…in functions to calibrate the stimulus amplitude and width according to myocardial excitability. This is done by repeatedly stimulating with gradually decreasing amounts of energy…

…predominant cause, accounting for approximately 60% of HFrEF cases in Western populations [14] . Non ischemic etiologies encompass a highly heterogeneous group of disorders. Idiopathic dilated…

…insufficiency Hypertensive disorders of pregnancy Preeclampsia Preterm delivery Gestational diabetes Small for gestational age delivery Placental abruption Pregnancy loss Polycystic ovary syndrome Functional hypothalamic amenorrhoea…

…contributes to the extension and severity of ischemic injury. In its most severe form, known as no reflow, structural and functional impairments sustain vascular obstruction…

…Asian ancestry Previous muscle disease or a personal or family history of muscle disorders Acute infection Renal or hepatic impairment Hypothyroidism Vitamin D deficiency Concomitant…

…PhD University of Gothenburg, The Sahlgrenska University Hospital, Sweden References Jervell A, Lange Nielsen F. Congenital deaf mutism, functional heart disease with prolongation of the…

…coronary disorders. The investigation should be undertaken when its diagnostic or therapeutic consequences are likely to outweigh procedural risks. This balance forms part of shared…

…depends on functional assessment. Coronary microvascular dysfunction (CMD) is characterized invasively by reduced CFR and increased microvascular resistance, measured by the index of microcirculatory resistance…

…Coronary vasomotor disorders may involve epicardial spasm or abnormalities of the coronary microcirculation. Microvascular angina reflects myocardial ischaemia caused by structural or functional microvascular abnormalities…

…Identification of PAD also provides an opportunity to recognise atherosclerosis in other arterial territories and to initiate secondary prevention. Clinical assessment should include functional status…

…Skipping a step is a common reason why mixed acid base disorders are missed. The blood gas describes the physiology at the moment of sampling…

…s disease), degeneration associated with connective tissue disorders (Marfan syndrome, Ehlers Danlos syndrome), osteogenesis imperfecta typically causes prolapse of P2 (Figure 1). Myocardial ischemia affecting…

…first sign of skin rash, mucosal lesions, or hypersensitivity. Interactions Pharmacodynamic interactions Anticoagulants, thrombolytics, or other platelet aggregation inhibitors: Salicylates inhibit platelet function and enhance…

…recurrent hospitalization for worsening heart failure, and improve symptoms, functional capacity and quality of life. The underlying aetiology is heterogeneous. Chronic heart failure evaluation should…

…causes immense strain on the ventricular myocardium, simultaneously as the cause of the arrhythmia already affects cellular function. This results in electrical instability which explains…

…an inherited disorder characterized by persistently elevated plasma low density lipoprotein cholesterol (LDL C) from early life and a consequent excess risk of premature atherosclerotic…

…factors—high LDL cholesterol, cigarette smoking, hypertension and diabetes mellitus—disturb endothelial function and favour the accumulation of fat, smooth muscle cells, fibroblasts and extracellular…

…Deterioration in ventricular function Hemodynamic instability Periprocedural myocardial infarction Cardiogenic shock Cardiac arrest The severity may be disproportionate to the angiographic appearance of the treated…

…4. Monitoring at the appropriate level of care , with readiness for respiratory support. 5. Treatment of the alcohol use disorder and planned follow up , not…

…coronary artery disease (CAD). It combines echocardiographic assessment of left ventricular (LV) structure and function with exercise or pharmacological stress. The physiological basis is an…

…Pathophysiology Chronic coronary syndromes (CCS) comprise the clinical manifestations of chronic structural and/or functional disease involving the epicardial coronary arteries and/or the coronary…

…infarction Definition and pathophysiology Fractional flow reserve (FFR) is an invasive, lesion specific physiological index used to estimate the functional significance of an epicardial coronary…

…anatomical or functional impairment of the left bundle branch (LBB), leading to a blockage of electrical impulse conduction through this bundle. Consequently, depolarization of the…

…Key evidence Fractional Flow Reserve (FFR) Ratio of distal coronary pressure (Pd) to aortic pressure (Pa) at maximal pharmacologic hyperemia (adenosine); approximates fraction of normal…

…an anatomical or functional dysfunction in the right bundle branch, such that the electrical impulse is blocked. Figure 1 illustrates the components of the ventricular…

…people with substantial functional impairment, multimorbidity, or limited life expectancy. Available randomized evidence has not demonstrated that frailty weakens the cardiovascular benefits of blood pressure…

…comprehensively. Exercise training can reverse deconditioning and increase functional capacity, while risk factor treatment and lifestyle modification reduce the burden of recurrent coronary risk. Nutritional…

…sarcopenia, cognitive function, functional capacity, and health related quality of life substantially influence both cardiovascular risk and the balance between treatment benefit and harm. Prevention…

…anticoagulation, renal function, age, comorbidity, and procedural complexity. Overall incidence and major complications Complications during diagnostic coronary angiography occur in approximately 2% of patients. Serious…

…decision making increasingly combines anatomical imaging with functional assessment. A central practical principle is that the visual severity of a stenosis does not reliably establish…

…of one or more coronary arteries. Epicardial spasm produces a reversible functional occlusion and usually causes transmural ischaemia. The resulting abnormalities in left ventricular function…

…not equate to normal cardiac function, but rather to a state where stroke volume is maintained only at the expense of pathologically elevated filling pressures…

…defect): constellations of bundle branch blocks and fascicular blocks (hemiblocks) This chapter discusses intraventricular conduction delays (defects), which are caused by functional or anatomical defects…

…in stroke Functional impact A low NIHSS does not exclude a disabling deficit, for example aphasia, hemianopia or hand paresis in a person of working…

…Evaluation of treatment effect in stable angina. Exercise induced arrhythmia or exercise induced syncope. Assessment of chronotropic function and pacemaker settings. Preoperative functional assessment before…

…outcome TTM2 (2021) 33 °C versus normothermia with active fever prevention (intervention at ≥ 37.8 °C) No difference in 6 month mortality or functional outcome…

…related to high ventricular rates and the loss of the atrial kick. The rapid ventricular response can lead to a reversible depression of systolic function…

…of intervention depend on the clinical setting, haemodynamic status, coronary anatomy, comorbidities, procedural complexity, age, frailty, and anticipated adherence to antithrombotic therapy. Anatomical and functional…

…abdominal distension and, in some patients, bendopnea. Congestion may also aggravate functional mitral regurgitation, ventricular dilatation, myocardial wall stress and subendocardial ischemia. Neurohormonal activation and…

…stratification and prognosis For patients with low or moderate pre test likelihood of obstructive CAD, CCTA or functional imaging should generally be preferred when available…

…prognosis. Pathophysiology The defining physiological abnormality is heart failure occurring with mildly impaired LV systolic function. The syndrome remains fundamentally one of impaired cardiac performance…

…been described in HFpEF, while nitrosative stress and abnormalities of cellular and molecular myocardial function may further impair contraction and relaxation. Structural and vascular consequences…

…This functional definition encompasses several physiological states. Brief coronary occlusion or relatively prolonged moderate ischemia may produce post ischemic stunning. In the absence of infarction…

…left main stenosis irrespective of symptomatic status or the documented ischaemic burden. In chronic coronary syndrome, revascularisation is particularly indicated when functionally significant disease produces…

…ventricular function, and, in selected circumstances, myocardial viability. Both techniques rely on intravenous radiopharmaceuticals that are taken up by myocardial tissue. The distribution of retained…

…dementia and osteoporosis. It also improves functional capacity, skeletal health, muscular strength, quality of life and psychological well being. Physical inactivity is itself a major…

…impair quality of life. The clinical impact should be assessed in terms of: Symptom frequency and duration. Functional limitation and effect on activities of daily…

…structural and functional microvascular impairment persists despite restoration of epicardial flow. The electrocardiographic appearance depends on several interacting factors: The stage of the ischaemic process…

…Baseline) : Reflects inhaled air devoid of CO 2 . Phase II (Rapid Expiration) : Represents the transition of air from anatomical dead space to functional alveolar space…

…Ejection fraction is routinely examined at rest, which does not reveal the functional (maximum) capacity of the left ventricle, as this would require measuring the…

…compared with chest pain and dyspnea, a poor predictor of cardiovascular and all cause mortality. However, leg fatigue must be registered. 2. Exercise performance (functional

…the exercise effort is terminated. Reliability as a function of workload In order for the exercise test to be reliable, the patient must perform maximally…

…the electrical impulse to the posterior and inferior walls of the left ventricle. Anatomical or functional block in the anterior fascicle leads to left anterior…

Cardiology The ischemic cascade The ischemic cascade describes the sequence of events during myocardial ischemia, beginning with perfusion abnormalities and ultimately leading to chest pain…

…is intensified [1,2]. The evidence that any particular intravenous drug improves mortality or long term functional outcome is limited. A Cochrane review found insufficient…

…76). Lack of Clinical Variables : The original SYNTAX Score focuses solely on anatomical factors, ignoring clinical variables such as age, diabetes, and renal function, which…

…chronic coronary syndromes Chronic coronary syndromes (CCS) describe stable period clinical presentations arising from structural or functional abnormalities of the coronary arteries or coronary microcirculation…

…duration and progression of symptoms should be documented carefully. Longer standing and more severe pain or functional loss reduce the likelihood of successful limb salvage…

…Coronary compression and a Venturi or “suction” effect have been proposed as mechanisms of inducible ischaemia. The functional impact depends on the bridge’s thickness…

…over an initial functional test. CCTA may be advantageous in adults younger than 65 years and in patients with a lower suspicion of obstructive disease…