By day four the CK-MB levels should have returned to normal from the initial myocardial infarction. If the CK-MB levels are elevated it would indicate a further coronary event Cardiac enzymes and protein markers Interpretation of the various cardiac enzymes …
Hypokalemia is the most important cause of ventricular tachycardia (VT) clinically, followed by hypomagnesaemia. Severe hyperkalaemia may cause VT in certain circumstances, for example in patients with structural heart disease, but it is not as common a cause as hypomagnesaemia. …
The echocardiogram shows a degree of left ventricular impairment. It is important an ACE inhibitor is started in such patients. This will help to both control her blood pressure and also slow the deterioration in her cardiac function. A beta-blocker …
If the patient has a prosthetic valve and endocarditis is suspected the initial therapy should consist of intravenous vancomycin + rifampicin + gentamicin. Infective endocarditis: prognosis and management Poor prognostic factors Staph aureus infection (see below) prosthetic valve (especially ‘early’, …
Slow influx of calcium is responsible for the plateau phase of the action potential Electrical activity of the heart Myocardial action potential  Phase Description Mechanism 0 Rapid depolarisation Rapid sodium influxThese channels automatically deactivate after a few ms 1 …
These are classical findings of a circumflex occlusion. The table below shows how the changes correspond to the cardiac anatomy: ST elevation greater in lead II than in lead III with abnormal Q waves in II, III, and aVF Inferior …
The average reading is above the treatment threshold for patients below the age of 80 years. Treatment with a calcium channel blocker should therefore be started. Hypertension: diagnosis and management NICE published updated guidelines for the management of hypertension in …
Her history of asthma is a contraindication to the prescription of a beta-blocker. NICE therefore recommend a rate-limiting calcium channel blocker. Consideration should also be given to antithrombotic therapy. Atrial fibrillation: rate control and maintenance of sinus rhythm The Royal …
Please see the note below and provided link – there are now specific guidelines relating to the use of oxygen in emergency situations. Acute coronary syndrome: management NICE produced guidelines in 2010 on the management of unstable angina and non-ST …
In cardiac tamponade there is characteristically no Y descent on the JVP. The other four features are seen in both cardiac tamponade and constrictive pericarditis Cardiac tamponade Features dyspnoea raised JVP, with an absent Y descent – this is due …