…the plaque through the disrupted surface. Type 2 MI: Attributed to an imbalance between myocardial oxygen supply and demand, without the presence of acute atherothrombosis…

…pleural incision may expose cardiac antigens and initiate an inflammatory response. The presence of antibodies directed against cardiac tissue, the latent interval of several weeks…

…may present with acute chest pain or chest pain equivalent symptoms. The ECG assessment remains necessary even when symptoms have improved by the time of…

…A routine PPCI strategy should be considered for presentation 12–48 hours after symptom onset. Routine PCI of an occluded infarct related artery is not…

…yields an injury current (ST vector) directed towards the back, where there is no exploring electrode (in the 12 lead ECG) that can present the…

…Conversely, an angiographically identified CTO without demonstrable ischaemia or viable myocardium provides a less compelling basis for intervention. The source material does not provide a…

…and how PCI was performed. The need for non cardiac surgery. The presence of an indication for oral anticoagulation (OAC). Clinical context and treatment objectives…

…for a selective invasive approach? Is the clinical likelihood of true NSTE ACS low enough that non invasive evaluation is more appropriate? The presence of…

…SYNTAX Score further. For example, the CatLet Score has been proposed as an alternative, addressing some of the SYNTAX Score's shortcomings, such as its…

…For adults with elevated BP, a calculated 10 year risk of ≥10% is considered sufficiently high to support BP lowering treatment, whether through lifestyle intervention…

…an option when bleeding risk is very high. Prasugrel or ticagrelor may be considered after complex interventions. The present chapter focuses principally on ACS, for…

…tamponade has an exceptionally poor prognosis. In the vast majority of these cases, the tamponade develops acutely or subacutely. It is uncommon for chronic pericardial…

…or percutaneous coronary intervention. The preferred terminology is contrast associated AKI when temporal association is present; contrast induced AKI should be reserved for the smaller…

…lesions producing myocardial ischaemia, either during the same procedure or through staged intervention. The rationale for complete revascularization is that untreated, flow limiting disease may…

…AF may be pre existing, newly detected for the first time, or newly developed during management of an acute illness. The clinical relationship between AF…

…diabetes; systematic screening for diabetes is therefore recommended in patients with CVD. The clinical consequences of diabetes may present through any major cardiovascular phenotype: CAD…

…Briefly, exercise stress testing must not be performed in the presence of absolute contraindications. Relative contraindications call for an individualized assessment of the risks; if…

…an incidental and asymptomatic finding. The absence of symptoms indicates that the bradycardia is compensated by an increase in stroke volume. Symptomatic bradycardia may present…

…therapeutic decisions in the presence or absence of an acute coronary occlusion, rather than rigid ECG thresholds. Several machine learning models for ECG interpretation have…

…acute myocardial infarction in order to assess the presence of myocardial ischemia, evaluate angina pectoris, evaluate exercise performance, evaluate the effect of interventions and medications…

…in multivessel disease. A British Cardiovascular Intervention Society myocardial jeopardy score is an alternative method for estimating the extent and severity of CAD. It can…

…reducing arrhythmic events, contingent upon the specific mutation present. For patients at elevated risk—such as those with a history of cardiac arrest, recurrent syncope…

…coronary anatomy unsuitable for further intervention. In ANOCA/INOCA, coronary atherosclerosis, endothelial dysfunction, and distinct coronary functional abnormalities may produce ischaemia without an obstructive epicardial…

…observational databases report approximately 5–10%. Only about 10% of patients who develop shock present with it at hospital admission; approximately 90% deteriorate during hospitalization…

…reducing arrhythmic events, contingent upon the specific mutation present. For patients at elevated risk—such as those with a history of cardiac arrest, recurrent syncope…

…coronary intervention (PCI), ischaemic risk, bleeding risk, need for anticoagulation, and whether coronary stents are present. Clinical objectives of therapy The main objectives of antiplatelet…

…platelet rich because they form under high shear conditions. Disruption of an atherosclerotic plaque or injury associated with PCI exposes thrombogenic material, promoting platelet activation…

…level of consciousness with inadequate protective reflexes active major haematemesis severe agitation respiratory failure an anticipated difficult or prolonged endoscopic intervention a need for general…

…Under such circumstances, the efficacy of compressions and defibrillation diminishes considerably. Extracorporeal Life Support (ECLS) emerges as the sole therapeutic alternative for such situations. Presently…

…definitions and recommendations presented in this chapter are in line with recent guidelines (2020) issued by the American Heart Association (AHA), American College of Cardiology …

…mechanism of an acute coronary syndrome or guide percutaneous coronary intervention (PCI). ICA therefore has three principal roles: Defining the anatomical distribution and severity of…

…The only treatment with a class I recommendation for the management of acute bradycardia is transcutaneous pacing. Pharmacological interventions (Table 4) should be considered temporary…

…result of which the myocardium is rigid and imperative, which also leads to an increase in diastolic pressure in the ventricles and atria. At present…

…Elevated lactate is an indicator of tissue hypoperfusion and can guide resuscitative efforts. If the patient presents with hypotension or has a lactate level exceeding…

…success of revascularization : Myocardial perfusion imaging can assess effectiveness of procedures such as coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI). Contraindications for…

…can refine interpretation. Coronary plaque and future events Angiographic stenosis severity is an imperfect predictor of future myocardial infarction or sudden death. Lesions causing only…

…anatomy responsible for a stenosis, define plaque morphology, identify occult lesions, and optimize percutaneous coronary intervention (PCI). Imaging can therefore influence several stages of intervention:…

…3% of PCI procedures overall. It is particularly associated with intervention on degenerated saphenous vein grafts (SVGs), rotational atherectomy, and procedures performed for acute myocardial…

…three hours. The evidence for an absolute one hour requirement is clearest in septic shock and less certain in sepsis without shock [3,4]. The…

…without clinical CVD who nevertheless have established risk factors or an elevated estimated risk. It combines lifestyle intervention with treatment of risk factors when indicated…

…and proposes an integrated decision pathway for physiology guided revascularization. Overview: Comparison of Physiological Indices The table below summarizes the four index families discussed in…

…Number Needed to Treat (NNT) is the number of patients you need to treat to save one. If an intervention has an NNT of 10…

…and infarction Definition and Purpose Cardiac rehabilitation is a comprehensive, multidisciplinary secondary prevention intervention for patients with cardiovascular disease, including those recovering from myocardial infarction…

…includes adjustments for race, particularly for individuals of African descent, which may not accurately reflect the diversity within racial groups and can lead to misestimations…

…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…

…from a more individualized selection strategy. When to Initiate Pharmacological Treatment Lifestyle intervention is an essential component of care. In adults with elevated blood pressure…

…haemostatic capacity, but it cannot compensate for an uncontrolled source of bleeding. Minimise the time to surgery, endoscopy, an obstetric procedure or angiographic intervention. Summon…

…shorter DAPT regimens are used. BMS now account for less than 10% of contemporary PCI procedures according to the source material. First generation DES The…

…through a catheter advanced from a peripheral artery to the aortic root and coronary ostia. It remains the reference standard for defining the extent of…

…In one trial of patients with previous myocardial infarction, the Mediterranean intervention involved greater consumption of fruits, vegetables, legumes, bread and an alpha linolenic acid…

…the index MI and how much is related to the intervention. Diagnostic criteria General principles For events occurring within 48 hours of the index procedure…

…risk of bleeding). An advanced airway (tracheal tube, supraglottic airway) should be established as early as possible. Airway management should not interrupt compressions for more…

…treat (NNT) for interventions in cardiopulmonary resuscitation. AED = automatic external defibrillator. The Number Needed to Treat (NNT) is the number of patients you need…

…JE, Gwyther R, Kirkman E. Closed chest compressions reduce survival in an animal model of hemorrhage induced traumatic cardiac arrest. Resuscitation 2019;140: 37 42…

…of thrombosis and evidence demonstrating long term durability (Filsoufi et al). Percutaneous interventions lack long term safety and efficacy data. References ESC EACVI Guidelines for…

…infusions. A ventilator, an arterial line, a central venous catheter, ECG monitoring, blood gases. Drugs for sedation, analgesia and control of shivering. Procedure 1. Start…

…Incomplete lesion preparation Persistent stenosis within the treated segment Mechanical factors are particularly important because correction of the underlying problem is necessary for durable treatment…

…include: Older age. Female sex. Hypertension. Absence of an adequate collateral circulation. A first or anterior infarction. Single vessel disease without collateral support. Chronic kidney…

…25% of children with congenital heart disease require intervention during their first year of life ( Triedman et al ). According to the European Society for Cardiology…

…bundle branches. This type of first degree AV block often progresses to third degree (complete) AV block, and therefore necessitates an artificial pacemaker. Blocks located…