Cardiology Myocardial ischemia and infarction Definition and pathophysiology Ischemic cardiomyopathy is severe myocardial dysfunction caused by coronary artery disease (CAD). The clinical syndrome may resemble…

…Ischemic cardiomyopathy should be suspected if there is significant stenosis ( 75% luminal obstruction) of the left main coronary artery (LAD) or 2 epicardial coronary arteries…

…prolapse DCM (dilated cardiomyopathy) Ischemic heart disease (coronary heart disease) Rheumatic valve disease Endocarditis Congenital mitral regurgitation Amyloidosis SLE Hypertrophic obstructive cardiomyopathy (HOCM) Rupture of…

…tachycardia . The vast majority of patients with ventricular tachycardia either have coronary artery disease (ischemic heart disease), heart failure, cardiomyopathy or valvular heart disease. In…

…persist for extended durations. As for any long standing tachycardia, there is a risk of developing tachycardia induced cardiomyopathy. In pediatric populations, a distinct form…

…most common indications are as follows: Assessment of cardiovascular risk in screening. Detection of coronary artery disease (ischemic heart disease). Evaluation of coronary artery disease…

…deaths annually worldwide. The most common cause of sudden cardiac death is acute or chronic coronary artery disease (ischemic heart disease). Cardiomyopathies (dilated or hypertr

…of HFrEF is broadly dichotomized into ischemic and non ischemic causes, a distinction that fundamentally alters diagnostic work up and device therapy eligibility. Ischemic cardiomyopathy…

…entry [6] . Non ischemic dilated cardiomyopathy (NICM), hypertrophic cardiomyopathy (HCM), and arrhythmogenic right ventricular cardiomyopathy (ARVC) also fall under this umbrella, each presenting unique fibrotic…

…in hypertrophic cardiomyopathy. Reduced ejection fraction Numerous conditions can lead to reduced ejection fraction. Cardiomyopathy, valvular heart disease, diabetes, hypertension, renal failure, ischemic heart disease…

…Acquired advanced or complete heart block Hypertrophic obstructive cardiomyopathy with severe resting gradient Recent stroke or transient ischemic attack Mental impairment with limited ability to…

…MI). MI denotes cardiomyocyte necrosis occurring in the clinical setting of acute myocardial ischaemia and is diagnosed according to the fourth universal definition of MI…

…the presence of a flow limiting coronary stenosis, supply cannot increase adequately. Ischaemia begins in the subendocardium, which contributes substantially to systolic wall thickening; consequently…

…ischaemia. Non ischaemic myocardial injury may accompany numerous cardiac and systemic disorders, including: Cardiac causes Systemic causes Heart failure Sepsis Myocarditis Chronic kidney disease Cardiomyopathy…

Clinical chemistry & laboratory medicine Myocardial ischemia and infarction Definition and Pathophysiology Myocardial injury Myocardial injury is a biochemical diagnosis defined by at least one cardiac…

…clinical risk factors rather than by the AF pattern. Important predictors include previous stroke or transient ischaemic attack (TIA), mitral stenosis, hypertrophic cardiomyopathy, diabetes mellitus…

…Ischemic heart disease Both acute and chronic ischemic heart disease (including complications) can cause embolisms. Left ventricular aneurysm with thrombus Cardiomyopathies Valve prosthesis Devices (pacemaker…

…diastolic dysfunction Valvular heart disease Pulmonary hypertension Ischaemic heart disease Atrial arrhythmias Pericardial disease, including constriction Right ventricular dysfunction caused by pulmonary embolism Infiltrative cardiomyopathies…

…foscarnet, atazanavir) Hypokalemia Hypocalcemia Hypomagnesemia Cerebrovascular insult (bleeding) Myocardial ischemia Cardiomyopathy Bradycardia Hypothyroidism Hypothermia A separate chapter discusses Long QT syndrome (LQTS). A complete list…

…stressors, with treatment directed at the precipitating condition. Myocardial and non ischaemic mimics Takotsubo syndrome, myocarditis, and cardiomyopathies may present with symptoms, ECG changes, and…

…be seen in heart failure, cardiomyopathies, and severe valvular heart disease. Type 2 MI and non ischaemic myocardial injury may coexist, and certain disease entities…

…ECG) become apparent. In contrast, modalities like echocardiography and ECG typically identify ischemia at later stages, when functional or electrical alterations are evident. Subjective symptoms…

…Although myocardial ischemia may affect every aspect of the ECG – from heart rhythm to QTc interval – the most prominent and reliable ECG changes occur in…

…the atherosclerotic artery. Whenever oxygen demand exceeds oxygen (blood) delivery ischemia occurs and this manifests with chest discomfort referred to as angina pectoris. If the…

…article will deal with the physiology of exercise and emphasis will be placed on myocardial oxygen consumption and the development of myocardial ischemia during exercise…

…Secondary prophylaxis to prevent recurrence of cerebrovascular diseases, such as: Transient ischemic attacks (TIA). Stroke Contraindications Cross reactivity: Do not administer to patients with a…

All patients with NSTE ACS (NSTEMI or unstable angina) are treated similarly with respect to anti ischemic and anti thrombotic drugs. Management must, however, be…

…ECG blog Coronary artery disease: On LDL cholesterol, dietary fat & statins You are probably aware that ischemic heart disease, also known as coronary artery disease…

…therapies in cardiovascular medicine, widely utilized for the management of hypertension, chronic ischemic heart disease, heart failure with reduced ejection fraction (HFrEF), and post myocardial…

…coronary syndromes, particularly ST elevation myocardial infarction (STEMI), ischemic injury can disrupt the conduction system at any level, producing atrioventricular (AV) or intraventricular blocks. Isolated…

Myocardial ischemia and infarction Pharmacology & dosing Definition and pathophysiological rationale Dual antiplatelet therapy (DAPT) denotes treatment with aspirin plus a P2Y12 receptor inhibitor. In the…

…chest discomfort requires a systematic differential diagnosis, as the syndrome associated with ischemic heart disease is broader than chest pain itself, encompassing symptoms like tightness…

…driver of global cardiovascular morbidity and mortality, primarily due to its association with ischemic stroke and systemic embolism. The contemporary understanding of AF has evolved…

…atrial fibrillation is more common. Atrial flutter occurs almost exclusively among persons with significant heart disease, predominantly ischemic heart disease. However, most cardiac conditions may…

…majority of cases, it is only possible to determine the ischemic/infarct area (and thus the culprit) if the ECG displays ST segment elevations. However…

Conduction defects ECG Myocardial ischemia and infarction Left bundle branch block (LBBB) in acute myocardial infarction (AMI): clinical implications & Sgarbossa criteria Contrary to right bundle…

…warranted. The normal T wave will be described first. Then, ischemic T wave changes – i.e hyperacute T waves, inverted T waves, flat T waves…

…75 years (2 points) D iabetes Mellitus (1 point) S₂ troke, Transient Ischemic Attack (TIA), or Thromboembolism history (2 points) V ascular Disease (1 point)…

…hour. Adverse effects Tachycardia. Flushing. Headache. Angina pectoris. Caution Heart failure. Angina pectoris (ischemic heart disease). Hydralazine doses and administration in hypertension (hypertensive crisis/emergency).

…such as gastrointestinal bleeding or intracranial hemorrhage. History of stroke or transient ischemic attack (TIA). Severely impaired liver function classified as Child Pugh Class C…

ECG Myocardial ischemia and infarction Lathundar ECG Criteria for ST Elevation Myocardial Infarction (STEMI) The diagnosis of STEMI relies on specific electrocardiographic thresholds for ST…

Myocardial ischemia and infarction ECG Definition and Pathophysiology Acute coronary syndromes (ACS) encompass a spectrum of clinical conditions characterized by a recent change in symptoms…

…in the myocardium. The electrical potential difference exists between ischemic and normal myocardium and it results in displacement of the ST segment. The ST segment…

ECG Myocardial ischemia and infarction Approach to patients with chest pain: differential diagnoses, evaluation and management Chest pain is one of the most common symptoms…

ECG Myocardial ischemia and infarction Use of ECG in acute coronary syndromes & chest pain patients An ECG must be performed on all patients seeking medical…

…hallmark of stable coronary artery disease is exercise related angina pectoris (chest pain); symptoms of ischemia appear during circumstances with increased myocardial demand, typically exercise…

ECG Myocardial ischemia and infarction Acute Myocardial Infarction: Definition & Criteria Acute myocardial infarction is the most severe complication of coronary artery disease. The most common…

ECG Myocardial ischemia and infarction Factors that modify infarct size and the natural course in acute myocardial infarction (AMI) The traditional distinction between NSTE ACS…

…requires continuous blood flow to maintain cellular function. Myocardial ischemia occurs when there is insufficient oxygen available. Insufficient oxygen supply results in diminished ATP production…

ECG Myocardial ischemia and infarction Pathological R wave progression Normal R wave progression implies that the R wave amplitude increases gradually from V1 to V5…

…angina at rest are not suitable candidates for perfusion imaging. Detecting ischemic regions requires provocation using pharmacologic agents or physical exercise. Pharmacologic agents include dipyridamole…

…defined as regional abnormalities in contractile function. Ischemic heart disease is the most common cause of wall motion abnormalities. Assessment of wall motion abnormalities is…

…Cause of cardiac arrest : Shockable rhythms (ventricular fibrillation, pulseless ventricular tachycardia) are mostly due to acute myocardial ischemia or myocardial infarction, and in these cases…

…Otherwise, ischemia is unlikely to be the cause of the ST segment depression. The horizontal ST segment depression is more specific than the downsloping depression…

…Current guideline criteria for ischemic ST segment elevation: New ST segment elevations in at least two anatomically contiguous leads: • Men age ≥40 years: ≥2 mm…

…hallmark of stable coronary artery disease is exercise related angina pectoris (chest pain); symptoms of ischemia appear during circumstances with increased myocardial demand, typically exercise…

ECG Myocardial ischemia and infarction The ECG in the assessment of myocardial reperfusion The ECG is an invaluable tool to assess whether an occlusion has…

…CHADS VASc Score Risk of ischemic stroke Risk för stroke/TIA/systemisk tromboembolism 0 0.2% 0.3% 1 0.6% 0.9% 2 2…

…patients without ST segment elevations, urgent angiography is considered after resuscitation if there is a high probability of ongoing myocardial ischemia. IIa C Pre hospital…

…patients treated with ticagrelor. Patients with a history of ischemic stroke can be treated with ticagrelor for up to 12 months. Use with caution in…