…coronary disease. Angina or ischaemia caused by epicardial vasomotor dysfunction or microvascular abnormalities without obstructive epicardial disease. The non acute phase after ACS or coronary…

…obstruction. In patients with anginal symptoms and unobstructed or non obstructive coronary arteries, possible mechanisms include microvascular obstruction, endothelial dysfunction and epicardial coronary spasm. The…

…of angina may differ between patients. Myocardial ischaemia may result predominantly from obstructive epicardial coronary disease, coronary vasospasm, microvascular dysfunction, or combinations of these mechanisms…

…obstructive atherosclerotic CAD, coronary microvascular dysfunction or vasospasm. A normal or non obstructive coronary anatomy does not necessarily exclude an ischaemic mechanism. Clinical assessment and…

…also by the vulnerability of the myocardium and coronary microcirculation. Endothelial dysfunction promotes leukocyte and platelet activation and interaction. Thrombotic debris may worsen microvascular obstruction…

…coronary artery spasm, coronary microvascular dysfunction (encompassing endothelial dysfunction, smooth muscle cell dysfunction, and dysregulation of sympathetic innervation), coronary embolism, and spontaneous coronary artery dissection…

…Mechanism or clinical setting Examples Acute coronary atherothrombosis Plaque disruption or erosion with thrombosis Reduced myocardial perfusion Coronary spasm, microvascular dysfunction, coronary embolism, coronary dissection…

…diffuse atherosclerosis, and coronary microvascular dysfunction. A reduced value may therefore identify clinically important vascular dysfunction even when regional perfusion images appear normal. Radionuclide imaging…

…as intermuscular adipose tissue (IMAT), is independently associated with coronary microvascular dysfunction and major adverse cardiovascular events (MACE), whereas BMI alone often fails to capture…

…chronic kidney disease (CKD), and multiple non cardiovascular conditions are frequent features. A proposed disease pathway involves systemic and coronary microvascular endothelial inflammation associated with…

…hypertension, diabetes) induce a chronic, systemic proinflammatory state. This circulating inflammation leads to coronary microvascular endothelial dysfunction, characterized by the upregulation of adhesion molecules (e…

…including chronic coronary syndromes and acute coronary syndromes HF across the spectrum of left ventricular ejection fraction AF and other arrhythmias Ischaemic stroke PAD CKD…

…abnormalities. Assessment of wall motion abnormalities is particularly important in the setting of chronic or acute coronary artery disease. All types of ischemia– chronic, acute…

…ischemia and infarction Definition and pathophysiology A chronic total occlusion (CTO) is a complete or nearly complete coronary arterial obstruction that has persisted for at…

…ST elevation myocardial infarction (STEMI) . Chronic Coronary Syndromes (CCS) Coronary artery disease is a progressive but dynamic disease. The majority of individuals in high income…

…ST elevation myocardial infarction (STEMI) . Chronic Coronary Syndromes (CCS) Coronary artery disease is a progressive but dynamic disease. The majority of individuals in high income…

…chronic coronary disease may remain stable for prolonged periods, it can progress or destabilize abruptly, leading to ACS. Thus, “disease” refers to the underlying coronary…

…Unstable myocardial ischaemia. Ventricular arrhythmia or sudden cardiac arrest. Chronic coronary dissection presenting as heart failure, although this is described as uncommon. In pregnancy associated…

…life. The underlying aetiology is heterogeneous. Chronic heart failure evaluation should therefore seek reversible or treatable causes. The source material identifies coronary disease, hypertension, diabetes…

Cardiology Nephrology Definition and pathophysiology Chronic kidney disease (CKD) is defined by abnormalities of renal structure or function that persist for more than 3 months…

…multivessel CAD varies from stable angina or exertional limitation to acute coronary syndrome (ACS), ventricular arrhythmia, heart failure or cardiogenic shock. In chronic coronary disease…

…Angina Pectoris. Atherosclerosis: the cause of coronary artery disease The underlying cause is atherosclerosis, which is a chronic inflammatory disease of the arteries. It has…

…main stenosis irrespective of symptomatic status or the documented ischaemic burden. In chronic coronary syndrome, revascularisation is particularly indicated when functionally significant disease produces persistent…

…by: advanced age; diabetes mellitus; chronic kidney disease or renal failure; congestive heart failure; prior stroke; emergency coronary angiography or PCI; cardiogenic shock; ST segment…

…major or life threatening bleeding. The clinical presentation, whether ACS or chronic coronary syndrome (CCS). Whether and how PCI was performed. The need for non…

…in coronary disease has principally involved two populations: Patients recently recovering from myocardial infarction or acute coronary syndrome. Patients with stable or chronic atherosclerotic coronary…

…patients with left ventricular dysfunction and/or MVD. Nevertheless, the optimal extent and timing of intervention depend on the clinical setting, haemodynamic status, coronary anatomy…

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…

Indications Acute myocardial infarction. Unstable coronary artery disease. Stable angina pectoris. Secondary prophylaxis to prevent recurrence of cerebrovascular diseases, such as: Transient ischemic attacks (TIA…

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…

…Excess adipose tissue promotes: Chronic, low grade systemic inflammation Insulin resistance Abnormal adipokine signalling Endothelial dysfunction Dyslipidaemia A prothrombotic state Albuminuria and declining estimated glomerular…

CPR It is commonly stated that approximately 80% of all cardiac arrests are caused by acute or chronic coronary artery disease, with the latter being…

…chronic total occlusion, incomplete revascularization, or coronary anatomy unsuitable for further intervention. In ANOCA/INOCA, coronary atherosclerosis, endothelial dysfunction, and distinct coronary functional abnormalities may…

…left main coronary artery disease . It integrates multiple variables, including the number of lesions, their location, and specific characteristics such as bifurcations, chronic total occlusions…

…are dysfunctional because of repeated ischemic episodes or chronic reductions in perfusion. The amount and distribution of both viable and nonviable myocardium, together with coronary…

…by disease in the treated segment. The clinical implications range from asymptomatic angiographic disease to chronic coronary syndrome (CCS), acute coronary syndrome (ACS), myocardial infarction…

…intensity statin plus ezetimibe during hospitalization should be considered. Chronic coronary syndrome For all patients with CCS, a maximally tolerated high intensity statin is recommended…

…after ACS or STEMI. Aspirin 75–162 mg once daily is described as an acceptable secondary prevention range in chronic coronary disease. For prolonged treatment…

…vasodilation in coronary, renal, cerebral and mesenteric vessels. Few Dopamine medium dose Cardiogenic shock Vasodilatory shock Heart failure (HF), acute Heart failure (HF), chronic Bradycardia…

…the risk is low. In patients undergoing percutaneous coronary intervention, even mild baseline renal dysfunction is associated with worse outcomes. The risk of death at…

…vasodilation in coronary, renal, cerebral and mesenteric vessels. Few Dopamine medium dose Cardiogenic shock Vasodilatory shock Heart failure (HF), acute Heart failure (HF), chronic Bradycardia…

…in ischemic events or stent thrombosis. Stable coronary disease and elective PCI For chronic coronary syndromes treated with elective PCI, the standard DAPT duration is…

…any statin regimen. The treatment sequence for patients with chronic coronary syndrome is: Lifestyle intervention and a maximally tolerated high intensity statin. Add ezetimibe if…

…FH are principal settings in which these drugs have received approval. In chronic coronary syndrome, the recommended LDL C objective is: LDL C <1.4…

…acute coronary syndrome Reinfarction reduced by approximately 30–40%; death reduced by approximately 35–45% Peripheral artery disease Lower risk of progression to chronic limb…

…papillary muscle, which only receives blood supply from one coronary artery (Coronary arteries). Chronic myocardial ischemia may also lead to left ventricular dilation, which is…

…Comment : : : MAP ≥ 65 mmHg 80–85 mmHg in chronic hypertension or when there are signs of inadequate perfusion Urine output 0.5 mL/kg/h…

…II Anatomical SYNTAX Score : Derived from the original SYNTAX Score, which evaluates the complexity of coronary lesions. Clinical Variables : Age : Older patients have a higher…

…is indicated for the prevention of atherothrombotic events in adult patients with acute coronary syndrome (ACS) or a prior heart attack and a high risk…

…exposure produces transient haemodynamic and myocardial effects, whereas sustained heavy consumption is associated with hypertension, coronary artery disease, arrhythmias, heart failure and alcohol related cardiomyopathy…

…a spectrum of rhythm disturbances characterized by an inappropriately slow heart rate. Within the context of acute coronary syndromes, particularly ST elevation myocardial infarction (STEMI)…

…United States, approximately one in four female deaths is attributed to CVD. The cardiovascular burden in women includes coronary heart disease, heart failure and stroke;…

…approximately 20–50%. Their greater analytical sensitivity improves diagnostic accuracy and negative predictive value in patients with suspected acute coronary syndrome (ACS). Cardiac troponin is…

…manifestation of systemic arterial disease rather than an isolated disorder of the lower limbs. Patients frequently have concomitant coronary, cerebrovascular or other peripheral arterial disease…

…and viable myocardium. The incidence has fallen substantially with contemporary reperfusion, particularly primary percutaneous coronary intervention (PCI). In a large epidemiological analysis, mechanical complications occurred…

…Cardiac causes Systemic causes Heart failure Sepsis Myocarditis Chronic kidney disease Cardiomyopathy Stroke or subarachnoid haemorrhage Takotsubo syndrome Pulmonary embolism Recent coronary revascularization Infiltrative disease…

…factors are as follows: male sex, hypertension, left ventricular hypertrophy, left ventricular dysfunction, valve disease, coronary artery disease, cardiomyopathy, congestive heart failure, congenital heart disease…

…Respiratory conditions : Tension pneumothorax Drowning Airway obstruction Hanging Pneumonia High altitude sickness Aspiration Chronic obstructive pulmonary disease (COPD) Bronchospasm (asthma) Other : Coma Central hypoventilation syndromes…

…and proximal aorta can cause stroke, TIA (transient ischemic attack), coronary artery occlusion, and peripheral embolization. Stroke is the third leading cause of death in…