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Auscultatory gap in hypertension

Auscultatory gap in hypertension

Sometimes during manual blood pressure measurement by auscultatory method, after a few initial tapping sounds, no sound is heard for a variable duration and then the sounds are heard again. This period when no sound is heard is called as auscultatory gap.
Korotkoff sounds:
When the cuff pressure is great enough to close the artery during part of the arterial pressure cycle, …

Unfractioned Heparin and Low Molecular Weight Heparins

Unfractioned Heparin and Low Molecular Weight Heparins

Unfractioned Heparin-
Unfractioned Heparin- is derived from  porcine intestinal mucosa or bovine lung tissue. UFH catalyzises that inactivation of thrombin and factor Xa by inhibiting Anti-thrombin III.  At usual dose it prolongs TT and aPTT and has a minimal effect on PT/INR.
Benefits of UFH-

1. The effect of UFH normalizes within hours of discontinuation
2. It is reversible with Protamine Sulphate.
3. Can be …

Acute Coronary Syndrome or ACS

Acute Coronary Syndrome or ACS

Acute Coronary Syndrome (ACS) consists of spectrum of illness which includes:

Unstable angina
NSTEMI or Acute Non Q web MI
Acute MI

Conventionally ACS refers to UA and NSTEMI
Pathophysiology:

Plaque rupture → Platelet adhesion to expose collagen in coronary arteries → Activation of platelets → Platelet aggregation → thrombus formation → ACS
Coronary spasm → Decreased Myocardial circulation → ACS

Stable and Unstable Plaque are the 2 …

Paroxysmal Nocturnal Dyspnea or PND : Classical attack

Paroxysmal Nocturnal Dyspnea or PND : Classical attack

Describing the attack of PND
Normally after 30 minutes to 2 hours of lying in bed for sleep, the patient wakes up with feeling of intense suffocation or chocking sensation. Classically he sits upright gasping in bed with legs hanging by bed or rushes to open the window to get cool air, hoping it will relieve his symptom. Profuse sweating occurs …

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