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

…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…

…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…

…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…

…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…

…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…

…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…

…Pathophysiology of pulmonary embolism (PE). Hemodynamic effects Pulmonary embolism leads to increased resistance in the main pulmonary artery, and thereby increased afterload on the right…

…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…

…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…

…The severity of ischaemia and whether infarction has occurred The extent and degree of myocardial involvement The anatomical territory, including anterior, inferoposterolateral or right ventricular…

…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…

…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…

…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…

…with oxygen demands. Depending on several factors– including the severity of the stenosis/occlusion, microvascular function, myocardial oxygen extraction, presence of collateral circulation, etc –ischemia…

…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…

…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…

…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…

…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…

…on the other hand, is caused by a complete coronary artery occlusion, which results in the complete stop of blood flow and thus more extensive…

…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…

…out of 100 cases had full recovery. More recent studies has reported mortality rates reaching 4%. ECG in takotsubo cardiomyopathy (broken heart syndrome) 80% of…

…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…

…aphasia, hemianopia or hand paresis in a person of working age Blood pressure Measure initially in both arms if this does not delay reperfusion treatment…

…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…

…ventricular rate (beta blockers being the mainstay of this therapy). Rate control does not affect the rhythm per se . Rhythm control, on the other hand…

…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…

…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…