…of diastolic pressures in the cardiac chambers, with chamber pressures approaching intrapericardial pressure. The jugular venous waveform typically has a prominent x descent and an…

Cardiology Myocardial ischemia and infarction Definition and pathophysiology Atherosclerosis is a chronic, inflammatory disease of the arterial wall in which lipid accumulation, vascular cell dysfunction…

…tuberculous infections. Post pericardiotomy syndrome. Acute transmural myocardial infarction. Rupture of the free ventricular wall. Neoplasms (particularly breast and lung cancer). Inflammatory conditions, such as…

…atherosclerotic burden rather than as a direct measure of luminal obstruction. Calcified plaque is generally less likely to rupture than non calcified, lipid rich plaque…

…Papillary muscle rupture, producing acute severe mitral regurgitation (MR). These complications result from transmural myocardial necrosis and subsequent tissue disruption. Infarct expansion and, in some…

…only 3–5 cm and almost straight, but the meatus can be hard to find in older women. Two things separate the safe catheterisation from…

…arrhythmias (bradyarrhythmia or tachyarrhythmia). Atrial or ventricular rupture : In severe cases, there can be a rupture of the atria or ventricles. Myocardial infarction : The contusion…

…a proximal dissection can result in hemorrhage within the pericardium. Ventricular rupture : A transmural infarction can cause a rupture in the left ventricular free wall…

…ventricular arrhythmias. A fall in systolic blood pressure, particularly when accompanied by evidence of ischaemia, may indicate exercise induced global left ventricular dysfunction. Exercise testing…

ECG Exercise stress test Indications, contraindications and subject preparations for exercise stress testing (exercise ECG) In this article, we will discuss indications, contraindications, and subject…

…Endocarditis Papillary muscle rupture (complication of acute myocardial infarction) Rupture of chordae tendineae. Acute regurgitation of blood into the left atrium results in sudden volume…

…tunnel syndrome The carpal tunnel An acceptable bridge to surgery De Quervain's tenosynovitis The first dorsal compartment A good effect Trigger finger The tendon…

…concept Myocardial infarction with non obstructive coronary arteries (MINOCA) describes a clinical presentation in which the patient has symptoms suggestive of acute coronary syndrome (ACS)…

…rupture typically involves a thin, collagen poor fibrous cap overlying a large lipid core with many macrophages, resulting in a red, fibrin rich thrombus. In…

…left ventricular hypertrophy. In patients with stable known or presumed CAD, an acute stressor—such as an acute gastrointestinal bleed causing a precipitous drop in…

…the cell membranes collapse whereby cellular proteins are released into the circulation. It is possible to detect elevated levels of myocardial proteins in blood within…

…is confined to the ascending aorta. Type III: originates in the descending aorta, usually just distal to the left subclavian artery. Type IIIa: remains confined…

…pain in the abdomen, chest, lower back or scrotum. Aneurysmal pain is clinically important because it may herald rupture and constitutes a medical emergency. Rupture…

…when angiography shows no significant obstructive disease or when the culprit lesion is uncertain. In these settings, OCT or IVUS may demonstrate plaque rupture, thrombus…

…dysfunction and death. In the setting of ST elevation myocardial infarction (STEMI), cardiogenic shock most commonly reflects severe left ventricular (LV) dysfunction, accounting for approximately…

…ECG. These situations are as follows: Transmural ischemia located in the posterolateral portion of the left ventricle . Transmural ischemia located in the right ventricle . Both…

…statin therapy. Unlike rupture, eroded plaques have an intact, thick fibrous cap but suffer from endothelial denudation. The local microenvironment is rich in hyaluronan, toll…

…dissection, aneurysm, or rupture. PAUs are usually located in the middle or distal descending thoracic aorta. The arch and ascending aorta are less commonly involved…

…inflammation results in increased levels of circulating pro inflammatory cytokines that may cause plaque rupture (i.e the risk of atherosclerotic plaque rupture is increased…

…disruption (rupture or erosion). The dynamic thrombotic component can vary in burden and may lead to distal coronary embolization, resulting in myocyte necrosis. Plaque rupture…

Echocardiography Myocardial ischemia and infarction Definition and pathophysiology Left ventricular (LV) thrombus is an intracavitary clot attached to the LV endocardium, typically overlying an akinetic…

…mm at end diastole after AMI should prompt investigation for possible subacute cardiac rupture, particularly when the effusion develops in the early post infarction period…

…hepatic capsule rupture, placental abruption, disseminated intravascular coagulation, and multiple organ failure. In the absence of treatment, approximately 1 in 100 cases of preeclampsia may…

…in patients at highest baseline risk, including older adults, although older patients also have more contraindications and a greater risk of bleeding and myocardial rupture…

…characteristics associated with rupture, fewer than 5% of such lesions caused a clinical event during 3.4 years of follow up in a prospective study…

…resulting in permanent wall motion abnormalities. Figure 1. Standardized myocardial segmentation and nomenclature for echocardiography. The left ventricle is divided into 17 segments for 2D…

…liver, lung or vessel lies in the path of the needle. Access Puncture site Direction Comment : : : : Subxiphoid 1–2 cm below and to the left

…particularly in individuals younger than 35 years during or after vigorous exercise. Anomalous origin of the left coronary artery is less frequent but is considered…

…upper reference limit (URL). It is considered acute when there is a rise and/or fall in cTn values. An elevated cTn alone does not…

…plaque rupture, and the ensuing atherothrombosis, causes a complete occlusion of the coronary artery. Ischemia will extend from the endocardium to the epicardium in the…

…plaque rupture, and the ensuing atherothrombosis, causes a complete occlusion of the coronary artery. Ischemia will extend from the endocardium to the epicardium in the…

…A positive FAST scan in an unstable trauma patient. An unstable pelvic fracture with circulatory compromise. A ruptured aortic aneurysm or another major vascular bleed…

…or examination under general anaesthesia. Placenta praevia or ruptured membranes in pregnancy — a speculum may be used, but not digital examination until the position of…

…The accumulation of these foam cells forms the earliest macroscopically visible lesion of atherosclerosis: the fatty streak [5] . Ruptured atherosclerotic lesion with atherotrombosis. Over decades…