Acute Heart Failure

Heart Failure is heart’s inability to eject blood (systolic dysfunction) or fill with blood (diastolic dysfunction), causing circulatory congestion, dyspnea, fatigue and weakness. Acute HF is a sudden reduction in cardiac performance, resulting in acute pulmonary edema and hypotension with or without peripheral edema.    Classification: ACC/AHA)  task force divided CHF into the following stages: Stage … Read more

Acute Coronary syndrome

Acute Coronary Syndrome Unstable angina (UA),  non–ST-segment elevation myocardial infarction (NSTEMI) and STEMI are among the acute coronary syndromes (ACS).  Stable angina pectoris is characterized by chest or arm discomfort that is reproducibly associated with physical exertion or stress and relieved within 5–10 minutes by rest and/or sublingual nitroglycerin.  Unstable angina describes the occurrence of angina pectoris or equivalent ischemic discomfort … Read more

Tachyarrythmias

Tachycardia  Tachycardia is defined as a heart rate above 100 beats per minute, but symptomatic tachycardia generally involves rates over 150 beats per minute, unless underlying ventricular dysfunction exists. Management of tachyarrhythmias is determined by the presence of clinical symptoms and signs caused by the rapid heart rate.    The fundamental approach is as follows: … Read more

Hypertensive Emergencies

Hypertensive Emergencies Patients with a systolic BP (SBP) > 179 mm Hg or a diastolic BP (DBP) > 109 mm Hg are usually considered to be having a “hypertensive crisis.” Severe elevations in BP were classified as hypertensive emergencies in the presence of acute end-organ damage or as hypertensive urgencies in the absence of acute … Read more

Cardiac Arrest

Cardiac Arrest Sudden cardiac arrest and sudden cardiac death refer to the sudden cessation of cardiac activity with hemodynamic collapse, typically due to sustained ventricular tachycardia/ventricular fibrillation.    Etiology: Coronary artery disease – 70% of sudden cardiac arrests are due to CAD. Other structural heart disease:  Heart failure and cardiomyopathy Left ventricular hypertrophy due to hypertension or other causes. … Read more

BLS and ACLS

Basic Life Support (BLS)      Immediate recognition and activation, early CPR, and rapid defibrillation (when appropriate) are the first three BLS links in the adult Chain of Survival. Patient survival depends primarily upon immediate initiation of excellent CPR and early defibrillation. AHA Guidelines 2015   Chest compressions  Chest compressions are the most important element of cardiopulmonary resuscitation (CPR). The recommended … Read more

Cardiac Tamponade

Cardiac Tamponade:  Cardiac tamponade – Characterized by the accumulation of pericardial fluid under pressure.   Constrictive pericarditis – Scarring of pericardium with resultant loss of elasticity of the pericardial sac.   An important pathophysiologic feature of both cardiac tamponade and constrictive pericarditis is greatly enhanced ventricular interaction or interdependence, in which the hemodynamics of the left and right … Read more

ECHO

Basic Views:    Parasternal long axis view (PLAX)  The parasternal long axis view is commonly the first view obtained in an echo examination and is useful for assessing contractility visually, assess mitral and aortic valves, calculating ejection fraction in M-mode, detecting regional wall motion abnormalities, measuring LV outflow tract diameter for cardiac output studies and identifying pericardial effusion.    … Read more