Key Documents

Displayed to the right are the key documents.

 

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Medical Notes

Name: Mr Jones

Mr Jones is a 56 year old man admitted to A&E by paramedics called to his house by his wife who is concerned that he is so breathless and confused.

Mr Jones is diabetic with stable angina. His medications include bisoprolol, aspirin, simvastatin and ramipril.

90/min

90/60

capillary refill 4 seconds

Sp02 94% on oxygen

RR 26, alert and orientated

MENU

Section 9

Vasoactive agents

Section 8

Circulatory shock

Section 7

Management of sepsis

Section 6

Introduction to sepsis

Section 5

Hypoxia

Section 4

Sedation and analgesia

Section 3

Ventilation

Section 2

Respiratory failure

Section 1

Referral to critical care

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Circulatory shock

The effects of the sympathetic nervous system on the heart:

 

• Increase heart rate (chronotropic effect).
• Increase contractility (positive inotropic effect).
• Increase the speed of conduction through the AV node.

 

 

These effects are achieved through the activation of ß receptors. There are at least two types of ß receptors, ß1 and ß2.

 

In normal hearts, the population of ß1 receptors is usually larger than that of the ß2 receptors.

 

In some pathological conditions, e.g. heart failure, there is a relative increase in the population of ß2 receptors.