…dissection. PAU is particularly associated with advanced age, smoking, coronary artery disease, chronic obstructive pulmonary disease, renal insufficiency, systemic hypertension, and concomitant abdominal aortic aneurysm…

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

…aneurysm, aortic dissection, and endocarditis. Figure 2 shows the normal tricuspid aortic valve. Figure 2. Normal (tricuspid) aortic valve with three cusps (RCC, NCC and…

…associated genetic variants and coronary artery disease. Associations have also been extended to peripheral arterial disease, ischaemic stroke, abdominal aortic aneurysm, and calcific aortic valve…

…This results in flow heterogeneity and perfusion defects in areas supplied by the disease artery. Thus, vasodilators replicate the effects of exercise on coronary arteries…

…coronary artery disease, especially when conventional risk estimates leave uncertainty near a treatment decision threshold. It can move estimated cardiovascular risk upward or downward and…

…with suspected coronary artery disease (i.e CCS). The new guidelines are based on data derived from studies conducted mainly in North America and Europe…

…Myocardial ischemia and infarction Definition and pathophysiology Spontaneous coronary artery dissection (SCAD) is an acute coronary disorder caused by separation within the coronary arterial wall…

…with suspected coronary artery disease (i.e. CCS). The new guidelines are based on data derived from studies conducted mainly in North America and Europe…

…more major epicardial coronary arteries. It frequently coexists with left main coronary artery disease, diabetes mellitus, left ventricular dysfunction, peripheral vascular disease and other manifestations…

Myocardial ischemia and infarction Definition and Pathophysiology Left main coronary artery disease (LMCAD) refers to atherosclerotic narrowing of the left main coronary artery, which supplies…

…hospital and 6 month mortality (up to 18% at 6 months for 1 mm elevation, vs 7.6% with no elevation). Figure 1. Coronary artery…

…aggressive lowering of blood lipids with statins and sophisticated treatments for hypertension. However, coronary artery disease remains the number one killer in most regions worldwide…

…to denote the occluded coronary artery. In the majority of cases, it is only possible to determine the ischemic/infarct area (and thus the culprit…

…Pathophysiology Coronary artery disease and obstructive stenosis Anatomically significant epicardial CAD is conventionally defined as stenosis of at least 70%, while a left main coronary…

…cause of coronary artery disease? First of all, don't confuse various lipids, since they are extremely different with regards to their effects and hazards…

…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…

…course can impair coronary perfusion, particularly during vigorous exercise. In AAOCA, high risk anatomical features include an interarterial course between the aorta and pulmonary artery…

…The left main coronary artery ( LMCA ) originates from the left anterior aspect of the aortic bulb. The LMCA is short and branches into the two…

…The clinical importance of residual disease is also influenced by anatomic complexity and comorbidity, which themselves may contribute to progression of native coronary artery disease…

…for selected patients with suspected coronary artery disease (CAD), particularly those with stable chest pain, no previous diagnosis of CAD, and a low clinical likelihood…

…and preferences. A multidisciplinary, shared decision making process is appropriate when revascularization is being considered. The choice between PCI, coronary artery bypass grafting (CABG) and…

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

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

…distribution and severity of epicardial coronary artery disease (CAD). Assessing the haemodynamic significance of lesions whose angiographic severity is uncertain. Supporting decisions regarding revascularization and…

…Moreover, STE ACS is caused by a complete coronary artery occlusion and virtually all these patients will develop myocardial infarction, which is classified as STEMI…

…demonstrates marked differences between rest and stress conditions, particularly in significant coronary artery stenosis. Stress can be induced pharmacologically with coronary vasodilatory agents or simulated…

…to coronary stents Balloon angioplasty was initially limited by acute vessel closure and later restenosis. Coronary stents provided a scaffold that tacked down dissection flaps…

…vasospasm Coronary microvascular dysfunction Spontaneous coronary artery dissection (SCAD) Standard angiography may fail to demonstrate plaque disruption, intraluminal thrombus, or dissection. Intravascular ultrasound (IVUS) and…

…and in some cases substantially narrowed, the role of revascularization itself in stable coronary artery disease, while a distinct evidence base has emerged for coronary…

…troponin and, where needed, coagulation tests. Blood sampling must not delay reperfusion. 5. Give aspirin if acute coronary syndrome is likely and aortic dissection or…

…distal embolization, coronary dissection, perforation, and abrupt closure. The clinical consequences depend heavily on the amount of viable myocardium supplied by the affected artery. Large…

…and incorporates advanced ECG interpretation, clinical context, imaging, biomarkers, and angiographic findings. OMI is defined by acute coronary artery occlusion causing transmural ischemia and requiring…

…with a calcified nodule. Epicardial or microvascular coronary spasm. Spontaneous coronary artery dissection. Coronary embolism of cardiac or non cardiac origin. Oxygen supply–demand mismatch…

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…

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

…or pericarditis Acute aortic dissection Physical disability that precludes safe and adequate testing Relative contraindications Known obstructive left main coronary artery stenosis Moderate to severe…

Cardiology Myocardial ischemia and infarction Definition and pathophysiology Ischemic cardiomyopathy is severe myocardial dysfunction caused by coronary artery disease (CAD). The clinical syndrome may resemble…

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…

ECG Myocardial ischemia and infarction Acute Myocardial Infarction: Definition & Criteria Acute myocardial infarction is the most severe complication of coronary artery disease. The most common…

…the progressive loss of myocytes following the occlusion of a coronary artery. The size, location, and duration of the occlusion are of prime importance but…

…of obstructive coronary artery disease, defined as no stenosis exceeding 50% diameter reduction and/or an FFR 0.80. Demonstration of reduced CFR and/or…

…from acute compromise of coronary flow. Mechanisms include: Coronary dissection with obstruction of the true lumen Occlusion of a major epicardial artery or bypass graft…

…models improve identification of patients with very low likelihood of obstructive CAD and may reduce unnecessary diagnostic testing. Coronary artery calcium (CAC) provides additional information…

…with nicardipine. Labetalol is safe in patients with coronary artery disease since it does not increase heart rate, and reduces myocardial oxygen consumption. Time to…

…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…

…heart failure with reduced ejection fraction (HFrEF) and coronary artery disease (CAD), and after acute coronary syndromes in patients with reduced left ventricular ejection fraction…

…ischaemic electrocardiographic changes during rapid AF. ST segment depression or T wave inversion can occur without coronary artery disease. Proposed explanations in the source material…

…particularly coronary artery disease (CAD). FH results from pathogenic variants affecting proteins in the hepatic LDL receptor pathway. Reduced cellular uptake and clearance of LDL…

…MI: Represents a periprocedural myocardial infarction associated with coronary artery bypass grafting (CABG). Clinical Presentation and Symptoms The diagnosis of an acute MI remains a…

…spontaneous coronary artery dissection (SCAD), or another occult structural abnormality. IVUS IVUS generates images by transmitting ultrasound from an intracoronary catheter and recording echoes reflected…

…be considered. Effective lipid lowering improves survival and reduces cardiovascular mortality in patients with coronary artery disease irrespective of the baseline cholesterol concentration. Intensive statin…

…disability and premature mortality. Cardiovascular conditions associated with obesity include hypertension, dyslipidaemia, coronary artery disease (CAD), atherosclerosis, heart failure (HF), atrial fibrillation and cardiovascular events…

…symptoms lasting more than 3 months and attributable to established reversible myocardial ischaemia in either of two settings: Obstructive coronary artery disease (CAD) that cannot…

…epicardial coronary artery. A vulnerable atherosclerotic plaque and thrombogenic blood interact to initiate and extend thrombosis. Plaque vulnerability is influenced by inflammation, plaque morphology and…

…ischaemia and to estimate prognosis in patients with suspected or established coronary artery disease (CAD). It combines echocardiographic assessment of left ventricular (LV) structure and…

…in lifetime cardiovascular disease (CVD) risk and approximately doubles cardiovascular risk on average. Its cardiovascular manifestations include atherosclerotic cardiovascular disease (ASCVD), coronary artery disease (CAD)…

…stress testing and revascularization (PCI, CABG) Stress testing is commonly performed at various stages before and after revascularization procedures (PCI or coronary artery bypass grafting…

…STEMI) is the most severe manifestation of coronary artery disease. This chapter deals with the pathophysiology, definitions, criteria and management of patients with acute STEMI…

…the right coronary artery (RCA). Nevertheless, if the right ventricle is affected, then the left ventricle is virtually always affected due to the coronary anatomy…