…et al. (2009): Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice. In European journal of echocardiography : the journal of the Working Group…

…et al. (2009): Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice. In European journal of echocardiography : the journal of the Working Group…

…et al. (2009): Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice. In European journal of echocardiography : the journal of the Working Group…

…artery (RCA). For details, refer to chapter The Coronary Arteries. Mitral valve disease A wide range of conditions may cause mitral valve disease, which results…

…target INR 2.0 3.0 A mechanical valve may require a higher target Doses in venous thromboembolism Treatment doses in deep vein thrombosis and…

…contraindicated, for example in asthma Contraindicated in impaired left ventricular function and together with an intravenous beta blocker Digoxin In heart failure or hypotension, or…

Echocardiography Methods for assessing systolic function (contractile function) Several echocardiographic measurements are available to assess left ventricular systolic function. These methods elucidate slightly different aspects…

…alter disease progression. Diuretics may be used for symptom relief. Surgical repair or valve replacement is considered when medical therapy is insufficient, or when concomitant…

…valve. Calcification has traditionally been considered a passive degenerative process, but emerging evidence suggests it is propelled by a biologically active process. Risk factors for…

Echocardiography Echocardiographic assessment of left ventricular diastolic function Methods for evaluating left ventricular diastolic function have evolved considerably in the past two decades. Currently recommended…

Echocardiography Tricuspid regurgitation The tricuspid valve separates the right ventricle and the right atrium. It normally consists of three leaflets (anterior, posterior and septal leaflet…

…Venturi mask with a set of valves, and a high flow nasal cannula where available. Bag mask equipment for a patient who is not breathing…

Arrhythmias and arrhythmology Pharmacology & dosing Definition and pathophysiology Atrial fibrillation (AF) is a major independent risk factor for thromboembolism, including ischaemic stroke. This risk applies…

…Continuous wave doppler along the left ventricle, the opening of the mitral valve and the left atrium. Recall that velocities (flows) directed away from the…

…more difficult for the ventricle to eject blood into the aorta during systole. In aortic stenosis, there is increased resistance in the aortic valve itself…

…the valvular apparatus. Age related degeneration affects 2% of the population and leads to gradual prolapse of the valve leaflets (Figure 1). Rheumatic heart disease…

…time integral. Corresponding formula for measurements in the aortic valve: SV aorta = area LVOT • VTI LVOT The area is measured in cm 2 . VTI…

…the terminology used by different devices vary; follow the local setting instructions for the device available on the unit. Preparation and equipment A device capable…

…A reservoir mask with a tight fitting seal, a separate nasal cannula for apnoeic oxygenation, a bag with a PEEP valve, and an oropharyngeal airway…

…with dosing support, but whoever starts the drug is responsible for the first week. Indications A mechanical valve prosthesis — warfarin is mandatory, and direct oral…

…BSA or severe extra aortic features 45 mm • Patients who are undergoing aortic valve surgery • Patients with Marfan syndrome who have additional risk factors • Patients…

…et al. (2003): Recommendations for evaluation of the severity of native valvular regurgitation with two dimensional and Doppler echocardiography. In Journal of the American Society…

…Danlos syndrome Inflammatory aortitis, including Takayasu arteritis and giant cell arteritis Bicuspid aortic valve Coarctation of the aorta Previous aortic trauma Pregnancy, particularly the third…

…or those undergoing aortic valve replacement [1, 5, 10]. A history of increasing frequency of hospitalizations and visits for heart failure without disease recognition in…

…shock most commonly reflects severe left ventricular (LV) dysfunction, accounting for approximately 80% of cases. Other causes include acute mechanical complications—particularly ventricular septal defect…

…factor for developing atrial fibrillation is age. Other significant risk factors are as follows: male sex, hypertension, left ventricular hypertrophy, left ventricular dysfunction, valve disease…

…as compared with atrial fibrillation, atrial flutter is not capable of persisting for longer periods of time. This is due to the fact that atrial…

…with impaired mobility (for example, after myocardial infarction), most likely has a parietal thrombus. The presence of ecotdense masses on valves should lead to suspicion…

…Doppler located across the mitral valve and the left atrium. The main advantage of color Doppler is that it allows for rapid visualization of flows…

…Infections are difficult to heal because the heart valves are not vascularized and therefore it is difficult for the immune system to reach the bacteria…

…due to pulmonary valve stenosis, increased pulmonary artery pressure etc . The right atrium must then enlarge (hypertrophy) in order to manage to pump blood into…

…right atrium and ventricle. The thrombus is pumped from the right ventricle through the pulmonary valve into the main pulmonary artery. Depending on the size…

…pulmonary regurgitation Echocardiography is the modality of choice for diagnosing pulmonary regurgitation. Continuous Doppler through the pulmonary valve reveals regurgitant blood flow in the parasternal…

…40 mm Hg in older and obese patients. References Baumgartner et al : Echocardiographic assessment of valve stenosis: EAE/ASE Recommendations for Clinical Practice (2009. JASE).

…Afterload : Afterload is the resistance that the the ventricle must overcome to pump blood out into the pulmonary artery. Resistance may increase in, for example…

…The diameter of the aortic valve is relatively constant during systole; this is important because a representative diameter is crucial for calculation of the area…

…17 mm/m2 Aortic arch 22 36 mm Descending aorta 20 30 mm ​Indexing means that the value is adjusted for body surface area (BSA)…

…the valve. The material determines how long the catheter may stay: all silicone and latex with a hydrogel or silicone elastomer coating may remain for…

…visualizing the pulmonary valve in long axis. Method : Trace the pulmonary valve’s Doppler profile using CWD to derive PV VTI. Formulas for Shunt Fraction…

…et al. (2009): Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice. In European journal of echocardiography : the journal of the Working Group…

…ischaemic stroke, abdominal aortic aneurysm, and calcific aortic valve stenosis. Lp(a) is not associated with venous thromboembolism in prospective epidemiological studies. Its biological effects…

…aortic stenosis (in which the narrowing of the opened aortic valve orifice makes it difficult for blood to flow from the ventricle to the aorta)…

…high, as compared with 2D echocardiography. M mode is useful for quantifying the mobility of structures and measuring dimensions. In order to obtain representative measurements…

…in on regions of interest; e.g the aortic valve can be zoomed in to study its anatomy and function. Zooming in improves the resolution…

…These formulas for PISA performs best when the surface surrounding the orifice is flat, which is often not the case for the valves. For example…

…Figure 1. Pulsed tissue doppler with sample volume in the mitral valve plane. Color Tissue Doppler Color tissue Doppler analyzes myocardial velocities within a color…

…pressure exceeds diastolic pressure in the aorta, the aortic valve opens and blood is ejected into the aorta. Left ventricular volume decreases as the ventricle…

…where the pads would go. Transvenous pacing: the relative contraindications are the same as for a central venous catheter — coagulopathy, infection at the puncture site…

…1). Emboli originating in the atria, left atrial appendage (LAA), ventricles, valves, and proximal aorta can cause stroke, TIA (transient ischemic attack), coronary artery occlusion…

…the mitral valve results in reduced E wave velocity during inhalation. Since the left ventricle is not filled normally, there is more room for the…

…relaxation lasts for approximately 80 milliseconds and ends when the mitral valve opens. The time interval between aortic valve closure and mitral valve opening is…

…ΔP = 4(v 2 2 – v 1 2 ) This formula is excellent for measuring pressure gradients across small openings, such as the valves…

…representative of ventricular function, since the activation proceeds abnormally. Normal value for fractional shortening (FS) Normal FS, M mode 25% Normal FS, 2D measurement 18…

…for at least 12 hours 3 At least 3.0 times baseline, or a creatinine of at least 353.6 µmol/L, or renal replacement…

…rate of rise, renal function and the clinical context , not by the potassium value alone. A normal ECG does not exclude dangerous hyperkalaemia. Record a…

…acute hypertension mediated organ damage or not? A single blood pressure value does not define a hypertensive emergency. Even a blood pressure above 220/120…

…expected pCO₂ or HCO₃. A value outside the expected range means there is a further primary disorder 4 Is there a metabolic acidosis? Calculate the…

…Pressure on the sensor, for example during sleep, can give falsely low values. When there are symptoms or an unexpected sensor value, the glucose should…

…information about the artery. The clinical value of these techniques rests on their ability to characterize the anatomy responsible for a stenosis, define plaque morphology…

…Reference limit for troponins Regardless of how sensitive troponin assays are, it is always possible to define an upper reference limit . Any value above the…