Echocardiography Myocardial ischemia and infarction Definition and pathophysiology Post infarction mechanical complications are structural disruptions of acutely infarcted myocardium occurring most often during the first…

…fluids in the human body. Sound waves arise when a sound source generates mechanical vibrations in the particles of the medium. These vibrations continue to…

…foundation for understanding subsequent chapters. SCA (Sudden Cardiac Arrest) : Sudden and unexpected cardiac arrest with loss of mechanical cardiac function. Results in loss of consciousness…

…this sequence, before mechanical dysfunction ( i.e. left ventricular systolic or diastolic dysfunction) or electrical changes (ST T changes on ECG) become apparent. In contrast…

…target INR 2.0 3.0 A mechanical valve may require a higher target Doses in venous thromboembolism Treatment doses in deep vein thrombosis and…

…cardiac arrest. Repeated blood gases, for example during mechanical ventilation or severe metabolic derangement. Major surgery with expected blood loss or large volume shifts. Patients…

…contraindicated, for example in asthma Contraindicated in impaired left ventricular function and together with an intravenous beta blocker Digoxin In heart failure or hypotension, or…

…EMG about 95 %). Contraindications Known hypersensitivity to edrophonium. Mechanical obstruction of the bowel or the urinary tract. Marked bradycardia, sick sinus syndrome or high grade…

…whoever starts the drug is responsible for the first week. Indications A mechanical valve prosthesis — warfarin is mandatory, and direct oral anticoagulants (DOACs) are contraindicated…

…dysfunction. Catastrophic or “supermassive” PE refers to refractory cardiogenic shock or the need for ongoing cardiopulmonary resuscitation. Mechanical circulatory support, including extracorporeal membrane oxygenation (ECMO)…

…mid QRS in at least two left facing leads [7]. These stricter parameters correlate more closely with abnormal LV mechanical function and the potential benefit…

…or atheroembolic material, but pharmacological and mechanical strategies directed specifically at reperfusion injury have not generally demonstrated sufficient clinical benefit for routine use. No reflow…

…heart failure, malignant arrhythmias, or mechanical complications. Risk assessment is intended to identify patients most likely to benefit from early coronary angiography and revascularization, while…

…more patients survive with severe, diffuse CAD that is no longer amenable to additional mechanical revascularization. Despite treatment with antianginal drugs and PCI or CABG…

…shock most commonly reflects severe left ventricular (LV) dysfunction, accounting for approximately 80% of cases. Other causes include acute mechanical complications—particularly ventricular septal defect…

…two broad categories: Electrical complications , particularly ventricular arrhythmias. Mechanical or pump failure complications , including heart failure and cardiogenic shock. Most out of hospital deaths occur…

…benefit Panchal et al Tracheal intubation vs bag mask ventilation ACLS Unclear benefit Jabre et al Mechanical compressions ACLS No benefit Rubertsson et al Amiodarone…

…dysfunction, and hypercoagulability [1] [2] . Mechanical stasis in AF is most pronounced in the left atrial appendage (LAA). The LAA is a highly trabeculated, windsock…

…g skeleton, calcifications, mechanical heart valves) and reflect virtually all sound waves, leaving too few waves to explore the area behind the reflector. This results…

…determinants of survival in cardiac arrest. All subsequent actions require trained professionals (e.g endotracheal intubation, mechanical chest compressions, targeted temperature management, etc.) and are…

…ultrasound waves, they begin to vibrate and these mechanical vibrations are converted into electric current that is sent back to the ultrasound machine, where the…

…disease (e.g mitral stenosis) requires intervention. Valve replacement can be performed with biological or mechanical prostheses. The former is preferred due to the lower…

…Anticoagulation before cardioversion After cardioversion the atrium does not regain its mechanical function until days to weeks have passed — atrial stunning — which means that the…

…Started within 48 h where possible Thromboprophylaxis Low molecular weight heparin unless contraindicated Head of the bed 30–45° Stress ulcer prophylaxis During mechanical ventilation…

…radiograph alone belongs to an earlier era. The needle is inserted close to the upper border of the rib, never at the lower border where…

…known thrombosis in the target vein. With a mechanical tricuspid prosthesis the lead must not be passed through the valve. The order of management in…

…If oral anticoagulation is indicated, NOACs should be chosen except in patients with moderate to severe mitral stenosis or mechanical heart valves; for these patients…

…instability or cardiogenic shock recurrent or ongoing chest pain refractory to medical treatment life threatening arrhythmias or cardiac arrest mechanical complications of acute myocardial infarction…

…while inflammatory cell proteinases degrade matrix constituents. The balance between synthesis and degradation influences plaque architecture and mechanical stability. Atherosclerotic lesions commonly arise at sites…

…adverse cardiovascular events. Complete revascularization is therefore considered an important therapeutic objective, particularly in patients with left ventricular dysfunction and/or MVD. Nevertheless, the optimal…

…are elevated. Consequently, congestion may occur across the full range of left ventricular ejection fraction and may result from systolic dysfunction, diastolic dysfunction, or both…

…Residual edge dissection Incomplete lesion preparation Persistent stenosis within the treated segment Mechanical factors are particularly important because correction of the underlying problem is necessary…

Echocardiography Myocardial ischemia and infarction Definition and pathophysiology Left ventricular (LV) thrombus is an intracavitary clot attached to the LV endocardium, typically overlying an akinetic…

…rate parameters. Clinical Presentation and Symptoms Acute heart failure necessitating inotropic or vasopressor support typically manifests in patients with left ventricular systolic dysfunction, low cardiac…

…small vessels, multivessel disease, bifurcation lesions, treatment of acute myocardial infarction Procedural and mechanical Stent underexpansion, incomplete wall apposition, residual inflow or outflow disease, edge…

…associated with roughly one in five strokes. Thrombus formation is most commonly related to the left atrial appendage, although competing mechanisms such as large artery…

…the rhythm [4]. Mechanical Support : Extracorporeal membrane oxygenation (ECMO) or intra aortic balloon pump (IABP) may be required for hemodynamic support [4]. Advanced Therapies : Consideration…

…cardiac arrest presenting with ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT) can be defibrillated to restore an organized rhythm and thus mechanical cardiac function…

…processes that lead to cell contraction. The spread of an electrical impulse is therefore directly coupled to a mechanical event; this is referred to as…

…The primary composite outcome included in hospital mortality, resuscitated cardiac arrest, cardiac transplantation or mechanical circulatory support, nonfatal myocardial infarction, transient ischemic attack or stroke…

…the ventricles. First degree AV block is rarely serious and may be left untreated in the vast majority of cases (exceptions are discussed later). Second…

…the acute phase of STEMI. Death due to ventricular dysfunction, or mechanical complications, is much less common in the acute phase. The chain of care…

…blow to the chest, typically over the precordium. The mechanical impact can induce ventricular fibrillation, even if the force seems relatively minor. It is believed…

Echocardiography Structure and contractile function of myocardial fibers The left ventricular wall can be subdivided into several layers. These layers are similar to those seen…

…myocardial mechanics. This section covers all clinically relevant aspects of myocardial mechanics, with emphasis on echocardiographic aspects. The bulk of the discussion concerns left ventricular…

…genes encoding desmosomal proteins . The desmosome is a component of the intercalated disc that connects myocardial cells mechanically and electrically. Most mutations are inherited in…

…clinical syndrome characterized by the cardinal symptoms and signs of heart failure (HF) in the presence of a left ventricular ejection fraction (LVEF) of ≥50%…

…left ventricular hypertrophy under normal loading conditions. Recommended reading Ventricular Pressure Volume Relationship: Preload, Afterload, Stroke Volume, Wall Stress & Frank Starling's law Myocardial Mechanics…

…an intuitive basis. Consider the fact that the left ventricle contracts and ejects blood into the aorta roughly 100,000 times daily, each time overcoming…

…dangerous than a corresponding stable chronic value [4]. The grading must not be used mechanically. A patient with a plasma potassium of 6.2 mmol…

…volume overload. Unfortunately, adaptation implies that the left ventricle dilates, which induces irreversible cellular and extracellular processes that ultimately lead to heart failure. This initially…

…a branch like morphology. As illustrated in Figure 2 all cardiac cells are connected, both electrically and mechanically, along their long axis. This cell architecture…

…thickness. Strain imaging is also used routinely to visualize regional myocardial function and mechanics. Loading conditions and heart rate may affect left ventricular function. Transesophageal…

…as ejection fraction may provide easily obtained parameters, but fail to provide important insights into left ventricular mechanics. Regional differences in contractile function are of…