Resistant hypertension is a multifaceted condition that complicates standard hypertension management. Its complexity stems from various overlapping causes and population-level disparities...
Approximately 95% of all patient with hypertension have "essential" or "primary" hypertension and have no underlying disease...
Heart failure occurs when the heart is unable to maintain sufficient cardiac output to meet the demands of the body, despite the presence of normal filling pressures.
![Read more about the article Left Ventricular Hypertrophy (LVH): How to Recognize it on ECG [With Examples]](https://manualofmedicine.com/wp-content/uploads/2022/01/Major-ECG-findings-induced-by-left-ventricular-hypertrophy-LVH.png)
Left Ventricular Hypertrophy (LVH) causes tall R waves in left sided and deep S waves in right sided leads. Always look for ‘strain’ pattern in left sided leads...
![Read more about the article Atrial Flutter: ECG Interpretation [With Examples]](https://manualofmedicine.com/wp-content/uploads/2022/01/Atrial-Flutter-with-4-1-AV-Block.png)
Characteristic features of Atrial Flutter are: Atrial rate around 300/min; ‘Sawtooth’ baseline; AV block (commonly 2:1, but can be 3:1, 4:1 or variable). You should always suspect atrial flutter with 2:1 block when a patient has a regular tachycardia with a ventricular rate of about 150/min.
In the ED patient with syncope, the ECG should be scrutinized for signs of ischemia, bradydysrhythmias, tachydysrhythmias, and conduction delays. Critical diagnoses to consider that can be detected with the ECG include: Brugada syndrome, Long or short QT syndromes ...
Shortness of breath (dyspnea) is the subjective sensation of breathlessness which is excessive for any given level of activity. It is important to remember that any component of the respiratory system can cause dyspnea.
Diuretics may not be the preferred initial therapy, however, for those patients with vascular failure, who are often euvolemic, or those with cardiogenic shock, who are often hypovolemic. In these patients, the emergency provider should first optimize preload and afterload reduction with the use of noninvasive positive pressure ventilation (NPPV), nitrates, or inotropes as indicated.
Always check what the patient means by "palpitations" or clarify what you mean, as the word means different things to different people. It is usually understood as an awareness of the heartbeat. The most common cause is an arrhythmia, although other causes include conditions causing an increase in stroke volume (e.g., regurgitant valvular disease) or conditions causing an increase in cardiac output, often noncardiac causes (e.g., exercise, thyrotoxicosis, anemia, or anxiety).
In recent years, there are increasing data that support the use of high-dose vasodilator therapy as the initial treatment for patients with acute decompensated heart failure (ADHF)