…obstruction) of the left main coronary artery (LAD) or 2 epicardial coronary arteries (Felker et al). Left ventricular dilation entails a markedly elevated risk of…

…VA may occur in the presence of obstructive coronary artery disease (CAD), in non obstructive coronary arteries, or in patients with intermediate lesions that do…

…defined by symptoms lasting more than 3 months and attributable to established reversible myocardial ischaemia in either of two settings: Obstructive coronary artery disease (CAD…

…arterial insufficiency can cause necrosis. Screening in diabetes of 10 years' duration, or in diabetes with age 50 years. Risk assessment in known coronary or…

…nearby arteries to grow new vessels into the ischemic zone. Newly formed vessels, which may originate from other branches of the same coronary artery or…

…associated with hypertension, coronary artery disease, arrhythmias, heart failure and alcohol related cardiomyopathy. The cardiovascular implications of lower alcohol intake remain controversial. Epidemiological studies have…

…of the size, mass, geometry, and function of the left ventricle is fundamental for the diagnosis and prognosis of most cardiac diseases, including coronary artery…

…serious arrhythmia or acute heart failure. Routine opening of a persistently occluded infarct related artery in a stable and asymptomatic patient is by contrast not…

…bleeding risk, the anticipated need for non cardiac surgery, procedural complexity, and the relative merits of PCI and coronary artery bypass grafting (CABG). Definition and…

…primarily for instability. Evaluation and physical examination Initial assessment should establish whether AF is associated with acute haemodynamic compromise, pulmonary oedema, or evidence of coronary…

…results from abrupt reduction in coronary blood flow caused by thrombotic occlusion of a previously atherosclerotic artery. Plaque erosion or rupture exposes thrombogenic material to…

…of coronary angiography and possible revascularization. Revascularization may be selected for symptom relief after shared decision making, particularly when the anginal burden is high or…

…attempts and their duration. Triggers for smoking and anticipated barriers to cessation. Exposure to second hand smoke. Use of cannabis, electronic cigarettes or other inhaled…

…and symmetric. Their duration is short; they typically disappear within minutes after a total occlusion in a coronary artery occurs (then of course, the ST…

…arrhythmias. Definitions and ECG criteria for ventricular rhythm and idioventricular rhythm Ventricular rhythm exists if 3 or more consecutive beats have a ventricular origin. The…

…muscle rupture. The risk of rupture is greater for the posteromedial papillary muscle, which only receives blood supply from one coronary artery (Coronary arteries). Chronic…

…either LCX or the right coronary artery (RCA). For details, refer to chapter The Coronary Arteries. Mitral valve disease A wide range of conditions may…

…instability or transiently toxic concentrations, adenosine requires a rapidly delivered bolus to achieve sufficiently high concentrations at its clinical site of action—the coronary artery…

…setting of acute coronary syndrome, AF is the most frequent supraventricular arrhythmia. It may predate the coronary event, be detected for the first time, or…

…of life if the circulation is temporarily supported by ECMO. Furthermore, ECMO might be required to facilitate procedures such as percutaneous coronary intervention (PCI) or…

…capacity, expressed by exercise duration, workload or metabolic equivalents, is among the strongest predictors of mortality in patients with cardiovascular disease after accounting for age…

…in persons who are otherwise healthy. The majority of those with LAFB, however, have significant heart disease. Myocardial infarction, coronary artery disease, left ventricular hypertrophy…

…is caused by a complete coronary artery occlusion, which results in the complete stop of blood flow and thus more extensive myocardial ischemia (referred to…

…with rapid onset of action. Labetalol has less antihypertensive efficacy as compared with nicardipine. Labetalol is safe in patients with coronary artery disease since it…

…patients with suspected or established coronary artery disease (CAD). It combines echocardiographic assessment of left ventricular (LV) structure and function with exercise or pharmacological stress…

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

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

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

…days duration. Vernakalant does not convert atrial flutter to sinus rhythm. Vernakalant is only administered in a monitored clinical setting appropriate for cardioversion. Administration of…

…not a treatment review. For a fuller account of two of the commonest acute drug problems, see Warfarin therapy and Opioid therapy in severe pain…

…or treatment with sodium nitroprusside. In most hypertensive emergencies the following is aimed for: 1. Lower the mean arterial pressure by no more than about…

…ACS or chronic coronary syndrome (CCS). Whether and how PCI was performed. The need for non cardiac surgery. The presence of an indication for oral…

…in arterial blood flowing through the pulmonary, coronary and cerebral circulation, as well as allowing for gas exchange in the lungs. A large number of…

…for the management of acute coronary syndromes with persistent ST segment elevations (i.e STEMI, ST segment elevation acute myocardial infarction). 1 Initial diagnosis of…

…lasting more than 20 minutes; new severe angina; an accelerating pattern with increasing frequency, duration, or severity; a lower threshold for symptom provocation; or angina…

…arteries does not exclude a coronary cause of symptoms. CCS is a clinical syndrome rather than a permanently stable state. Patients may remain stable for…

…elevated for up to 2 weeks after a heart attack. The larger the infarction, the higher the troponin level and the longer the duration of…

…occurs in diastole or the decompression phase during CPR). High aortic pressure and low right atrial pressure favor coronary blood flow. A CPP of approximately …

…more frequent, more prolonged, or provoked by less exertion. Angina occurring after a recent myocardial infarction. UA belongs to the broader spectrum of acute coronary…

…combination with acetylsalicylic acid (ASA), is indicated for the prevention of atherothrombotic events in adult patients with acute coronary syndromes (ACS), including: Unstable angina (UA…

…is 12 months of DAPT unless there is a contraindication, an indication for oral anticoagulation, or an excessive risk of bleeding. The duration and intensity…

…primarily in the context of suspected acute coronary syndrome and acute myocardial ischaemia. Patients may present with acute chest pain or chest pain equivalent symptoms…

…that the reference level for measuring deviation (elevation or depression) of the ST segment is the PR segment (the terminal portion of the PR interval…

…linked or other non autosomal dominant mechanisms. Complex or multifactorial genetic architecture. The inheritance pattern affects the appropriate scope and duration of family surveillance. For…

…16 years of age, and greater than 80 ms in children less than 8 years of age without meeting the criteria for RBBB or LBBB…

…minute) should never be used for mor than 10 minutes. Administer sodium thiosulfate (cyanide into thiocyanate) and terminate infusion of nitroprusside if cyanide toxicity is…

…associated with lower cardiovascular and all cause mortality and with reduced incidence or burden of hypertension, type 2 diabetes, coronary disease, stroke, peripheral arterial disease…

…myocardial ischaemia caused by an acute coronary process. Myocardial injury leads to release of cardiac troponin, but troponin elevation is not specific for myocardial infarction…

…enlargement or left ventricular hypertrophy, or echocardiographic evidence of impaired filling, make the diagnosis more likely. HFpEF and HFmrEF together account for approximately half of…

…considered for its prognostic implications. Clinicians often check pupil size and reactivity as part of initial and ongoing evaluations of patients in cardiac arrest or…

…help determine expected normal values based on body surface area (BSA), aiding in the diagnosis of aortic root dilation. Key Formulas BSA Calculation (Mosteller formula): [ …

…The incidence is 10–34% among patients with premature ventricular contractions and/or nonsustained ventricular tachycardia who are referred for electrophysiological evaluation (Hasdemir et al…

…Tetralogy of Fallot Marfan syndrome Takayasu's arteritis Iatrogenic (e.g complication of catheterization) Congenital dysplasia/aplasia of the pulmonary valve Idiopathic pulmonary artery dilation…

…of both thromboembolic and hemorrhagic risks. The diagnostic prerequisite for clinical AF remains the documentation of the arrhythmia via a standard 12 lead ECG or…

…tricuspid regurgitation is more pronounced. Echocardiography is the preferred method for diagnosing tricuspid regurgitation. Causes of tricuspid regurgitation The most common causes of tricuspid regurgitation…

…prevent, or alleviate, the pressure increase in the left ventricle and left atrium. Chronic aortic regurgitation leads to dilatation and hypertrophy of the left ventricle…

…size and form of the thrombus, it will occlude the main pulmonary artery or its branches. The larger the thrombus, the more proximal the occlusion…

…prevalence of ARVC is between 0.02 and 0.05% in Europe (Corrado et al). ARVC is more malignant in men, the reason for which…

…by aortic or mitral disease (most commonly mitral stenosis). Simultaneous tricuspid regurgitation is also common. Echocardiography Echocardiography has replaced catheterization for the assessment of tricuspid…

…depression, or untreated severe respiratory failure without the possibility of monitoring. Paralytic ileus and suspected obstructive ileus (an opioid can be given for the pain…