Patients with neurofibromatosis may develop hypertension for three main reasons: coexistant essential hypertension phaechromocytoma renal vascular stenosis secondary to fibromuscular dysplasia The normal renal function in this patient points away from a diagnosis of renal vascular disease Phaechromocytoma therefore needs …
Infective endocarditis – indications for surgery: severe valvular incompetence aortic abscess (often indicated by a lengthening PR interval) infections resistant to antibiotics/fungal infections cardiac failure refractory to standard medical treatment recurrent emboli after antibiotic therapy Lengthening of the PR interval …
Long QT syndrome Long QT syndrome (LQTS) is an inherited condition associated with delayed repolarization of the ventricles. It is important to recognise as it may lead to ventricular tachycardia and can therefore cause collapse/sudden death. The most common variants …
This was demonstrated in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA). Hypertension: diagnosis and management NICE published updated guidelines for the management of hypertension in 2011. Some of the key changes include: classifying hypertension into stages recommending the …
Jervell-Lange-Nielsen syndrome is associated with profound deafness and a prolonged QT interval Long QT syndrome Long QT syndrome (LQTS) is an inherited condition associated with delayed repolarization of the ventricles. It is important to recognise as it may lead to …
Electrical activity of the heart Myocardial action potential Phase Description Mechanism 0 Rapid depolarisation Rapid sodium influx These channels automatically deactivate after a few ms 1 Early repolarisation Efflux of potassium 2 Plateau Slow influx of calcium 3 Final repolarisation …
Warfarin should be continued indefinitely as this is his second episode of atrial fibrillation and he has risk factors for stroke (age, hypertension) Atrial fibrillation: anticoagulation The European Society of Cardiology published updated guidelines on the management of atrial fibrillation …
Infective endocarditis: prognosis and management Poor prognostic factors Staph aureus infection (see below) prosthetic valve (especially ‘early’, acquired during surgery) culture negative endocarditis low complement levels Mortality according to organism staphylococci – 30% bowel organisms – 15% streptococci – 5% …
Heart failure: diagnosis NICE issued updated guidelines on diagnosis and management in 2010. The choice of investigation is determined by whether the patient has previously had a myocardial infarction or not. Previous myocardial infarction arrange echocardiogram within 2 weeks No …
These ECG changes are most consistent with a lateral myocardial infarction. An anterolateral infarction is more likely to have changes in the chest leads. ECG: coronary territories The table below shows the correlation between ECG changes and coronary territories: ECG …