…is supplied by the left circumflex coronary artery (LCX). Right dominant system is by far the most common anatomy, occurring in 90% of all individuals…

…Left ventricular aneurysm with thrombus Cardiomyopathies Valve prosthesis Devices (pacemaker, ICD CRT) Endocarditis Cardiac tumors Atherosclerosis of the aorta LOW EMBOLIC POTENTIAL SEP (Spontaneous Echocardiographic…

…a proximal occlusion (in the RCA) which cuts off blood flow to the right ventricle, will also affect the inferior wall of the left ventricle…

…of the Left Ventricle). Regional wall motion abnormalities are defined as regional abnormalities in contractile function. Ischemic heart disease is the most common cause of…

…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…

…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…

…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…

…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…

…coronary artery occlusion can be identified. Injection of contrast media into the ventricle will instead reveal that the apical portion of the left ventricle is…

…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…

…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…

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

…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…

…formation of thrombi in the left atrial appendage . Such thrombi may leave the appendage and enter the systemic circulation which causes thromboembolic occlusions of arteries…

…left coronary cusp (LCC), and noncoronary cusp (NCC), showing the same branches as in panel A for cross modality comparison. Clinical features Occlusion of the…

…hypertension with or without left ventricular hypertrophy. Among patients with NSTE ACS undergoing angiography, approximately 10% have no critical epicardial stenosis. In some of these…

…are robust indicators of successful reperfusion (patent artery). This is also associated with better prognosis, return of R wave amplitudes, and improved left ventricular function…

…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…

…and Pathophysiology Posterior myocardial infarction is myocardial necrosis involving the posterior region of the left ventricle, usually as part of an inferoposterior or posterolateral infarction…

…vasoconstriction of one or more coronary arteries. Epicardial spasm produces a reversible functional occlusion and usually causes transmural ischaemia. The resulting abnormalities in left ventricular…

…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…

…objective, particularly in patients with left ventricular dysfunction and/or MVD. Nevertheless, the optimal extent and timing of intervention depend on the clinical setting, haemodynamic…

…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…

…tunica adventitia , respectively. Figure 1. Layers of the left ventricular wall, pericardium and ventricular cavity. The endocardium The endocardium lines the atria, ventricles and the…

…left main coronary artery disease . It integrates multiple variables, including the number of lesions, their location, and specific characteristics such as bifurcations, chronic total occlusions…

…hypertension and atherosclerotic coronary disease In patients with heavy alcohol use, left ventricular dilation may precede the development of increased left ventricular hypertrophy and mass…

…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…

…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…

…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…

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

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

…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…

…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…

…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…

…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…

…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…

…segment. The phenomenon occurs in approximately 2%–3% of PCI procedures overall. It is particularly associated with intervention on degenerated saphenous vein grafts (SVGs), rotational…

…represents impaired antegrade myocardial perfusion in the absence of a flow limiting epicardial stenosis. It is associated particularly with intervention on degenerated saphenous vein grafts…

…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…

…rich and less occlusive, often presenting clinically as Non ST Elevation Myocardial Infarction (NSTEMI) rather than STEMI [4] . Calcified Nodules: A less common mechanism (2…