…no reflow, structural and functional impairments sustain vascular obstruction. Endothelial dysfunction triggers leukocyte and platelet activation, while thrombotic debris may worsen the obstruction. Furthermore, cardiomyocyte…

…myocardium and coronary microcirculation. Endothelial dysfunction promotes leukocyte and platelet activation and interaction. Thrombotic debris may worsen microvascular obstruction, while cardiomyocyte swelling, interstitial oedema and…

…Dobutamine increases myocardial oxygen demand, while dipyridamole, adenosine, and regadenoson create blood flow disparities between healthy and diseased coronary arteries, allowing ischemia to be detected…

…time windows, indications and contraindications for intravenous thrombolysis, weight based tenecteplase dosing, blood pressure thresholds, monitoring, complications and when thrombectomy should be considered. The doses…

…fibre rich and bioactive foods, including fruits, non starchy vegetables, beans, whole grains, nuts and seeds, yogurt, seafood and plant oils. They contain less refined…

…that these parameters are highly interdependent and rather complex. Indeed, myocardial mechanics constitute a whole research field. Cardiac function is also dependent on circulatory, pulmonary…

…assessed. 3. Take an arterial blood gas in respiratory compromise, low saturation, suspected carbon dioxide retention, reduced consciousness, or when NIV is being considered. 4…

…wave. The whole value of the investigation lies in the ratio between the number of atrial and ventricular complexes — more atrial than ventricular complexes, the…

…and from secondary prevention, which addresses patients with established disease to reduce recurrent events and mortality. Risk factor modification is therefore directed at identifying individuals…

…nutrition, drugs and fluid balance. Fluid administration can dilute the creatinine and mask the deterioration, while dehydration can concentrate it. In older, malnourished, amputee or…

…a dialysis fistula. Preparation and equipment Hand disinfection; gloves where there is a risk of blood contact. An alcohol or chlorhexidine swab. Let the skin…

…Blood and colloids flow more slowly, and every additional length of tubing, every tap and every filter reduces the flow further — it is the whole…

…leaves no specimen . That makes the choice of lesion the critical point: never freeze anything whose diagnosis you have not established. Indications Lesion Freeze time…

…to 32–36 °C. The HYPERION result means that active hypothermia is still used in some units with a non shockable rhythm; this is the…

…Ageing is associated with progressive increases in systolic blood pressure (SBP), while diastolic blood pressure (DBP) rises less steeply and may remain stable or decline…

…it is used : : : Blood grouping ABO and RhD typing. Requires two samples drawn on two separate occasions with a separate identity check each time Always…

…cause a hypertensive crisis through interactions, while venlafaxine and higher doses of bupropion, among others, can raise the blood pressure. Serotonin syndrome can also cause…

…negative findings. Radiotracers in myocardial perfusion imaging Radiotracers are designed to identify ischemic areas of the myocardium by highlighting regions with reduced blood flow. Radiotracers…

…a risk based approach because cardiovascular benefit from blood pressure reduction may also occur in selected people whose pressure is elevated but below the conventional…

…a distinct disease. It identifies patients whose blood pressure remains uncontrolled despite intensive antihypertensive treatment and who therefore require assessment for pseudo resistance, secondary hypertension…

…crisis. Mechanism of action Phentolamine is a non selective alpha adrenergic blocker. Phentolamine reduces blood pressure while increasing catecholamine activity. Effects Primarily causes afterload reduction…

…while the typical local signs of inflammation may be faint or absent. Take cultures immediately, but never let sampling, imaging, the blood count or contact…

Cardiology Endocrinology & metabolism Definition and pathophysiology Secondary hypertension is elevated blood pressure attributable to a specific, identifiable underlying cause. It should be considered in every…

…receptor agonist. • Lowers blood pressure while maintaining or increasing kidney perfusion. Effects Dopamine 1 receptor agonists lower systemic blood pressure and increase renal perfusion. Time…

…saturation, chest movement and a blood gas. Ventilate by mask in opioid induced respiratory depression while naloxone is prepared C Pulse, blood pressure, peripheral perfusion…

…directed primarily at reducing myocardial ischaemia and relieving anginal symptoms, while maintaining tolerability and adherence. Selection should be individualized according to blood pressure, heart rate…

Cardiology Clinical medicine Introduction Cardiovascular disease becomes increasingly prevalent with advancing age, while its clinical expression and management become progressively more complex. Older adults, often…

…mildly reduced ejection fraction (HFmrEF; LVEF 41–49%) and heart failure with preserved ejection fraction (HFpEF; LVEF ≥50%). Patients with HFmrEF may represent individuals whose…

…usually on a treadmill, while symptoms, a 12 lead ECG, heart rate and blood pressure are monitored. The test is generally symptom limited and is…

…failure (HF) is a clinical syndrome in which the heart cannot deliver blood at a rate appropriate to tissue requirements unless filling pressures are elevated…

…objective is individualized blood pressure reduction sufficient to reduce cardiovascular risk while preserving tolerability and daily function. Decisions should incorporate the confirmed blood pressure level…

…and Pathophysiology Angina with non obstructive coronary arteries (ANOCA) describes anginal symptoms in patients whose epicardial coronary arteries are normal or show no obstructive disease…

…and infarction Definition and conceptual framework Acute coronary occlusion is the abrupt or progressive reduction of coronary blood flow sufficient to produce myocardial ischaemia and…

…that the aortic valve leaks during diastole, such that blood regurgitates back from the aorta into the left ventricle. This results in volume overload in…

…of free air in the thoracic cavity. While this can occasionally be benign and manifest even in healthy individuals, a tension pneumothorax arises when the…

…and vascular resistance. Advantages of measuring MAP over systolic blood pressure While systolic blood pressure (SBP) indicates the maximum pressure during heart contraction, it does…

…but rousable patient, while ventilation, circulation and underlying disease are monitored [3]. The management of complicated withdrawal varies between regions and units. Follow the local…

…necessary. After previous punctures: change side, and avoid irradiated fields. Preparation and equipment Informed consent, current full blood count and coagulation screen, medication list. Chlorhexidine…

…litre that has accumulated slowly can be asymptomatic, while 150 mL collected over an hour causes tamponade. The indication rests on the clinical picture together…

…T2DM) and obesity was siloed, with clinicians focusing primarily on hemoglobin A1c (HbA1c) reduction, blood pressure, lipids and smoking cessation. Weight loss was considered extremely…

…profibrotic mediators. Perinephric fat is associated with hypertension and blood pressure variability, while obesity and hypertension together promote left ventricular hypertrophy and kidney injury. The…

…of atherosclerotic plaques [1] . While stable plaques are characterized by a thick fibrous cap and a small lipid core, the pathophysiology of Acute Coronary Syndromes…

…retrospective definition of at least 10 units of red cells in 24 hours [5]. A continuing transfusion requirement while definitive control of the bleeding has…

…across the aortic valve. Trace the Doppler profile to calculate the AV VTI, representing the distance blood travels during systole. 3. Right Ventricular Outflow Tract…

…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…

…capacity, while risk factor treatment and lifestyle modification reduce the burden of recurrent coronary risk. Nutritional counselling, smoking cessation, blood pressure and lipid management, and…

…and/or the coronary microcirculation. These abnormalities may produce a transient mismatch between myocardial oxygen demand and coronary blood supply, resulting in myocardial hypoperfusion or…

…ostia. It remains the reference standard for defining the extent of coronary artery disease because it provides anatomical information while permitting functional assessment and, when…

…ventricular systolic and pulse pressures are reduced. The central management principle is preservation of adequate right ventricular preload while supporting left ventricular performance and systemic…

…supraventricular tachycardia, and hemodynamically compromising ventricular tachycardia, while defibrillation (unsynchronized shock) is reserved for ventricular fibrillation, where urgent reversion to sinus rhythm is required. The…

…it more difficult to eject blood into the aorta. In the early stages of aortic stenosis, stroke volume becomes smaller. Reduced stroke volumes and increased…

…of the tracheal tube. Cardiac arrest without adequate blood flow or ineffective compressions. While ETCO 2 is optimally measured in tracheal tubes, it can also…

…instances, favorable neurological outcomes are possible even with prolonged periods of no blood flow, due to the reduced metabolic rate that accompanies declining body temperature…

…increased demand using vasodilatory agents). A radiotracer is administered at peak stress to capture blood flow distribution under these conditions. If stress imaging results are…

…the assessment of myocardial reperfusion The ECG is an invaluable tool to assess whether an occlusion has been resolved and blood flow has been restored…

…valve opens. When the mitral valve opens, blood flows into the left ventricle. This results in a rapid increase in left ventricular volume, but only…

…while a PEF below 33 percent or signs of ventilatory failure means life threatening illness [1,2]. Important interpretation of the blood gas A normal…

…catheter). Measurement of central venous pressure and central venous oxygen saturation. Repeated blood sampling during intensive care. Exhausted peripheral venous access during prolonged intravenous therapy…

…With blood ketones ≥ 3 mmol/L and acidosis, the ketosis must be treated immediately with DKA dose insulin, while the osmolality is corrected cautiously [1…

…release. In cardiac arrest with suspected hyperkalaemia, advanced life support is followed while the hyperkalaemia is treated. Calcium chloride is then usually the first choice…