…when multiple modifiable and non modifiable risk factors converge. The electrophysiological mechanism underlying TdP involves prolonged ventricular repolarisation, which allows for the recovery of time…

…Atherosclerotic lesions commonly arise at sites of disturbed flow, including branch points in the epicardial coronary arteries. Early lesions may undergo positive or compensatory remodelling…

…multiple angiographic projections. Although traditionally regarded as an anatomical examination, contemporary ICA can provide complementary functional and structural information. Coronary pressure measurements permit assessment of…

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

…infection. Suspected inflammatory disease: multiple sclerosis, Guillain–Barré syndrome, autoimmune encephalitis. Meningeal carcinomatosis and CNS involvement in haematological malignancy. Investigation of dementia with biomarkers (amyloid…

…decrease (e.g due to sinus pause or post VPC pause) results in augmentation of early afterdpolarization amplitude (typically seen with large T wave amplitude)…

…with multiple ventricular premature beats) spontaneously converting to Torsade de Pointes ventricular tachycardia. Notice how arterial blood pressure (ABP) drops at the onset of TdP…

…anatomical complexity of CAD, particularly in patients with multivessel disease or left main coronary artery disease . It integrates multiple variables, including the number of lesions…

…methods may also contribute. The cardioprotective effect is therefore likely to result from the cumulative influence of multiple modest dietary changes. Mediterranean type diets provide…

…therapeutic options cannot be pursued. Patients receiving digoxin may present with symptoms of digitalis toxicity, which manifests across multiple organ systems. Non cardiac symptoms include…

…In the earliest stages of ischemia, this may manifest as tall, positive hyperacute T waves [15]. Profound ST elevation across multiple leads generally indicates very…

…involve multiple vessels. Pregnancy associated SCAD can occur at any stage of pregnancy or after delivery, although more than 70% of cases occur early postpartum…

…and multiple vessel spasm during provocation testing is also reported more frequently in East Asian populations. VA can occur as part of a more generalized…

…considers both the plaque and the patient. Multiple potentially high risk plaques may exist throughout the coronary tree, while inflammation and thrombotic susceptibility are often…

…even in the absence of classic ST elevation. Multiple studies have demonstrated the superior sensitivity of OMI criteria—including subtle and nontraditional ECG patterns such…

…decrease (e.g due to sinus pause or post VPC pause) results in augmentation of early afterdpolarization amplitude (typically seen with large T wave amplitude)…

…resistance increases, making it more difficult to eject blood into the aorta. In the early stages of aortic stenosis, stroke volume becomes smaller. Reduced stroke…

…waves can be reflected multiple times between dense structures ( i.e structures with high echogenicity). For each reflection, a portion of the sound waves return…

…in multiple leads P pulmonale Figure 1. ECG changes seen in left ventricular hypertrophy (LVH) and right ventricular hypertrophy (RVH). The electrical vector of the…

…This has multiple effects which are discussed in detail below. This article will deal with the physiology of exercise and emphasis will be placed on…

…Combination therapy with multiple antihypertensives is often necessary to normalize blood pressure. Management of hypertension requires careful consideration of other cardiovascular risk factors and coexisting…

…Figure 2. Measuring the radius of PISA. Color Doppler is used to revealing PISA. As discussed earlier, aliasing occurs when using color Doppler to analyze…

…ventricle is divided into 17 segments for 2D echocardiography. One can identify these segments in multiple views. Note that the terms ischemic heart disease (IHD…

…stretching of myocardial fibers). The opposite is also true; the stiffer the myocardium, the slower and less pronounced the relaxation. Left ventricular compliance Multiple factors…

…the difference in R wave amplitude, note the slurred terminal portion of the R wave in the high risk morphology, which replaces the sharp negative…

…patients with multiple vascular comorbidities. An isolated PAU is one without associated IMH, dissection, or saccular aneurysm. Symptomatic isolated lesions may represent early periulcer haemorrhage…

…Thromboxane A2 promotes vasoconstriction and platelet aggregation. Because aspirin affects only one pathway of platelet activation, its antiplatelet effect is relatively limited compared with agents…

…difficult. In patients with normal renal function, the occurrence of contrast induced AKI is negligible or very low. Risk rises substantially with chronic kidney disease…

…atherosclerotic plaque, and the severity and distribution of coronary stenosis. Modern cardiac CT can acquire a three dimensional cardiac dataset within approximately 5–15 seconds…

…are elevated. The syndrome is therefore defined by symptoms and signs of congestion or impaired cardiac performance rather than by ejection fraction alone. Heart failure…

…of patients after ST segment elevation myocardial infarction (STEMI), with rates approaching 25% after anterior MI. Thrombi may form early, within 48–72 hours of…

…significant cause of maternal morbidity and mortality during the postpartum period. Maternal and obstetric complications Immediate maternal complications include placental abruption, stroke, multiple organ failure…

…despite multiple antianginal agents and prior revascularization procedures. In many patients, the burden is sufficiently severe to limit ordinary activities and substantially impair quality of…

…often exhibit multiple villi . These myxomas are more likely to embolize (Cardiac Thromboembolism). There are genetic syndromes that result in the emergence of multiple myxomas…

…for 2D echocardiography. One can identify these segments in multiple views. The basal part is divided into six segments of 60° each. The segments along…

…decreases and vice versa. The physiological purpose of this phenomenon is to allow for faster cardiac cycles during tachycardia (e.g during physical exertion). Therefore…

…adjusted using multiple controls that each represent a specific depth in the image (Figure 1). The bottom control adjusts gain at the bottom of the…

…They are contraindicated in patients with bronchospastic lung disease, or a history of significant reactive airway disease. Contraindications also include second degree or third degree…

Echocardiography The standard transthoracic echocardiographic examination This chapter presents a sequential series of images that comprise a complete standard echocardiographic examination. The image views are…

…majority of cases, which is explained by the following: The aortic valve is easy to visualize and image quality is typically high in multiple views…

…mobility and coaptation of the leaflets are assessed visually in multiple views. It should be noted that imaging of the right ventricle requires an experienced…

…concept offers an easy way of expressing the energy cost of any exercise. The energy cost is expressed as multiples of the resting metabolic rate…

…are blocked sporadically (without any Wenckebach phenomenon). The pauses between the visible beats are always multiples of the normal P P interval (Figure 3). Typically…

…multiplied by 100 to obtain percentage (%). Normal FS 25% (M Mode) 18% (Direct 2 D measurement) Tissue Doppler Tissue Dopplerrecords the speed and direction of…