…circumflex coronary artery (LCX). Right dominant system is by far the most common anatomy, occurring in 90% of all individuals. Figure 2 is also important…

…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…

…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…

…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…

…cardiogenic shock, right ventricular free wall rupture and cardiac tamponade. The most common of these are hypotension, low cardiac output and sensitivity to drugs that…

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

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

…not be depolarized via the Purkinje network, but rather via spread of the depolarization from the right ventricle. The abnormal ventricular depolarization will cause an…

…is the most common cause of false activations of the catheterization laboratory. LBBB may mask (conceal) ongoing ischemia : LBBB causes severe disturbance of ventricular repolarization…

…Clinical features Occlusion of the left main coronary artery (LMCA) abruptly interrupts blood flow to both the left anterior descending (LAD) and left circumflex (LCx…

…waves ( Figure 2 shows right ventricular hypertrophy). The following rules will distinguish the two conditions in the vast majority of cases: Right ventricular hypertrophy shifts…

…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…

…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…

…specific ST T changes are very common. Non specific ST depressions, T wave inversions (negative T waves) do not affect the management of cardiac arrest…

…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…

…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…

…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…

…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…

…intimal injury promote atherosclerosis. The principal anatomical distributions are: Abdominal aorta and iliac arteries, involved in approximately 30% of symptomatic patients. Femoral and popliteal arteries…

…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…

…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…

…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…

…particularly inverted T waves. Below follows a discussion which aims to clarify some of the common misunderstandings. All T waves are illustrated in Figure 18…

…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…

…The benefit of antiplatelet therapy must always be balanced against bleeding. This balance changes according to the clinical setting, time from MI or percutaneous coronary…

…myocardial ischaemia caused by transient abnormal vasoconstriction of one or more coronary arteries. Epicardial spasm produces a reversible functional occlusion and usually causes transmural ischaemia…

…episodes of more severe myocardial ischemia. Collateral circulation may be very effective in reducing ischemia. Indeed, it may be so efficient that a total occlusion…

…is caused by a complete coronary artery occlusion, which results in the complete stop of blood flow and thus more extensive myocardial ischemia (referred to…

…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…

…can shorten the time to diagnosis and facilitate triage of patients with suspected ST segment elevation myocardial infarction to a percutaneous coronary intervention capable hospital…

…no coronary artery occlusion can be identified. Injection of contrast media into the ventricle will instead reveal that the apical portion of the left ventricle…

…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…

…toe pressure < 30 mmHg. Decompensated heart failure — compression of both legs acutely increases preload. Untreated deep vein thrombosis in the acute phase. Septic phlebitis…

…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…

…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…

…coronary artery occlusions. This is discussed in detail in the chapter NSTEMI (Non ST Elevation Myocardial Infarction). Orientation of myocardial fibers The orientation of myocardial…

…s predictive accuracy. The SYNTAX Score remains a cornerstone in the management of complex CAD, providing a structured approach to revascularization strategy. While it has…

…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…

…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…

…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…