…Coronary arterial thrombi are predominantly platelet rich because they form under high shear conditions. Disruption of an atherosclerotic plaque or injury associated with PCI exposes…

Cardiology Pharmacology & dosing Definition and pathophysiology Lipid lowering therapy is a central component of cardiovascular prevention, particularly in patients with established atherosclerotic cardiovascular disease (ASCVD)…

Cardiology Myocardial ischemia and infarction Definition and pathophysiology Atherosclerosis is a chronic, inflammatory disease of the arterial wall in which lipid accumulation, vascular cell dysfunction…

…been identified as important risk factors. Severe atherosclerosis of the axillary or subclavian arteries may increase the risk of embolization. Risk assessment should be individualized…

…Left ventricular aneurysm with thrombus Cardiomyopathies Valve prosthesis Devices (pacemaker, ICD CRT) Endocarditis Cardiac tumors Atherosclerosis of the aorta LOW EMBOLIC POTENTIAL SEP (Spontaneous Echocardiographic…

Cardiology Coronary Atherosclerosis Coronary atherosclerosis is a chronic, progressive, and highly complex lipid driven inflammatory disease of the arterial intima that serves as the fundamental…

Introduction to Coronary Atherosclerosis, Plaques, Atherothrombosis Coronary atherosclerosis is a chronic, progressive, and highly dynamic inflammatory disease of the arterial wall. It is characterized by…

…and size of atherosclerotic plaques. Typically, the first manifestation of coronary artery disease is stable angina, defined by exercise related chest pain. Patients with stable…

…and size of atherosclerotic plaques. Typically, the first manifestation of coronary artery disease is stable angina, defined by exercise related chest pain. Patients with stable…

…two vascular beds. Carotid disease therefore commonly coexists with coronary artery disease (CAD), peripheral artery disease (PAD), and other manifestations of systemic atherosclerosis. The principal…

…Patients with stable or chronic atherosclerotic coronary disease, many of whom have a previous acute coronary syndrome. The available evidence supports consideration of low dose…

…the anticipated benefit–risk balance of revascularization. Coronary angiography remains primarily an anatomical examination, whereas contemporary decision making increasingly combines anatomical imaging with functional assessment…

…and cardiovascular rationale Smoking cessation is the complete discontinuation of tobacco smoking, with avoidance of second hand smoke and, where possible, other inhaled nicotine products…

…related to insulin resistance and the risk of diabetes and cardiovascular disease than total adiposity alone. The waist circumference associated with risk varies among populations…

…sedentary behaviour and loss of independence. Identification of PAD also provides an opportunity to recognise atherosclerosis in other arterial territories and to initiate secondary prevention…

…with worse outcomes. Unprotected Left Main Disease : Increases complexity and risk. Peripheral Vascular Disease (PVD) : Indicates systemic atherosclerosis. Chronic Obstructive Pulmonary Disease (COPD) : Associated with…

…in atherosclerotic cardiovascular disease (ASCVD). Atherosclerosis develops through the progressive deposition and retention of LDL C and other apoB containing lipoproteins within the arterial wall…

…of cardiovascular disease (CVD), cardiovascular risk factor clustering, disability and premature mortality. Cardiovascular conditions associated with obesity include hypertension, dyslipidaemia, coronary artery disease (CAD), atherosclerosis…

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

…coronary arteries. It frequently coexists with left main coronary artery disease, diabetes mellitus, left ventricular dysfunction, peripheral vascular disease and other manifestations of diffuse atherosclerosis…

…health status but does not reverse coronary atherosclerosis. Long term benefit therefore depends on the integration of revascularisation with guideline directed medical therapy and secondary…

…dissection of the coronary artery wall with accumulation of blood within the false lumen, which compresses the true lumen to varying degrees; this non atherosclerotic…

…atherosclerotic arteries. This engenders the typical ECG changes as well. In acute coronary syndromes, however, symptoms and ECG changes are manifest at rest because of…

…atherosclerotic plaques start building up early in childhood and by middle age, most persons have some degree of atherosclerosis in the coronary arteries. Advanced atherosclerotic…

…of a myocardial territory to augment blood flow during exercise or pharmacological vasodilation. Relative differences in regional tracer uptake during stress are compared with rest…

…objective is prevention of thromboembolic complications, particularly stroke. In untreated AF, stroke risk is increased approximately five fold, and AF is associated with roughly one…

…obstruction of epicardial coronary arteries. Endothelial dysfunction, coronary microvascular disease and vasospasm may coexist with atherosclerosis or may be the dominant cause of ischaemia. Other…

…elevated natriuretic peptide levels and/or objective evidence of pulmonary or systemic congestion [3] . Within this spectrum, Heart Failure with Reduced Ejection Fraction (HFrEF) is…

…dissection, intramural haematoma (IMH), and penetrating atherosclerotic ulcer (PAU). Aortic dissection accounts for approximately 80%–90% of acute aortic syndromes, IMH for approximately 10%–20%…

…contribution to chronic coronary disease, cerebrovascular disease, and peripheral arterial disease. More than 70% of older adults presenting with myocardial infarction, stroke, acute aortic syndromes…

…arteritis, giant cell arteritis and APS may also be associated with premature atherosclerotic disease. In a large UK clinical database, autoimmune disease was associated with…

…Individuals with homozygous FH typically die from acute myocardial infarction at 20 to 30 years of age. People with familial hypercholesterolemia have no other metabolic…

…Ischaemia with non obstructive coronary arteries (INOCA) denotes the subgroup in whom objective myocardial ischaemia is demonstrated. ANOCA may occur in up to 70% of…

…patterns: Type Angiographic appearance Diagnostic considerations Type 1 Contrast staining of the arterial wall with multiple lumens or radiolucent channels The classic appearance and usually…

…coronary syndromes HF across the spectrum of left ventricular ejection fraction AF and other arrhythmias Ischaemic stroke PAD CKD with associated cardiovascular complications Symptoms are…

…Risk factors for calcification overlap with risk factors for coronary heart disease (atherosclerosis). The average age at diagnosis of aortic stenosis is 75 years in…

…and results of the exercise test may be affected by patient characteristics. For example, exercising patients with ongoing myocardial ischemia may provoke life threatening ventricular…

…radiation may reflect the segment of aorta involved, although the source material does not provide a detailed symptom to anatomy correlation. Pain may be absent…

…caused by partial occlusion of the artery (i.e. coronary blood flow is not completely obstructed). NSTE ACS typically presents with ST segment depressions and…

…myocardial necrosis. It most commonly reflects atherothrombosis: disruption of an atherosclerotic plaque followed by platelet activation and coagulation, with formation of an intraluminal thrombus. The…

…risk of atherosclerotic plaque rupture is increased during infections). As noted by Bonow et al, it is also reasonable to believe that patients with heart…

…to chest pain. It is appropriate when the expected information is likely to change management. In patients with a very low probability of obstructive CAD…

…haemorrhage into the plaque. The diagnosis is supported by the general criteria for acute MI together with evidence of acute coronary atherothrombosis. Post mortem demonstr

…and clinical approach. This culminated in the Universal Definition of Myocardial Infarction Consensus Documents, with the Fourth Universal Definition published in 2018. A fundamental prerequisite…

…acute coronary syndrome is the result of a perfect storm scenario, where disruption of an atherosclerotic plaque coincides with a pro thrombogenic moment in thrombocytes…

…patients with ischemic heart disease, the majority of all ischemic episodes are asymptomatic (refer to The Ischemic Cascade). Acute coronary syndromes occur when atherosclerotic plaques…

…rest pain in the foot or leg, or a non healing distal ulcer. Before compression treatment of a leg ulcer — compression in arterial insufficiency can…

…They should not be applied as the principal risk tool in people with: Documented atherosclerotic cardiovascular disease (ASCVD) Diabetes mellitus in circumstances where diabetes specific…

…or ECG changes consistent with myocardial infarction/ischemia. Most patients, however, display both ECG changes and symptoms. Troponins and other biomarkers of myocardial necrosis (infarction…

…al ). Among patients with coronary heart disease, left ventricular function is actually a stronger predictor of death than the atherosclerotic burden. Assessment of the size…

…be initiated concurrently. In patients with a confirmed indication for treatment but blood pressure in the range of 120–139/70–89 mmHg, concomitant indications…

…L) Triglyceride rich lipoproteins, remnant lipoproteins and insulin resistance are associated with atherosclerotic cardiovascular disease (ASCVD), particularly in peripheral arterial disease. The relationship between triglyceride…

…for approximately 80% of cases. Other causes include acute mechanical complications—particularly ventricular septal defect (VSD) and papillary muscle rupture with acute severe mitral regurgitation…

…cardiovascular death, and progression of atherosclerotic disease in patients with established coronary or other atherosclerotic vascular disease. Antiplatelet therapy is a central component because platelet…

…tomographic angiography (CCTA) is a non invasive anatomical examination that depicts the coronary arterial lumen, atherosclerotic plaque, and the severity and distribution of coronary stenosis…

…characterized by persistently elevated plasma low density lipoprotein cholesterol (LDL C) from early life and a consequent excess risk of premature atherosclerotic cardiovascular disease (ASCVD)…

…arteries and are related to atherosclerotic disease. At least 90% of AAAs larger than 4 cm are associated with atherosclerotic pathology. AAA prevalence increases with…

…stress. Palpitations associated with physical activity, a large meal, emotional upset, or cold exposure. The absence of chest pain does not exclude clinically important CCS…

…with or without other LDL C lowering drugs, when additional LDL C reduction is required, including in patients with atherosclerotic cardiovascular disease (ASCVD) or heterozygous…

…therapy, generally with ezetimibe where appropriate. Established clinical atherosclerotic cardiovascular disease (ASCVD) and FH are principal settings in which these drugs have received approval. In…