…myocardial infarction Coronary microvascular dysfunction Myocarditis and pericarditis Coronary or large vessel arteritis Pulmonary arterial vasculopathy and pulmonary hypertension Arterial and venous thrombosis Valvular heart…

…therefore be considered throughout assessment. Coronary disease is most commonly related to atheromatous plaque producing progressive narrowing or obstruction of epicardial coronary arteries. Endothelial dysfunction…

…hypertension Endocarditis Myxoma Carcinoid heart disease Tetralogy of Fallot Marfan syndrome Takayasu's arteritis Iatrogenic (e.g complication of catheterization) Congenital dysplasia/aplasia of the…

…Danlos syndrome Inflammatory aortitis, including Takayasu arteritis and giant cell arteritis Bicuspid aortic valve Coarctation of the aorta Previous aortic trauma Pregnancy, particularly the third…

…injury, recent cervical spine surgery, atlantoaxial instability, severe rheumatoid arthritis of the neck. Symptomatic carotid stenosis, recent stroke or TIA in the vertebrobasilar territory. Retinal…

…surgeon under strictly sterile conditions. For corticosteroid injection there is an additional absolute contraindication: the slightest suspicion of septic arthritis. If the picture is unclear…

…Cellulitis, a skin wound or other infection over the injection site. Bacteraemia or suspected septic bursitis or arthritis. A joint prosthesis in the adjacent joint…

…of disease progression. Assessment of pulmonary involvement in systemic disease, for example rheumatoid arthritis or scleroderma, and during treatment with pulmonary toxic drugs. Contraindications Forced…

…Rupture of the free ventricular wall. Neoplasms (particularly breast and lung cancer). Inflammatory conditions, such as rheumatoid arthritis, systemic lupus erythematosus, scleroderma, and rheumatic fever…

…mobility, a cervical collar, rheumatoid arthritis, ankylosing spondylitis MACOCHA is validated for the intensive care patient and totals 12 points: Mallampati III–IV (5 points)…

…other cause As above Severe pain Titrate the pressure up gradually Rheumatoid arthritis with vasculitis Individual assessment Repeat the ABI every three to six months…

…conclusions. Systemic inflammatory and autoimmune diseases, including systemic lupus erythematosus and rheumatoid arthritis, are important risk enhancing conditions and are more prevalent in women. Chronic…

…artery (RCA). For details, refer to chapter The Coronary Arteries. Mitral valve disease A wide range of conditions may cause mitral valve disease, which results…

…The most common causes are as follows: Rheumatoid arthritis (RA) Systemic Lupus Erythematosus (SLE) Acute myocardial infarction (AMI) Post infarction (including Dressler syndrome) Uremia Radiation…

…of the aortic bulb. The LMCA is short and branches into the two arteries supplying the anterior and left side of the heart, as follows:…

…ischemia and infarction Definition and clinical concept Myocardial infarction with non obstructive coronary arteries (MINOCA) describes a clinical presentation in which the patient has symptoms…

[calc_map] Mean arterial pressure (MAP) represents the average pressure within the arteries throughout a single cardiac cycle, encompassing both systole and diastole. It is…

Cardiology Neurology Definition and Pathophysiology Carotid artery stenosis is an atherosclerotic narrowing of the carotid arteries. It forms part of multisite artery disease, defined as…

…patterns. Patients may present with: exertional angina or angina like chest discomfort; symptoms suggestive of myocardial ischaemia despite normal or non obstructive coronary arteries; dyspnoea…

…involving the origin, course, distribution, or termination of the coronary arteries. They include anomalous aortic origin of a coronary artery (AAOCA), coronary fistulae, and myocardial…

…medicine Definition and pathophysiology Peripheral artery disease (PAD) is a clinical disorder caused by stenosis or occlusion of the aorta or arteries supplying the limbs…

…abdominal aortic diameter exceeds 3 cm. Most AAAs are located below the renal arteries and are related to atherosclerotic disease. At least 90% of AAAs…

…and thrombosis interact to produce focal arterial lesions. Although epicardial coronary arteries are a major site of disease, atherosclerosis is systemic and may affect multiple…

…Chronic coronary syndromes (CCS) comprise the clinical manifestations of chronic structural and/or functional disease involving the epicardial coronary arteries and/or the coronary microcirculation…

…procedure in which contrast media are injected selectively into the epicardial coronary arteries through a catheter advanced from a peripheral artery to the aortic root…

…and infarction Definition and therapeutic rationale Multivessel coronary artery disease (CAD) refers to clinically significant atherosclerotic disease affecting two or more major epicardial coronary arteries…

…formerly termed Prinzmetal or variant angina, is myocardial ischaemia caused by transient abnormal vasoconstriction of one or more coronary arteries. Epicardial spasm produces a reversible…

…localization, hemodynamic effects and possible impact on the coronary arteries. The tumors can be asymptomatic for a long time and be detected randomly when investigating…

…acute coronary syndromes. The LMCA supplies a large myocardial territory through the left anterior descending (LAD) and left circumflex (LCx) arteries (Figure 1). Acute obstruction…

…be subdivided into several layers. These layers are similar to those seen in arteries throughout the circulatory system (Figure 1). The ventricular wall consists of…

…with nitroprusside, nicardipine induces relatively greater venodilation than arteriolar dilation. Effects Nicardipine causes dilation of the coronary and systemic arteries, decreases total peripheral resistance, decreases…

…beds. Malignant hypertension represents an extreme form in which acute microvascular injury occurs, classically involving fibrinoid necrosis of small arteries in the kidneys, retina, and…

…50%. Severe proximal disease of both the proximal left anterior descending and proximal left circumflex arteries may constitute a functional equivalent of left main disease…

…attempted recanalization of a chronic total coronary occlusion. Angina or ischaemia with non obstructive coronary arteries (ANOCA/INOCA), after appropriate investigation has identified the relevant…

…including the renal, carotid, vertebral and coronary arteries. In one study cited in the source material, FMD was identified in 86% of patients with SCAD…

…or TIA. The purpose of performing an ultrasound is to scrutinize potential cardiac sources of emboli and to evaluate the carotid and cerebral arteries. Ultrasound…

…of the aortic bulb. The LMCA is short and branches into the two arteries supplying the anterior and left side of the heart, as follows:…

…there are additional factors that deserve mention. Collateral circulation: connected coronary arteries Coronary collateral circulation may be extremely important. Collateral circulation develops in ischemic myocardium…

…Of every 10 such victims, the heart in 6 or 7 showed no recent disease in coronary arteries or in heart muscle. In other words…

…coronary artery disease The underlying cause is atherosclerosis, which is a chronic inflammatory disease of the arteries. It has become increasingly clear in the past…

…is greater for the posteromedial papillary muscle, which only receives blood supply from one coronary artery (Coronary arteries). Chronic myocardial ischemia may also lead to…

…supplied by the disease artery. Thus, vasodilators replicate the effects of exercise on coronary arteries, without the need for physical activity. Advantages of regadenoson over…

…ischemia, seen in multivessel disease, exists when all coronary arteries are equally compromised, leading to uniform perfusion that may appear deceptively normal on SPECT. Detecting…

…while dipyridamole, adenosine, and regadenoson create blood flow disparities between healthy and diseased coronary arteries, allowing ischemia to be detected during imaging. Exercise is the…

…Causes of pulmonic stenosis. Tetralogy of Fallot Transposition of the great arteries) Dysplastic, bicuspid or unicuspid pulmonary valve Noonan syndrome : 60% of all individuals with…

…regional abnormalities in contractile function. The abnormalities affect the myocardial area supplied by the arteries distal to the occlusion or stenosis. If the ischemia persists…

…echocardiography. Causes of right ventricular hypertrophy Lung disease (with increased pulmonary vascular resistance), congenital heart disease (transposition of the great arteries, pulmonary valve stenosis, atrial…

…to the coronary anatomy (refer to the chapter Coronary Arteries and Localization of Infarction & Ischemia). Figure 1 shows a detailed view of the coronary arteries…

…arterial disease. Toe brachial index (TBI). The digital arteries rarely calcify, which makes toe pressure the method of choice in diabetes and renal failure. A…

…with nitroprusside, nicardipine induces relatively greater venodilation than arteriolar dilation. Effects Nicardipine causes dilation of the coronary and systemic arteries, decreases total peripheral resistance, decreases…

…chronic coronary syndromes Chronic coronary syndromes (CCS) describe stable period clinical presentations arising from structural or functional abnormalities of the coronary arteries or coronary microcirculation…

…epicardial stenosis and the coronary microcirculation. Microvascular dysfunction may impair maximal vasodilation even when the epicardial arteries are normal, and it may amplify the physiological…

…occur despite the absence of significant epicardial obstruction. In patients with anginal symptoms and unobstructed or non obstructive coronary arteries, possible mechanisms include microvascular obstruction…

…change dramatically, including in the left ventricle, left atrium, aorta and coronary arteries. As the valve area becomes smaller, the transvalvular resistance increases, making it…

…atrial appendage . Such thrombi may leave the appendage and enter the systemic circulation which causes thromboembolic occlusions of arteries in the brain, limbs or other…

…the relationship between the ventricles, the ventriculo arterial connection and the relationship of the great arteries (segmental analysis). Ventricular function is evaluated using ejection fraction…

…be suspected if there is significant stenosis ( 75% luminal obstruction) of the left main coronary artery (LAD) or 2 epicardial coronary arteries (Felker et al)…

…with nitroprusside, nicardipine induces relatively greater venodilation than arteriolar dilation. Effects Nicardipine causes dilation of the coronary and systemic arteries, decreases total peripheral resistance, decreases…

…the stress test is to increase the myocardial workload (and thus the oxygen demand) in order to provoke ischemia in myocardium supplied by atherosclerotic arteries…