done…

…value above the 99th percentile upper reference limit (URL) in the appropriate clinical context. Unstable Angina presents with clinical and/or electrocardiographic signs of myocardial…

…Sinoatrial (SA) block implies that the impulses discharged in the sinoatrial node are either not conducted to the atria or are so with a delay…

…artery disease has been classified into the following three syndromes: Stable angina pectoris : Symptoms appear primarily during exercise or other situations with increased myocardial load…

…rhythms may (1) not occur, (2) occur transiently, or (3) occur but generate insufficient cardiac output. If no escape rhythm occurs, cardiac arrest will ensue…

…which is discussed below. The pressure volume loop in Figure 1 can be moved along the black lines called EDPVR and ESPVR. EDPVR (End Diastolic…