…showing the same branches as in panel A for cross modality comparison. Clinical features Occlusion of the left main coronary artery (LMCA) abruptly interrupts blood…

…The left main coronary artery ( LMCA ) originates from the left anterior aspect of the aortic bulb. The LMCA is short and branches into the two…

…and form of the thrombus, it will occlude the main pulmonary artery or its branches. The larger the thrombus, the more proximal the occlusion and…

…that applying a 5 minute occlusion reflow cycle repeatedly to the circumflex artery before a 60 minute occlusion of the left anterior descending coronary artery…

…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…

…ischemia and infarction Definition and conceptual framework Acute coronary occlusion is the abrupt or progressive reduction of coronary blood flow sufficient to produce myocardial ischaemia…

…a cerebral artery is occluded due to local atherothrombosis or occlusion due to embolization. Approximately 30% of all ischemic strokes are caused by cardiac embolism…

…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…

…infarction The ECG in the assessment of myocardial reperfusion The ECG is an invaluable tool to assess whether an occlusion has been resolved and blood…

…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…

…lesions can cause acute severe regurgitation, a left to right shunt, tamponade, or sudden loss of effective cardiac output. Their recognition is essential because treatment…

…diagnostic angiography. Collateral vessels may maintain distal perfusion and permit visualization of the vessel beyond the occlusion when the patent donor artery is injected. The…

…The heart is rotated 30° to the left in the thorax. This positions the basal portion of the left lateral wall posteriorly in thorax (Figure…

…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…

…the conventional 12 lead ECG. These situations are as follows: Transmural ischemia located in the posterolateral portion of the left ventricle . Transmural ischemia located in…

…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…

…30 days if left untreated. Moreover, the pathophysiology of NSTEMI and unstable angina is very similar: both are due to partial (incomplete) coronary artery occlusions …

…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…

…encompasses several physiological states. Brief coronary occlusion or relatively prolonged moderate ischemia may produce post ischemic stunning. In the absence of infarction, contractile recovery can…

…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…

…substantial number of these patients had complete coronary artery occlusions, and outcomes improved when they were treated as acute STEMI cases. Management of left bundle…

…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…

…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…

…identification of acute coronary occlusion (Al Zaiti et al, 2023). The proposed transition from the traditional STEMI/NSTEMI/UA classification to the OMI/NOMI approach…

…without significant ST segment elevations on ECG. NSTE ACS is caused by partial occlusion of the artery (i.e. coronary blood flow is not completely…

…acute total occlusion of an epicardial coronary artery (i.e. STEMI), pathological Q waves can develop already within 2 hours after the onset of infarction…

…ESC), American College of Cardiology (ACC), American Heart Association (AHA), and World Heart Federation (WHF) collaborated to redefine MI using a biochemical and clinical approach…

…after coronary occlusion and progress over time. Experimentally, necrosis advances from the subendocardium towards the subepicardium over several hours. The extent and tempo of injury…

…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…

…PAD) is a clinical disorder caused by stenosis or occlusion of the aorta or arteries supplying the limbs. In adults over 40 years of age…

…ischemia and infarction Definition and pathophysiology Stent thrombosis is thrombotic occlusion arising within a coronary stent or at its margins after percutaneous coronary intervention (PCI)…

…despite escalation of antianginal medical therapy, coronary artery bypass grafting (CABG), or percutaneous coronary intervention (PCI), including attempted recanalization of a chronic total coronary occlusion…

…and infarction ECG Definition and Pathophysiology Acute coronary syndromes (ACS) encompass a spectrum of clinical conditions characterized by a recent change in symptoms or signs…

…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…

…Disruption of an atherosclerotic plaque may also release atherosclerotic debris downstream, causing microvascular embolization (i.e occluding smaller vessels downstream). The thrombosis causes occlusion of…

…Clinical presentation and symptoms Symptoms commonly develop rapidly, often within an hour of arterial occlusion. The classic clinical constellation is remembered as the “six Ps…

…opening of a persistently occluded infarct related artery in a stable and asymptomatic patient is by contrast not recommended [1,5]. STEMI criteria and occlusion…

…percutaneous coronary intervention (PCI), ischaemic risk, bleeding risk, need for anticoagulation, and whether coronary stents are present. Clinical objectives of therapy The main objectives 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…

…The clinical importance of the finding is related to the extent of myocardium at risk. Occlusion or impaired perfusion in a vessel supplying a large…

…Stent thrombosis Graft occlusion after CABG No reflow despite removal of an apparent epicardial stenosis The clinical consequences depend on the amount of viable myocardium…

…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…

…and in patients with diabetes or renal failure the index may be falsely normal because of medial sclerosis — in that case add toe pressure measurement…

…deposition, culminating in a partially or fully occlusive intraluminal thrombus [5] . ACS Classification The clinical spectrum of Acute Coronary Syndromes encompasses Unstable Angina (UA), Non…