…Velocity Imaging) Previous chapters on Doppler imaging have all focused on measurements of blood flow. However, the Doppler effect can also be used to study…

…2D) imaging. Some measurements are still done using M mode echocardiography. A formal consensus regarding the components of the standard study has not been established…

…follow up in a prospective study of patients with acute coronary syndrome. Thus, an individual plaque’s morphology does not reliably establish that it will…

…disease Type 3 Focal or tubular stenosis resembling atherosclerosis Often requires intravascular imaging to demonstrate an intramural haematoma or double lumen Type 1 is reported…

…which during systole travels towards the apex, and then recoils to its starting position. Mitral annulus velocity is used to study longitudinal contraction; during systole…

…autosomal dominant syndrome (4). Figure 1 . 12 lead ECG (presented according to Cabrera), recorded at 63 years of age, demonstrates concave upward ST segment depression…

…SPECT imaging is recommended as the initial study in patients with low to moderate risk of CAD. In patients with a high to very high…

…intravascular imaging provides cross sectional and longitudinal information about the artery. The clinical value of these techniques rests on their ability to characterize the anatomy…

…Imaging is generally performed at rest and during exercise or pharmacological stress, allowing comparison between myocardial blood flow states. MPI is used principally to: Diagnose…

…Ultrasound artifacts The following artifacts are common in ultrasound imaging: The ultrasound image displays non existing structures. The ultrasound image does not display existing structures…

…What is myocardial redistribution? In myocardial perfusion imaging, redistribution refers to the movement of a radiotracer within the myocardium over time. Radiotracers without redistribution maintain…

…blood flow disparities between healthy and diseased coronary arteries, allowing ischemia to be detected during imaging. Exercise is the preferred method for inducing myocardial stress…

…Echocardiographic windows to obtain images. The standard examination include the following four imaging windows: Parasternal window Apical window Subcostal window (SC) Suprasternal window (suprasternal notch…

…and nomenclature is to develop consistency across examinations. This is of utmost importance when assessing myocardial structure, perfusion and wall motion. Cardiac planes All imaging…

…A3 receptors. Fixed dose administration : Regadenoson dosing is not weight based, simplifying administration. Dipyridamole Dipyridamole has multiple targets that contribute to its vasodilatory effects. It…

…pulmonary pressure, or haemodynamics Stress imaging is not recommended in patients undergoing urgent non cardiac surgery or those with an unstable clinical condition. In patients…

…decision whether to perform it now or after imaging, how the patient is positioned, which needle is chosen, and that the tubes go to the…

…American Society of Echocardiography (ASE) and the European Association of Cardiovascular Imaging (EACVI). Use the table of contents to go straight to the relevant section…

…a blood gas, coagulation tests and other investigations according to the clinical picture 5 Take cultures or molecular tests from the suspected focus, but avoid…

…they may be categorized according to whether they are: Not associated with ischaemia Associated with episodic ischaemia Associated with obligatory ischaemia Anomalies may involve the…

…infarction (MI) is a clinical diagnosis that integrates myocardial injury, evidence of acute myocardial ischaemia, electrocardiographic findings, cardiac biomarkers, imaging, angiography, and, occasionally, pathological examination…

…perfusion imaging (MPI) is based on principles similar to those used in echocardiography. The 17 segment model of the left ventricle serves as a standardized…

…of events during myocardial ischemia, beginning with perfusion abnormalities and ultimately leading to chest pain (angina). Myocardial perfusion imaging techniques, such as SPECT and PET…

Procedurer The value of the exercise test lies not in ST depression alone but in the overall picture : exercise capacity, symptoms, blood pressure response, heart…

…hyponatraemia is acute or chronic. The aim is to relieve the cerebral oedema quickly, not to normalise the plasma sodium. Chronic or minimally symptomatic hyponatraemia…

…mm. Limitations Formulas assume normal body habitus Ethnic variations may require adjusted thresholds Always correlate with imaging measurements Not valid for pediatric patients <15 years

…inhibitor to prevent symptomatic hypotension. Diagnostics The source material does not cover specific diagnostic modalities such as ECG, imaging, or electrophysiology in relation to ACE…

…lumen. It is commonly attributed to rupture of the vasa vasorum, although improved imaging demonstrates small intimal disruptions in approximately 20%–60% of cases. These…

…with both RV dysfunction on imaging and elevated cardiac biomarkers. Intermediate low risk PE includes stable patients who are not low risk but have either…

…of the bridged segment may extend into diastole, so the physiological effect is not limited to systole. Exercise may amplify the abnormality through increased myocardial…

…as an imaging biomarker of coronary atherosclerotic burden rather than as a direct measure of luminal obstruction. Calcified plaque is generally less likely to rupture…

…CAC imaging is a rapid, non contrast, low radiation CT examination that quantifies coronary calcification, whereas CCTA uses iodinated contrast to assess the coronary lumen…

…risk stratification information Assessment of response to selected medical, revascularization, rehabilitation, ablative or surgical interventions The test does not define the structure or composition of…

…not be regarded as a series of completely discrete diseases. Heart failure extends across the full range of LVEF, and echocardiographic measurement is subject to…

…haemorrhage occurs within the media without imaging evidence of an intimal tear or flap. AAS is classified anatomically according to involvement of the ascending aorta…

…the clinical significance of imaging findings. Historically, revascularization was considered capable of improving LV systolic function and prognosis by restoring perfusion to viable dysfunctional myocardium…

…include: Greater thrombus mobility. Protrusion into the LV cavity. Visualization on multiple imaging planes. Location adjacent to hyperkinetic myocardium. Large thrombus burden. Cardiac magnetic resonance…

…elevation indicates chronic myocardial injury . Myocardial injury is not synonymous with myocardial infarction. Cardiac troponin identifies injury to myocardial cells, but infarction requires additional clinical…

…do not exhibit classic ST segment elevation on ECG, leading to substantial delays in reperfusion therapy. Advanced ECG interpretation, combined with clinical assessment and imaging…

…Tissue Doppler is used to measuring mitral annular plane velocity. The American Society for Echocardiography (ASE) and the European Association of Cardiovascular Imaging (EACVI) stress…

…predisposes to ventricular tachycardia. The ECG is a useful tool for detecting hypertrophy/dilatation but echocardiography and magnetic resonance imaging (cardiac MRI) are superior to…

…Moreover, magnetic resonance imaging has suggested that pathological Q waves may also arise due to extensive subendocardial infarction (NSTEMI). If pathological Q waves occur as…

…provides a fundamental parameter that cannot be obtained by other imaging methods, namely exercise capacity (and VO2 max , see below). In addition to exercise capacity…

…the pericardial sac contains 25 to 50 ml of liquid. This volume is so small that the pericardial space is usually not visible on ultrasound …

…The Bernoulli principle. According to the Bernoulli principle, the sum of kinetic energy (K) and pressure energy (P) is constant as blood flows through the…

…the principle of ultrasound imaging is simple: sound waves are sent into the tissue and the reflected waves are used to create an image of…

…cardiac magnetic resonance (CMR) imaging, and landmark clinical trials, the field has transitioned from a predominantly pharmacological strategy to one that heavily integrates early catheter…

…must not delay treatment unnecessarily. 10. In unknown time of onset, wake up stroke or a late time window: perform advanced imaging according to the…

…half of patients with a central cause. A normal routine neurological examination is therefore not sufficient to exclude stroke [3]. Step 1: classify by time…

…gain valuable insights into shunt severity and directionality. While the technique requires meticulous attention to imaging standards, its non invasive nature and reproducibility make it…

…The HCM Risk SCD score aims to identify individuals with a high risk of SCD and determine whether an implantable cardioverter defibrillator (ICD) is warranted…

…in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. In European heart journal cardiovascular Imaging 16 (3)…

…cumulative incidence. The source material does not provide a detailed standardized physical examination protocol beyond assessment for a pulsatile abdominal mass and associated manifestations. Screening…

…imaging and revascularisation. Severe sensory loss, profound anaesthesia and paralysis suggest that the limb may already be unsalvageable. Clinical categories ALI is classified according to…

…not recommended because the prevalence of severe asymptomatic stenosis is low, screening has not been shown to reduce stroke risk, and detection may lead to…

…an acute coronary process. Myocardial injury leads to release of cardiac troponin, but troponin elevation is not specific for myocardial infarction. Other conditions may produce…

…is transmitted to the renal veins and can reduce GFR. Conversely, a rise in creatinine during effective decongestion and overall clinical improvement does not necessarily…

…Historically referred to as coronary thrombosis, the term myocardial infarction ultimately prevailed. The need for a standardized global definition led to early efforts by the…

…CFR) is the ratio of maximum hyperaemic coronary flow to resting coronary flow. It can be assessed invasively or with myocardial perfusion imaging using PET…

…to both ISR and stent thrombosis. Optical coherence tomography (OCT) is currently the most suitable imaging modality for detecting neoatherosclerosis, although its resolution does not…