…metabolic abnormalities; and abnormal pain perception in patients without demonstrable ischaemia. The absence of obstructive disease therefore does not establish a benign diagnosis. ANOCA/INOCA…

…systolic blood pressure alone. Predictive Value : Elevated MAP has been associated with an increased risk of cardiovascular diseases, such as stroke, and mortality. Stability : MAP…

…the article follows: [...] Of every 10 such victims, the heart in 6 or 7 showed no recent disease in coronary arteries or in heart muscle…

…three main questions discussed in media, blogs and on social plattforms: Is high cholesterol a true cause of coronary artery disease? Does diet affect cholesterol…

…obstructive atherosclerotic disease. Patients with MINOCA tend to be younger and more often female than patients with atherosclerotic mediated myocardial infarction. A history of cigarette…

Cardiology Neurology Definition and Pathophysiology Carotid artery stenosis is an atherosclerotic narrowing of the carotid arteries. It forms part of multisite artery disease, defined as…

…over 40 years of age, atherosclerosis is the predominant cause. Other mechanisms include thrombosis, embolism, vasculitis, fibromuscular dysplasia, arterial entrapment, cystic adventitial disease and trauma…

…diseased coronary arteries, allowing ischemia to be detected during imaging. Exercise is the preferred method for inducing myocardial stress, as it provides additional diagnostic and…

…ostia. It remains the reference standard for defining the extent of coronary artery disease because it provides anatomical information while permitting functional assessment and, when…

…all coronary arteries are equally compromised, leading to uniform perfusion that may appear deceptively normal on SPECT. Detecting multivessel disease requires quantification of absolute coronary…

…catastrophic manifestation of acute coronary syndromes. The LMCA supplies a large myocardial territory through the left anterior descending (LAD) and left circumflex (LCx) arteries (Figure…

…isolates microvascular resistance. Only indices that detect microvascular disease as an independent cause of ischemia, including with non obstructive epicardial arteries (ANOCA/INOCA); CFR has…

…anterior descending and left circumflex arteries The number of additional diseased vessels Lesion morphology and technical feasibility of PCI The likely completeness of revascularisation with…

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

…arteries is a major pathological substrate, but ischaemia may also result from epicardial vasomotor abnormalities or structural and functional microvascular disease. Thus, the presence of…

…inflammatory disease of the arteries. It has become increasingly clear in the past few decades that atherosclerosis is not caused by the passive deposition of…

…testing), and cardiac catheterization. Principles of management of congenital heart disease and GUCH Complex malformations often require intervention (surgical or catheter based intervention). In addition…

…Atherosclerotic disease appears more likely to develop in the arterial segment proximal to the bridge, particularly in older adults. Consequently, an adult with bridging and…

…Most AAAs are located below the renal arteries and are related to atherosclerotic disease. At least 90% of AAAs larger than 4 cm are associated…

…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…

…stroke constitutes 87% of all stroke cases and is further divided into the following categories: Lacunar stroke or lacunar infarct (occlusion of small penetrating arteries) :…

…atherosclerotic arteries. This engenders the typical ECG changes as well. In acute coronary syndromes, however, symptoms and ECG changes are manifest at rest because of…

…functional abnormalities of the coronary arteries or coronary microcirculation. These abnormalities can produce a transient and reversible mismatch between myocardial oxygen demand and blood supply…

…Coronary disease is most commonly related to atheromatous plaque producing progressive narrowing or obstruction of epicardial coronary arteries. Endothelial dysfunction, coronary microvascular disease and vasospasm…

…conduction system and the arterial blood supply. The first third of the right bundle branch run in the endocardium, near the ventricular cavity, and it…

…is a frequent trigger of decompensation and may produce abrupt pulmonary oedema, sometimes requiring non invasive ventilation or intubation. Aortic disease An acute aortic dissection…

…in the context of the clinical presentation and other findings. A reduced CFR may occur with angiographically insignificant epicardial disease because of abnormalities in the…

…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…

…low risk of recurrence. Atrial fibrillation in other circumstances (particularly those listed above) is usually a progressive disease. Complications of atrial fibrillation and available treatments…

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…

…disease, accounting for 50% of all cardiovascular deaths ( Tsao et al ). A recent meta analysis showed that survival to hospital discharge is 8.8% and…

…demonstrating peripheral arterial disease, and it is needed more often than it is used — not only in claudication, but before every compression treatment of a…

…heart disease (CHD) , and coronary artery disease (CAD) are used interchangeably throughout this text. Wall motion abnormalities in ischemic heart disease In the setting of…

…of a chronic total coronary occlusion. Angina or ischaemia with non obstructive coronary arteries (ANOCA/INOCA), after appropriate investigation has identified the relevant endotype and…

…For details, refer to chapter The Coronary Arteries. Mitral valve disease A wide range of conditions may cause mitral valve disease, which results in changes…

…2% of the population and leads to gradual prolapse of the valve leaflets (Figure 1). Rheumatic heart disease is the leading cause of mitral regurgitation…

…PASP is an independent predictor of survival and for elevated left ventricular filling pressures (Lam et al). PASP is elevated in pulmonary arterial hypertension (PAH)…

…trans thoracic echocardiography. Causes of right ventricular hypertrophy Lung disease (with increased pulmonary vascular resistance), congenital heart disease (transposition of the great arteries, pulmonary valve…

…Diagnostic considerations Type 1 Contrast staining of the arterial wall with multiple lumens or radiolucent channels The classic appearance and usually readily recognized Type 2…

…coronary arteries (Felker et al). Left ventricular dilation entails a markedly elevated risk of ventricular tachycardia and cardiac arrest, regardless of the underlying cause of…

…for coronary heart disease (atherosclerosis). The average age at diagnosis of aortic stenosis is 75 years in high income countries. In low and middle income…

…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…

…of systemic arterial pressure. This renoprotective effect involves a reduction in intraglomerular hyperfiltration and hypertension by disproportionately reducing glomerular efferent arteriolar vasoconstriction. Clinical Presentation and…

…Behçet disease can cause both arterial and venous thrombosis. In SLE, renal artery involvement may contribute to difficult to control hypertension. The cardiovascular consequences of

…arterial hypertension and thromboembolic disorders. Most recognised heritable cardiovascular conditions demonstrate autosomal dominant transmission, in which an affected heterozygous individual has a 50% risk of…

…DW, Wickman LL, Swart GL. The hemodynamic and arterial blood gas response to asphyxiation: a canine model of pulseless electrical activity. Resuscitation 1995;30:16975…

…The cardiovascular burden of CKD extends beyond CAD to peripheral arterial disease, cerebrovascular disease, valvular heart disease, heart failure, atrial fibrillation, and other arrhythmias or…

Procedurer An arterial line is easy to insert and easy to trust too much. Two errors make the reading useless without anyone noticing: the transducer…

…8. Document the ceiling of care and the decision on intubation early. Initial assessment Confirm that the presentation fits an exacerbation A COPD exacerbation is…

…Dark skin: a risk of permanent hypopigmentation. Areas with poor circulation, above all the lower leg in a patient with peripheral arterial disease or diabetes —…

…diffuse, leading to underestimation of the overall disease burden. Angiography also provides limited information about plaque composition, vulnerability and the risk of future plaque rupture…

…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…

…of any nail bed laceration Contraindications There are no absolute contraindications, but be cautious and consider referral in: Diabetes with neuropathy or peripheral arterial disease…

…chronic, progressive, and highly dynamic inflammatory disease of the arterial wall. It is characterized by the subendothelial accumulation of apolipoprotein B containing lipoproteins, macrophage infiltration…

…stroke, transient ischaemic attack, and peripheral arterial disease. Heart failure is also considered established clinical CVD in the risk based approach to elevated BP. Risk…

…PH in the absence of CTEPH, lung disease, or another explanatory cause. PAH reflects marked pulmonary arterial remodelling, with fibroproliferative, plexogenic, and sometimes thrombotic changes…

…90% of prevalent hypertension. Hypertension has a major population attributable contribution to chronic coronary disease, cerebrovascular disease, and peripheral arterial disease. More than 70% of…

…time Highest risk of pneumothorax, the vessel cannot be compressed after arterial puncture, technically more difficult with ultrasound Femoral vein Fastest, and does not interfere…

…and loss of deep tendon reflexes. Pulses are absent distal to the obstruction, although Doppler examination may detect residual arterial flow in less advanced disease…

…prosthesis — warfarin is mandatory, and direct oral anticoagulants (DOACs) are contraindicated. Antiphospholipid syndrome, particularly triple positive disease or after an arterial event, where DOACs have…