…artery occlusion is located. The term culprit – which means "the guilty one" – is used to denote the occluded coronary artery. In the majority of cases…

…waves) do not affect the management of cardiac arrest. Recurrent VT or VF after ROSC in a patient with a coronary risk profile should lead…

…or lacunar infarct (occlusion of small penetrating arteries) : This is the most common type of ischaemic stroke, resulting from the occlusion of small penetrating arteries…

…of the stenosis/occlusion, microvascular function, myocardial oxygen extraction, presence of collateral circulation, etc –ischemia may also develop during resting conditions. Indeed, in patients with…

…Additional features associated with greater difficulty include a previously failed attempt, a blunt proximal stump, vessel bending, calcification and an occlusion length of at least…

…is particularly common in older people and in patients with diabetes. The haemodynamic consequences depend on lesion location, severity, length, the presence of multilevel disease…

…with tamponade, and less common causes such as severe pre existing valvular disease or excessive beta blocker or calcium channel blocker exposure. The incidence of…

…requires elevated levels of cardiac troponins. In addition to elevated troponins, the patient must display either symptoms or ECG changes consistent with myocardial infarction/ischemia…

…setting of ischemia. Normal T wave inversion An isolated (single) T wave inversion in lead V1 is common and normal. It is generally concordant with…

…are common risk factors (see Risk factors below). A significant proportion of cases with pulmonary embolism require thrombolysis to dissolve the occlusion. Administration of thrombolysis…

…have been reported, with clusters occurring in the morning within a few hours of awakening. Pain is the most common presenting complaint. The pain is…

…occur simultaneously (if both territories are affected by the same artery occlusion). Approximately 30% of patients with posterolateral infarction will also have right ventricular infarction…

…research has been devoted to it in recent years. Most cases (70%) of takotsubo cardiomyopathy occur in situations with extreme stress, such as car accidents…

…Coronary dissection with obstruction of the true lumen Occlusion of a major epicardial artery or bypass graft Side branch occlusion or thrombus Disruption of collateral…

…patients with acute coronary syndromes is permeated by the mantra time is myocardium, which refers to the progressive loss of myocytes following the occlusion of…

…involve partial occlusions, resulting in subendocardial ischemia and comparatively milder symptoms. For the same reason, patients with STEMI are at higher risk of life threatening…

…in people with diabetes and becomes more common with advancing age. Presentations without pain may include: Sudden breathlessness Syncope or sudden loss of consciousness Confusion…

…also supplies the inferior left ventricular wall in over 90% of all individuals. Hence, a proximal occlusion (in the RCA) which cuts off blood flow…

…Occurrence of upsloping ST segment depressions with prominent T waves in the majority of the chest leads may indicate an acute occlusion in the LAD…

…the most common abnormal tachyarrhythmia (only sinus tachycardia is more common). The prevalence of atrial fibrillation correlates strongly with age. Approximately 10% of individuals aged…

…coronary artery occlusions, and outcomes improved when they were treated as acute STEMI cases. Management of left bundle branch block (LBBB) in patients with acute…

…linking). Concurrent activation of the coagulation cascade leads to thrombin generation and fibrin deposition, culminating in a partially or fully occlusive intraluminal thrombus [5] . ACS…

…including acute occlusions, subtotal stenoses, and discusses associated clinical presentations, prognostic implications, and management strategies. In the GRACE ECG substudy of 5000 patients with non…

…myocardial necrosis. It most commonly reflects atherothrombosis: disruption of an atherosclerotic plaque followed by platelet activation and coagulation, with formation of an intraluminal thrombus. The…

…reperfusion therapy. This approach fails to identify a substantial proportion of patients with acute coronary occlusion (ACO) who present without diagnostic ST elevation, often resulting…

…is caused by partial occlusion of the artery (i.e. coronary blood flow is not completely obstructed). NSTE ACS typically presents with ST segment depressions…

…microcirculation. Indeed, studies show that 15–35% of patients with STE ACS/STEMI have inadequate microvascular flow despite patent epicardial blood flow. In such cases…

…19th century first linked thrombotic occlusion of a coronary artery with myocardial necrosis. Although early clinical descriptions emerged at the dawn of the 20th century…

…subepicardium over several hours. The extent and tempo of injury are influenced by collateral flow, myocardial oxygen consumption, and intermittent occlusion with reperfusion. Prompt reperfusion…

…and the ensuing atherothrombosis, causes a complete occlusion of the coronary artery. Ischemia will extend from the endocardium to the epicardium in the affected myocardial…

…and the ensuing atherothrombosis, causes a complete occlusion of the coronary artery. Ischemia will extend from the endocardium to the epicardium in the affected myocardial…

…with ACS. Clinical manifestations therefore commonly include recurrent myocardial ischaemia, recurrent infarction, or acute coronary occlusion. Stent thrombosis may occur within hours or days of…

…CABG), or percutaneous coronary intervention (PCI), including attempted recanalization of a chronic total coronary occlusion. Angina or ischaemia with non obstructive coronary arteries (ANOCA/INOCA)…

…by rhabdomyolysis, with potential renal failure and increased mortality. Clinical presentation and symptoms Symptoms commonly develop rapidly, often within an hour of arterial occlusion. The…

…unstable angina. Management begins in parallel with the diagnostic work up. Obtain an interpretable 12 lead ECG within 10 minutes of first medical contact, attach…

…cardiovascular death, and progression of atherosclerotic disease in patients with established coronary or other atherosclerotic vascular disease. Antiplatelet therapy is a central component because platelet…

…defined. Proposed contributors include hypercontractility or hypersensitivity of coronary vascular smooth muscle to vasoconstrictor stimuli, including adrenergic agonists, leukotrienes, and serotonin. In patients with CAD…

…a 60 minute occlusion of the left anterior descending coronary artery (LAD) would reduce the infarct size by 60%, as compared with directly occluding the…

…15%–20%, substantially exceeding those seen with native vessel PCI. Mechanisms The principal mechanism is distal embolization of atheromatous and thrombotic material. Plaque or thrombus…

…NSTEMI) since they present with ST segment depressions on the 12 lead ECG (recall that ST segment depression is the hallmark of NSTE ACS/NSTEMI…

…of patients with suspected ST segment elevation myocardial infarction to a percutaneous coronary intervention capable hospital. The initial ECG should be interpreted in conjunction with…

…The standard investigation in acute stroke to identify large vessel occlusion, dissection or other vascular pathology CT perfusion Used with an unclear time of onset…

…failure — compression of both legs acutely increases preload. Untreated deep vein thrombosis in the acute phase. Septic phlebitis, ongoing soft tissue infection with systemic involvement…

…total occlusion is an important predictor of incomplete anatomical revascularization with PCI. PCI of chronic total occlusion lesions may improve angina and quality of life…

…coronary occlusion or relatively prolonged moderate ischemia may produce post ischemic stunning. In the absence of infarction, contractile recovery can occur rapidly after reperfusion, with…

…connective tissue and a very high density of capillaries. The muscle fibers are organized into several sheets that wrap around the ventricle with varying orientation…

…quantitative scoring system designed to assess the complexity of coronary artery disease (CAD) and guide the choice between percutaneous coronary intervention (PCI) and coronary artery…

…or at least four drinks for women or five for men on one occasion. Pharmacokinetics and pathophysiology Approximately 95% of ingested ethanol undergoes hepatic metabolism…