…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…

…fluid (black) and swings back and forth in the fluid. One can also note that the right ventricular free wall is being compressed by the…

…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…

…SA, et al. Use of CPR in hemorrhagic shock, a dog model. J Trauma Acute Care Surg 2016; 81:27 33 . Watts S, Smith JE…

ECG Exercise stress test Definition and clinical role Exercise electrocardiographic testing is a standardized assessment in which a patient performs progressively increasing external work, usually…

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…

…income countries. Rheumatic heart disease typically results in thickening of the leaflets and may coexist with mitral stenosis. Idiopathic degeneration (Barlow's disease), degeneration associated…

…Mix the corticosteroid and the lidocaine in the same syringe. The anaesthetic confirms that the injection has gone to the right place — immediate pain relief…

…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…

…Type 2 myocardial infarction (MI) is defined as an ischaemic myocardial injury occurring in the context of a mismatch between myocardial oxygen supply and demand…

…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…

…high mortality when malperfusion or rupture develops; surgery or endovascular treatment is therefore generally favoured within 14 days of symptom onset in the source material…

…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…

…Rupture may involve the ventricular free wall, interventricular septum, or mitral valve apparatus. These lesions can cause acute severe regurgitation, a left to right shunt…

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

…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…

…the extent of myocardial injury and its complications—shock, reinfarction, myocardial rupture, and ventricular tachyarrhythmia—rather than embolization itself. A thrombus may be: Mural: flattened…

…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…

…integral aspect of virtually every echocardiographic examination. Wall motion is assessed in each segment of the left ventricle (Figure 1; refer to Segments of the…

…and right ventricle The cardinal echocardiographic finding A dilated inferior vena cava without respiratory variation Strongly suggests a raised filling pressure Marked respiratory variation in…

…Conversely, apparently mild lesions may rupture and precipitate myocardial infarction or sudden death. Coronary anatomy must therefore be interpreted within the broader clinical and physiological…

…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…