…Clinical Context Cardiac amyloidosis should be suspected in patients older than 65 years presenting with heart failure and increased left ventricular (LV) wall thickness [3…

…41–49%. In this group, structural abnormalities such as left atrial enlargement or left ventricular hypertrophy, or echocardiographic evidence of impaired filling, make the diagnosis…

Procedurer What determines the outcome of a central venous catheter insertion is decided before the needle goes in: the choice of site, the use of…

…intraosseous needle. Procedure Peripheral venous cannula 1. Apply the tourniquet 10–15 cm proximal to the intended puncture site, let the arm hang, ask the…

Procedurer Compression is the treatment that heals venous leg ulcers; everything else is supportive. But the same compression applied to a limb with arterial insufficiency…

Cardiology Pulmonary embolism occurs when venous thrombi embolize to the pulmonary artery or its branches. In the majority of cases, the thrombus is formed in…

…on venous circulation. • May cause reflex sympathetic stimulation (can be counteracted with simultaneous administration of beta blockers). Effects Induces arteriolar vasodilation without effects on venous…

…etiologies when promptly and appropriately addressed. Both venous and arterial blood gases can be utilized for the analysis of electrolyte levels. Electrocardiography (ECG) serves as…

…air is substantial enough to compress the superior and inferior vena cava, impeding or halting venous return to the heart. In instances of tension pneumothorax…

…Management : : : Medial triangle of the face (nasal root, alae nasi, upper lip) Venous drainage towards the cavernous sinus Surgeon or ENT; often antibiotics Palm, fingers…

…or unexplained AKI. 3. Assess the circulation and volume status, including signs of both hypovolaemia and venous congestion. 4. Take an urgent panel: creatinine, urea…

…3.0 A mechanical valve may require a higher target Doses in venous thromboembolism Treatment doses in deep vein thrombosis and pulmonary embolism differ from…

…are routinely missed. The third thing to know by heart is that an arterial line must never be confused with a venous access. Indications Continuous…

…has high diagnostic accuracy [2]. A venous blood gas is generally sufficient for the assessment of pH and bicarbonate. An arterial blood gas is needed…

…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…

…and haemodynamic monitoring with ECG, a central venous catheter and an arterial line is necessary to achieve an optimal result. Overview of vasopressors and inotropes…

…access, or rapid central access, but do not delay transfusion or control of the bleeding in order to obtain a central venous catheter. 4. Take…

…renal failure or on dialysis, where DOACs lack documentation or have only weak evidence. Venous thromboembolism when a DOAC cannot be used (interactions, cost, adherence…

…resistance (SVR). Clevidipine does not reduce cardiac filling pressure (pre load), since it has no effects on the venous capacitance vessels. Hence, Clevidipine reduces blood…

…resistance (SVR). Clevidipine does not reduce cardiac filling pressure (pre load), since it has no effects on the venous capacitance vessels. Hence, Clevidipine reduces blood…

…as described by the relationship: MAP = (CO × SVR) + Central Venous Pressure (CVP) This equation illustrates that MAP is determined by the volume of blood…

…occurs when intrapericardial pressure equals or exceeds right atrial pressure. The haemodynamic consequences are progressive impairment of right and left sided filling, reduced stroke volume…

…or large vessel arteritis Pulmonary arterial vasculopathy and pulmonary hypertension Arterial and venous thrombosis Valvular heart disease Cardiac dysrhythmias Arterial stiffness and endothelial dysfunction The…

…systemic congestion. Interventricular dependence may impair left ventricular filling and reduce systemic output. In this setting, venous congestion is generally treated initially with diuretics, whereas…

…the coronary resistance vessels. Left ventricular hypertrophy also reduces coronary flow reserve: myocardial mass increases without a proportional increase in the microcirculatory resistance network, reduci

…and calcific aortic valve stenosis. Lp(a) is not associated with venous thromboembolism in prospective epidemiological studies. Its biological effects appear to differ from those…

…higher doses, vasoconstriction may occur, accompanied by decreased venous capacitance and an elevation in right atrial pressure. Levosimendan represents a distinct class of inodilator. It…

…precapillary pulmonary vascular component. PAWP is used to distinguish pulmonary venous hypertension caused by left heart disease from pulmonary vascular disease. Although a PAWP of…

…Right sided filling pressures—including central venous, right atrial, and right ventricular end diastolic pressures—are elevated, whereas left ventricular filling pressure is usually normal…

…occur in over 40% of females and 30% of males due to a lack of effective reflex response to posture, venous pooling, or external stimuli…

…reduced, potentially leading to complete obstruction of venous return by the uterus. This can be remedied by manual displacement of the uterus to the left…

…result in hemorrhage within the pericardium. Ventricular rupture : A transmural infarction can cause a rupture in the left ventricular free wall. Mediastinal trauma : Penetrating injuries…

…fraction <55%. This implies that left ventricular pumping capacity is reduced and it is synonymous with heart failure with reduced ejection fraction (HFREF ). Average ejection…

…a type of ECLS, operates by drawing venous blood from the patient to an oxygenator (gas exchanger), where it undergoes oxygenation and carbon dioxide removal…

…resistance (SVR). Clevidipine does not reduce cardiac filling pressure (pre load), since it has no effects on the venous capacitance vessels. Hence, Clevidipine reduces blood…

Echocardiography Left ventricular function and its echocardiographic assessment Cardiac function depends on a large number of parameters, including atrial function, valvular function, and ventricular function…

…arterial line, PiCCO, central venous catheter). The hemodynamic effects persist for 7–10 days after the end of infusion. Refer to Table 2 for a…

…Thromboembolic risk, for example immobilisation, cancer and previous venous thromboembolism. A documented decision on the ceiling of care. Signs of a serious condition Finding Significance…

…a systemic steroid early. 7. Insert intravenous access, but do not let blood sampling or cannulation delay inhaled treatment. 8. Reassess speech, work of breathing…

…stockings. Avoid measuring the arm pressure on the side with a dialysis fistula, lymphoedema after axillary clearance or a recently inserted venous port. Procedure 1…

…failure. A peripheral venous blood gas is easier to obtain and can often be used for an initial assessment of pH and the metabolic component…

…drawn up in a syringe as a standby dose. Glycopyrronium (Robinul) 0.2 mg is an alternative premedication. Peripheral venous cannula, saline flush. ECG monitoring…

…visible. Capnography connected and calibrated. Working venous access, fluid and a vasopressor drawn up — push dose noradrenaline or phenylephrine must be ready before induction , not…

…blood pressure measurement when a hypertensive emergency is suspected. 3. Insert a peripheral venous cannula. 4. Measure the blood pressure in both arms at the…

…masks the diagnosis has been disproved — withholding it delays the investigation instead. Preparation and equipment Working venous access and an infusion solution. A pulse oximeter…

…and intubation can precipitate circulatory collapse in a tamponaded patient , since positive airway pressure further reduces the venous return. Procedure Choice of access The ultrasound…

…without antiphospholipid syndrome. The doses in venous thromboembolism include an initial high dose phase and differ from the doses used in atrial fibrillation. Follow the…

…MAP remains below 65 mmHg or the hypotension is marked. Do not wait for a central venous catheter Continuously Reassess the mental state, capillary refill…

…according to local practice. Let the patient rest lying down or sitting for at least 15 minutes. 2. Insert a venous cannula. Wait a few…

…the initial sympathetic response can give way to hypotension, hypoxia, hypoglycaemia and circulatory failure [5]. Plasma glucose immediately Check the capillary or venous glucose i

…fan, paracetamol, cold infusions. A ventilator, an arterial line, a central venous catheter, ECG monitoring, blood gases. Drugs for sedation, analgesia and control of shivering…

…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…

…Severe hypernatraemia. Preparation and equipment Two peripheral venous cannulas, or a central venous catheter for longer treatment. Sodium bicarbonate 50 mg/mL (corresponding to 0…

…or mottled. Capillary refill is delayed, and venous filling may be reduced. Other possible findings include muscle stiffening and loss of deep tendon reflexes. Pulses…

…be 0.05 to 0.3 mg/kg. Central venous access: When injected into a central vein, the initial dose should be reduced to 3…

…may produce cardiorenal syndrome. Worsening renal function in the presence of persistent congestion is particularly associated with elevated central venous pressure, which is transmitted to…

…or daytime symptoms suggestive of sleep disordered breathing Hypoventilation Peripheral oedema or venous disease Reduced mobility Osteoarthritis and low back pain Symptoms of type 2…

…infarction (STEMI). The principal lesions are: Ventricular septal rupture (VSR), producing an acute left to right shunt. Ventricular free wall rupture, producing haemopericardium and cardiac…

…coronary collateral growth. Redistribution of myocardial blood flow across the ventricular wall. Modification of coronary venous haemodynamics. Neuromodulation of cardiac pain signalling. Experimental angiogenic or…

…In the setting of ST elevation myocardial infarction (STEMI), cardiogenic shock most commonly reflects severe left ventricular (LV) dysfunction, accounting for approximately 80% of cases…