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…

…can detect perfusion abnormalities early in this sequence, before mechanical dysfunction ( i.e. left ventricular systolic or diastolic dysfunction) or electrical changes (ST T changes…

…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…

…time limit before cardioversion Duration Management : : Reliably < 24 hours, no mechanical valve, CHA₂DS₂ VA 0–1 Cardioversion (electrical or pharmacological) can be performed directly…

…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…

…PE) is classified according to haemodynamic status, clinical severity, evidence of right ventricular (RV) dysfunction, and myocardial injury. This classification is central to determining the…

…leads, and narrow r waves followed by broad, deep S waves in the right precordial leads [7]. Septal q waves are usually absent [7]. Stricter…

…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…

…Other causes include acute mechanical complications—particularly ventricular septal defect (VSD) and papillary muscle rupture with acute severe mitral regurgitation—predominant right ventricular (RV) infarction…

…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…

…treat (NNT) for the ACLS specific interventions is much higher or uncertain, meaning that the efficacy of these interventions is much lower or uncertain. Indeed…

…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…

…Valve replacement can be performed with biological or mechanical prostheses. The former is preferred due to the lower risk of thrombosis and evidence demonstrating long…

…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…

…close to the upper border of the rib, never at the lower border where the neurovascular bundle lies, and the drainage is stopped for coughing…

…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…

…B In patients with inferior myocardial infarction, consider connecting V3R and V4R to detect concomitant right ventricular infarction. IIa B Routine blood sampling for serum…

…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…

…acute severe mitral regurgitation, and other mechanical complications. Shock occurs more often when the coronary artery is completely occluded and is particularly associated with MVD…

…organ injury Consider mechanical circulatory support Refractory advanced disease Consider palliative care Right ventricular failure is characterized by increased right atrial and right ventricular pressures…

…frequent cause of PCI failure, despite its substantially lower incidence with drug eluting stents (DES) than with bare metal stents (BMS). Clinical ISR is generally…

…In patients with recurrent chest pain and hemodynamic compromise after MI, mechanical complications should be considered. Transthoracic echocardiography (TTE) can help assess for these complications…

…and calcium, as well as through the direct activation of voltage sensitive calcium channels. At lower doses, dobutamine stimulates beta2 and alpha receptors, inducing vasodilation…

…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…

…the anticoagulation indication. Previous stroke or TIA. The presence of mitral stenosis, a mechanical heart valve or hypertrophic cardiomyopathy. Heart failure, hypertension, diabetes and vascular…

…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 electrical impulse travels through the His bundle, which bifurcates into the left and right bundle branches. The left bundle branch further subdivides into two…

…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…

…cardiac arrest is 2.5%. As per data from the registry, only suicide attempts have lower survival outcomes. Nonetheless, prompt interventions can reverse cardiac arrest…

…that these parameters are highly interdependent and rather complex. Indeed, myocardial mechanics constitute a whole research field. Cardiac function is also dependent on circulatory, pulmonary…

…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…

…1] [2] . The evolution of HF terminology has been driven by a deeper understanding of myocardial mechanics and clinical outcomes. The 2022 American Heart Association…

…Stroke Volume, Wall Stress & Frank Starling's law Myocardial Mechanics It is fundamental to distinguish hypertrophic cardiomyopathy from hypertrophy caused by increased loading conditions. The…

…three distinct ventricular contractions, namely longitudinal, radial and circumferential contraction (refer to Myocardial Mechanics and Figure 1). Diastole starts immediately after systole. The entire ventricular…

…start cardiac monitoring at a plasma potassium above 6.0 mmol/L, and at lower values if the rise is rapid, the patient has symptoms…

…Contractile dysfunction further aggravates the regurgitation (the regurgitation volume increases). Mechanically, wall stress (the load on individual muscle fibers) increases while the contractile function worsens…

…actual contraction but are also capable of transmitting the action potential, albeit at a much lower speed than the conduction cells. The terms contractile myocardium …

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

…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…