…and arrhythmology Critical care Definition and pathophysiology Atrial fibrillation (AF) is the most frequent supraventricular arrhythmia in patients with acute coronary syndromes (ACS) and is…

…developing atrial fibrillation is age. Other significant risk factors are as follows: male sex, hypertension, left ventricular hypertrophy, left ventricular dysfunction, valve disease, coronary artery…

…comparison of P wave morphology during tachycardia and sinus rhythm is typically required. The isoelectric baseline lacks the saw tooth pattern characteristic of atrial flutter…

…should always be completed (regardless of whether conversion to sinus rhythm occurs) unless contraindications occur. If hemodynamically stable atrial flutter occurs after the first dose…

…conductance shortens the atrial action potential duration (APD), hyperpolarizes the membrane potential, and decreases atrial contractility. Analogous electrophysiological changes occur within the sinus and atrioventricular…

…average. Its cardiovascular manifestations include atherosclerotic cardiovascular disease (ASCVD), coronary artery disease (CAD), myocardial infarction, stroke, heart failure (HF), atrial fibrillation (AF), aortic disease, and…

…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…

…sinus rhythm . Parts of the atrial myocardium : There are clusters of atrial myocardial cells located around the crista terminalis , the entrance of the coronary sinus…

…contraindication) . Irregular wide complex tachycardia is most often due to atrial fibrillation with wide QRS complexes due to bundle branch blocks or other conduction defects…

…congenital anomalies include anomalous origin of a coronary artery from the pulmonary artery and anomalous origin of one coronary artery from the opposite aortic sinus…

…a coronary lesion depends on more than its visual diameter reduction. Relevant determinants include: Lesion eccentricity Vessel tortuosity Calcification Plaque rupture or asymmetric filling defects…

CPR Sex : Male Age : 62 years History : Coronary bypass grafting; history of arrhythmias. Medications : beta blockers ECG 1 . Sinus rhythm interrupted by ventricular tachycardia (VT)…

…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)…

…poorer than the prognosis for most cancers, whereas tachycardia induced cardiomyopathy can be cured completely by restoring sinus rhythm. Dilated cardiomyopathy is currently the most…

…fibrillation prior to the cardiac arrest. Most of these have atherosclerotic heart disease (coronary artery disease) as the underlying cause. Other common causes are cardiomyopathy…

…the heart rate or a PVC induced pause. The subsequent sinus beat typically exhibits a longer QT interval, and the T wave is interrupted by…

…defect can enlarge and cause rapid haemodynamic deterioration. Inferior infarction is associated with basal septal perforation and a worse prognosis than the typically apical defect…

…some patients exhibit a primary cardioinhibitory response with pronounced bradycardia. Most cardioinhibitory events are due to sinus bradycardia, though transient atrioventricular (AV) block can also…

Conduction defects ECG Management and treatment of AV blocks (AV block 1, 2 & 3) Evaluation of patients with suspected AV blocks requires a thorough medical…

…in other situations than does ventricular rhythm; idioventricular rhythm is primarily seen after reperfusion in an occluded coronary artery. It also occurs as side effect…

…In contrast, coronary CT angiography (CCTA) can characterize both calcified and non calcified plaque and can assess stenosis. A major limitation is that CAC does…

…15 seconds, with submillimetre spatial resolution. Iodinated contrast is generally required for coronary angiography because the intrinsic contrast between the cardiac chambers, blood pool, and…

…managed as a distinct clinical entity. The hallmark of stable coronary artery disease is exercise related angina pectoris (chest pain); symptoms of ischemia appear during…

Kardiologi Akutsjukvård Lathundar Overview Acute coronary syndrome comprises STEMI, NSTEMI and unstable angina. Management begins in parallel with the diagnostic work up. Obtain an interpretable…

Emergency medicine Myocardial ischemia and infarction Definition and pathophysiology Acute coronary syndrome (ACS) comprises a spectrum of clinical presentations caused by suspected acute myocardial ischaemia…

…also occur at rest or remain clinically silent. The underlying coronary disease may be obstructive or non obstructive. Atherosclerotic plaque accumulation in the epicardial arteries…

…in selected patients, identifying microvascular or vasomotor coronary disorders. The investigation should be undertaken when its diagnostic or therapeutic consequences are likely to outweigh procedural…

…is a complete or nearly complete coronary arterial obstruction that has persisted for at least 30 days. CTOs are common among patients undergoing coronary angiography…

…procedure, however, reverses the underlying coronary atherosclerotic process. Their clinical effects therefore occur within the broader framework of guideline directed medical therapy and secondary prevention…

…approximately 40–50 years. Hormonal influences, including oestrogen and progesterone related structural changes in the coronary media. The early postpartum period, when marked hormonal changes…

…managed as a distinct clinical entity. The hallmark of stable coronary artery disease is exercise related angina pectoris (chest pain); symptoms of ischemia appear during…

…Figure 1. The coronary arteries and their relation to the ECG leads. Localization of myocardial infarction / ischemia is done by using ECG changes to determine…

…and procedural complexity. Overall incidence and major complications Complications during diagnostic coronary angiography occur in approximately 2% of patients. Serious events such as stroke and…

Myocardial ischemia and infarction Introduction Drug eluting stents (DES) are the predominant device used during percutaneous coronary intervention (PCI). They evolved from balloon angioplasty and…

…territory at risk has been described as approximately 75–100%, depending on coronary dominance. Significant left main stenosis is generally defined as a diameter reduction…

…infarction Classification, diagnosis and definitions of acute coronary syndromes (ACS) and acute myocardial infarction (AMI) Acute coronary syndromes occur when atherosclerotic plaques disrupt, resulting in…

…to both the left anterior descending (LAD) and left circumflex (LCx) coronary artery territories, resulting in extensive myocardial ischemia or infarction involving the anterior, septal…

…in these regions. Mortality rates and case fatality in coronary artery disease peaked in the 1970s and have declined steadily ever since. The marked decline…

Abstract Angiographic stenosis severity is a poor surrogate for the hemodynamic significance of a coronary lesion, with anatomic and functional assessment discordant in a substantial…

…pressure and high cholesterol levels, among other risk factors, were strongly associated with coronary artery disease and myocardial infarction. However, association is not the same…

Myocardial ischemia and infarction Pharmacology & dosing Definition and pathophysiology Atherosclerosis and acute coronary syndromes have important inflammatory components. Inflammation contributes to atherothrombosis through activation of…

…and/or MVD. Nevertheless, the optimal extent and timing of intervention depend on the clinical setting, haemodynamic status, coronary anatomy, comorbidities, procedural complexity, age, frailty…

…inhibition therefore provides complementary platelet inhibition. The clinical rationale for DAPT is particularly strong after ACS and coronary stent implantation. ACS is associated with a…

…a definitive disease diagnosis. It is a descriptive and provisional classification that should trigger further investigation. The underlying mechanism may be coronary, myocardial, or systemic…

…for routine use. No reflow may also occur in association with other procedural complications, including distal embolization, coronary dissection, perforation, and abrupt closure. The clinical…

…5% of such lesions caused a clinical event during 3.4 years of follow up in a prospective study of patients with acute coronary syndrome…

ECG Introduction The traditional classification of acute coronary syndromes (ACS) into ST segment elevation myocardial infarction (STEMI), non STEMI (NSTEMI), and unstable angina (UA) has…

…Figure 1A. The coronary arteries and their relation to the ECG leads. Localization of myocardial infarction / ischemia is done by using ECG changes to determine…

Cardiology Principles of myocardial perfusion imaging Myocardial perfusion imaging (MPI) is a non invasive technique for detecting and quantifying coronary artery disease (CAD). It offers…

…the onset of myocardial infarction. This is utilized in clinical practice by detecting troponins in patients with suspected acute coronary syndromes. Several manufacturers have developed…

…progressive, and highly complex lipid driven inflammatory disease of the arterial intima that serves as the fundamental pathophysiological substrate for acute coronary syndromes (ACS), including…

…and a small lipid core, the pathophysiology of Acute Coronary Syndromes (ACS) is driven by the sudden destabilization of these lesions, a process known as…

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…

CPR The forces that drive coronary and cerebral perfusion, and ventilation of the lungs during cardiopulmonary resuscitation (CPR) differ substantially from normal circumstances. The purpose…

…standardized method to evaluate the anatomical complexity of CAD, particularly in patients with multivessel disease or left main coronary artery disease . It integrates multiple variables…

Myocardial ischemia and infarction ECG Definition and Pathophysiology Acute coronary syndromes (ACS) encompass a spectrum of clinical conditions characterized by a recent change in symptoms…

ECG Myocardial ischemia and infarction Use of ECG in acute coronary syndromes & chest pain patients An ECG must be performed on all patients seeking medical…

Cardiology Indications for myocardial perfusion imaging Diagnosis of coronary artery disease (CAD) : Myocardial perfusion imaging can confirm or rule out CAD in patients with symptoms…