…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…

…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…

…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…

…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…

…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…

…in the leads with the highest ST segment elevation. Figure 2. The electrocardiographic natural course in STEMI (ST elevation myocardial infarction). Inversion of T waves…

…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…

…observational databases report approximately 5–10%. Only about 10% of patients who develop shock present with it at hospital admission; approximately 90% deteriorate during hospitalization…

…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…

…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…

…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…

…deep veins of the legs or pelvis. Thrombi formed in the deep veins in the legs or pelvis can detach and flow via inferior vena…

…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…

…and degree of myocardial involvement The anatomical territory, including anterior, inferoposterolateral or right ventricular involvement Pre existing abnormalities such as prior infarction, left bundle branch…

…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…

…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…

…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…

…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…

…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…

…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…

…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…

…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…

…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…

…threatening ischaemia (CLTI). Clinical presentation and symptoms Asymptomatic and atypical disease Fewer than half of patients with PAD have typical symptoms. Many have impaired walking…

…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…

…unexplained drop in arterial pressure. Silent or unrecognized infarction occurs more often in patients without antecedent angina and in those with diabetes and hypertension. Of

…Their duration is short; they typically disappear within minutes after a total occlusion in a coronary artery occurs (then of course, the ST segment will…

…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…

…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…

…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…

…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…

…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…