…Quantification of blood flow using PET Quantitative PET perfusion imaging offers precise measurements of myocardial blood flow in milliliters per minute per gram of tissue…

…perfusion imaging can determine whether dysfunctional myocardium or myocardium supplied by a diseased vessel, is viable and could benefit from revascularization. Evaluating the success of…

…muscles are considered part of the left ventricular cavity. Other dimensions– including atrial dimensions, mitral annulus, aortic annulus, etc –are measured using the blood tissue…

…recognition of edge dissection, tissue prolapse, thrombus, or other acute complications; investigation of restenosis and stent thrombosis. Intravascular imaging may also clarify the mechanism of…

…ischemia. Inverted U waves are even more typical of ischemia (but the sensitivity is low). U wave changes always accompany other ischemic ST T changes…

Echocardiography Tissue Doppler (Tissue Velocity Imaging) Previous chapters on Doppler imaging have all focused on measurements of blood flow. However, the Doppler effect can also…

…followed by disruption of the intima. Intramural haematoma differs from classic dissection because haemorrhage occurs within the media without imaging evidence of an intimal tear…

…Definition and pathophysiology Myocardial infarction (MI) is a clinical diagnosis that integrates myocardial injury, evidence of acute myocardial ischaemia, electrocardiographic findings, cardiac biomarkers, imaging, angiography…

…when combined with metabolic imaging. Contribute to assessment of cardiac inflammation, infective endocarditis, and cardiac amyloidosis using appropriate radiopharmaceuticals. Functional perfusion imaging primarily identifies haemodynamically…

…imaging has suggested that pathological Q waves may also arise due to extensive subendocardial infarction (NSTEMI). If pathological Q waves occur as a result of…

…imaging, where defects are more pronounced during stress. RR is characterized by normal or near normal perfusion observed during stress, followed by the appearance of…

…ultrasound imaging: The ultrasound image displays non existing structures. The ultrasound image does not display existing structures. The ultrasound image misrepresents the echogenicity of structures…

…Cardiac planes All imaging modalities define, orient and display the heart using the long axis of the left ventricle and selected planes oriented at 90°…

…On the other hand, sinus bradycardia developing during physical exercise is considered abnormal, because heart rate must increase during exercise. Mechanisms of cardiac arrhythmias The…

…fibroatheromas may have imaging characteristics associated with rupture, fewer than 5% of such lesions caused a clinical event during 3.4 years of follow up…

…The majority of examinations included in the standard protocol are performed using two dimensional (2D) imaging. Some measurements are still done using M mode echocardiography…

…SOVd} = 1.92 + 0.74 \times \text{BSA} ) Definition of aortic aneurysm Sinus of Valsalva 45 mm. Any other segment 40 mm in diameter…

…blood tests and other radiological examinations are most often required, in particular computed tomography (DT) and/or magnetic resonance imaging (MRI). Anatomy of the pericardium…

…peripheral artery disease (PAD), and other manifestations of systemic atherosclerosis. The principal clinical concern is cerebral embolism or haemodynamic compromise leading to transient ischaemic attack…

…atrial fibrillation, and other arrhythmias or conduction abnormalities. CKD also worsens the prognosis of established CVD. Mechanisms linking CKD to cardiovascular disease The association is…

…pain or a rapid deterioration in general condition may be the only signs of infection. Corticosteroids and other immunosuppressive treatments can blunt the febrile response…

…hypertrophy, LV dysfunction, or other pathology that could affect the safety or interpretation of the examination. Evaluation and Physical Examination Before stress echocardiography, clinical assessment…

…Patients without haemodynamic instability require more detailed prognostic evaluation using two complementary domains: Indicators of acute PE severity , including clinical findings, RV dysfunction on imaging…

…and imaging technique. Coronary fistulae represent abnormal communications between a coronary artery and a cardiac chamber or vessel. Other congenital anomalies include anomalous origin of…

…to Evaluation of coronary artery disease and angina pectoris). Yet, exercise stress testing provides a fundamental parameter that cannot be obtained by other imaging methods…

…Only clinical signs of herniation halt the puncture, and antibiotics and a corticosteroid are then given immediately after blood cultures. For questions other than acute…

…a long time and be detected randomly when investigating other conditions. More dramatic onset of symptoms can be seen in arrhythmogenic tumors of the myocardium…

…that ensures that no other sound waves affect the transducer. The crystals are supported by a backing layer that suppresses the vibrations of the crystals…

…5. With severe symptoms: give hypertonic saline immediately. Do not wait for a complete work up of the cause or for imaging. 6. Document the…

…and venous filling may be reduced. Other possible findings include muscle stiffening and loss of deep tendon reflexes. Pulses are absent distal to the obstruction…

…and other symptoms may occur without chest pain and should be considered anginal equivalents. The emergency evaluation of non traumatic chest discomfort is structured around…

…of onset, wake up stroke or a late time window: perform advanced imaging according to the local protocol. 11. Document weight, agent, dose, time of…

…but only if the examiner is trained. Brief attacks triggered by the position of the head relative to gravity: perform Dix Hallpike and, if needed…

…CFR) is the ratio of maximum hyperaemic coronary flow to resting coronary flow. It can be assessed invasively or with myocardial perfusion imaging using PET…

…Intracoronary imaging is encouraged to define the mechanism rather than relying on angiography alone. Factors associated with restenosis The risk of restenosis after metallic stent…

…measurements permit assessment of the physiological significance of selected stenoses using fractional flow reserve (FFR) and instantaneous wave free ratio (iFR). Other invasive techniques can…

…and non transmural infarction are no longer considered reliable descriptors of pathological extent. Magnetic resonance imaging findings indicate that Q wave development relates more closely…

…volume of blood pumped from the left ventricle into the aorta during systole. It is easily calculated by measuring VTI (Velocity Time Integral), using pulsed…

…from a previous value of at least 50%. A patient with persistently mildly reduced systolic function. This dynamic nature makes prior imaging particularly important when…

…dominant manifestation of CAD. As LV dysfunction and HF become more prominent, angina may diminish or disappear. Others have no recognized history of angina or…

…Lathundar Key messages Two things set the COPD exacerbation apart from many other causes of acute dyspnoea: oxygen must be titrated cautiously and the blood…

…and other relevant information for the drug Ticagrelor . Table 1 Summary Indications Ticagrelor, in combination with acetylsalicylic acid (ASA), is indicated for the prevention of…

…Familial and genetic screening in cardiovascular medicine is the systematic assessment of relatives and other individuals who may carry an inherited predisposition to cardiovascular disease…

…C) is the principal therapeutic target in lipid management because LDL and other apolipoprotein B containing lipoproteins play a causal role in atherosclerotic cardiovascular disease…

…and infarction Myocardial ischemia: cellular changes, ECG signs and development of infarction Like all other cells in the human body, cardiac myocytes use ATP (adenosine…

…begins in parallel with the diagnostic work up. Obtain an interpretable 12 lead ECG within 10 minutes of first medical contact, attach continuous rhythm monitoring…

…history, a positive Dix–Hallpike test and the absence of other neurological findings. The treatment is a repositioning manoeuvre. Indications Brief attacks of vertigo, seconds…

…NSAIDs). Other contraindications: Hemophilia. Thrombocytopenia. Active gastric or duodenal ulcers. Liver cirrhosis. Severe heart failure. Doses 100 mg/day during the third trimester of pregnancy…

…acute ACS, aspirin should be administered as soon as possible in the absence of contraindications, using a loading dose followed by maintenance treatment. The source…

…C and other apoB containing lipoproteins within the arterial wall. This initiates inflammatory reactions that promote plaque formation and progression. As the burden of retained…

…aggregation. Because aspirin affects only one pathway of platelet activation, its antiplatelet effect is relatively limited compared with agents that inhibit other platelet pathways. The…

…with homozygous FH typically die from acute myocardial infarction at 20 to 30 years of age. People with familial hypercholesterolemia have no other metabolic aberration…

…from selected populations, frequently with low or intermediate ischemic risk and under representation of patients with STEMI or other very high risk features. Noninferiority studies…

…or other vascular beds. Malignant hypertension represents an extreme form in which acute microvascular injury occurs, classically involving fibrinoid necrosis of small arteries in the…

…left ventricular dysfunction, peripheral vascular disease and other manifestations of diffuse atherosclerosis. Percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are revascularization procedures…

…Other mechanisms include thrombosis, embolism, vasculitis, fibromuscular dysplasia, arterial entrapment, cystic adventitial disease and trauma. Atherosclerotic PAD is a manifestation of systemic arterial disease rather…

…and cardiovascular rationale Smoking cessation is the complete discontinuation of tobacco smoking, with avoidance of second hand smoke and, where possible, other inhaled nicotine products…

…beats per minute. Note that with a paper speed of 25 mm/s, which is standard in the US and many other countries, a 2…

…cancel each other out. However, the ECG may show features characteristic of biventricular hypertrophy. Biventricular hypertrophy ECG In case the ECG or other examinations suggest…

…myocardial ischemia. Other symptoms include dyspnea, pain radiating to the left arm/shoulder/throat, palpitations, back pain and selected cases of upper abdominal pain. An…