…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…

…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…

…with a worse prognosis. VA may occur in the presence of obstructive coronary artery disease (CAD), in non obstructive coronary arteries, or in patients with…

…sustained heavy consumption is associated with hypertension, coronary artery disease, arrhythmias, heart failure and alcohol related cardiomyopathy. The cardiovascular implications of lower alcohol intake remain…

…for assessing ventricular function. For better or worse, ejection fraction has become virtually synonymous with left ventricular function. An obvious drawback with the use of…

…is still indicated with continuing ischaemia, shock, serious arrhythmia or acute heart failure. Routine opening of a persistently occluded infarct related artery in a stable…

…with lesion anatomy, clinical presentation, bleeding risk, the anticipated need for non cardiac surgery, procedural complexity, and the relative merits of PCI and coronary artery…

…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…

…safe in patients with coronary artery disease since it does not increase heart rate, and reduces myocardial oxygen consumption. Time to onset of action: 5…

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

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

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

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

…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…

…with PCI or without revascularization, although the exact antithrombotic strategy may differ when long term OAC is also indicated. Possible shortening of DAPT A duration…

…or with prolonged periods of VF (fine VF resistant to defibrillations), the purpose of CPR is to induce myocardial electrical activity by generating adequate coronary…

…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…

…angina, angina or ischaemia with non obstructive coronary arteries (ANOCA/INOCA), post ACS or post revascularization states, and heart failure of ischaemic or cardiometabolic origin…

…Although both troponin T and I may be chronically elevated in patients with renal failure, this is more pronounced for troponin T ( Seng et al )…

…ROSC) : Return of mechanical cardiac function resulting in circulation with pulse. Coronary perfusion pressure (CPP) : The pressure that drives blood flow through the coronary arteries…

…coexist with atherosclerosis or may be the dominant cause of ischaemia. Other mechanisms capable of obstructing coronary arteries include embolism, dissection, coronary arteritis associated with…

…established. Limited data are available for children with sickle cell anemia. Method of Administration Route : Oral. Prasugrel can be taken with or without food. Administering…

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

…particularly when the clinical presentation is compatible with acute coronary syndrome. Recurrent or persistent symptoms should prompt repeat ECG acquisition and consideration of additional leads…

…The reader should already be familiar with the classification of acute coronary syndromes. Subsequent chapters will deal with ST segment elevation myocardial infarction (STEMI) and…

…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…

…of all cause death and cardiovascular death, compared to patients without such disturbances, including those with RBBB and LBBB. This was reported in the Coronary…

…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…

…hypertrophy, or echocardiographic evidence of impaired filling, make the diagnosis more likely. HFpEF and HFmrEF together account for approximately half of patients with symptomatic HF…

…a sensitivity of 72.2% for predicting an unfavorable neurological outcome, indicating that the test failed to identify 27.8% of individuals with poor neurological…

…or annual growth 3 mm. Limitations Formulas assume normal body habitus Ethnic variations may require adjusted thresholds Always correlate with imaging measurements Not valid for…

…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…

…portion of the pulmonary artery may also be dilated in patients with pulmonary hypertension. Echocardiography in pulmonary regurgitation Echocardiography is the modality of choice for…

…with more severe neurological deficits, and carry higher rates of mortality and long term disability compared to non cardioembolic ischemic strokes. Consequently, the cornerstone of…

…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…

…al). ARVC is more malignant in men, the reason for which remains elusive. Gene mutations can be confirmed in roughly 60% of individuals with ARVC…

…Valve replacement can be performed with biological or mechanical prostheses. The former is preferred due to the lower risk of thrombosis and evidence demonstrating long…

…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…