…accounting for approximately 80% of cases. Other causes include acute mechanical complications—particularly ventricular septal defect (VSD) and papillary muscle rupture with acute severe mitral…

…18% for those associated with NSTEMI. The timing of VSR, free wall rupture, and papillary muscle rupture is characteristically bimodal. Events may occur within the…

…Anatomy of the mitral valve Acute mitral regurgitation Acute mitral regurgitation is relatively rare. The most common causes are as follows: Endocarditis Papillary muscle rupture…

…and favour the accumulation of fat, smooth muscle cells, fibroblasts and extracellular matrix beneath the endothelium. Plaques that are particularly prone to rupture characteristically contain:…

…90 days. The central clinical danger is progressive aortic wall disruption, rupture and compromise of branch vessels. Type A disease may cause cardiac tamponade, severe…

…to activation of coagulation. Plaque rupture is typically associated with a fibrin rich, red thrombus. The size and persistence of the thrombus depend not only…

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

…MI using a biochemical and clinical approach. This culminated in the Universal Definition of Myocardial Infarction Consensus Documents, with the Fourth Universal Definition published in…

…Identification of a coronary thrombus by angiography or autopsy, except in type 2 and type 3 MI. A diagnosis of MI should not be made…

…with functional assessment. A central practical principle is that the visual severity of a stenosis does not reliably establish its haemodynamic importance. A lesion that…

…Traditional classification of coronary artery disease Traditionally, coronary artery disease has been classified into the following three syndromes: Stable angina pectoris : Symptoms appear primarily during…

…occur when atherosclerotic plaques rupture or erode, leading to atherothrombosis and occlusion. This causes severe ischemia and the vast majority of patients experience angina pectoris…

…Traditional classification of coronary artery disease Traditionally, coronary artery disease has been classified into the following three syndromes: Stable angina pectoris : Symptoms appear primarily during…

…This causes adverse hemodynamic effects, and the condition is classified as cardiac tamponade. The classical signs of cardiac tamponade are hypotension, muffled heart sounds and…

…or rupture, resulting in myocardial infarction. Initial rhythm in traumatic cardiac arrest The initial rhythm in traumatic cardiac arrests comprises PEA in 60% of instances…

Procedurer Pericardiocentesis is performed on the basis of the haemodynamics, not the volume of fluid. A litre that has accumulated slowly can be asymptomatic, while…

…by the fact that there is no (or very little) turnover of myocardial cells and therefore myocardial troponins should not be detected in the blood…

…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…

…cardiac troponin concentrations. Based on the presenting electrocardiogram (ECG) and the presence of troponin elevation, ACS are classified into unstable angina (UA), non ST segment…

…been out of stock for a long period — check local availability. Betamethasone (Betapred 4 mg/mL) is water soluble and short acting, not a depot…

…interval of several weeks, improvement with anti inflammatory treatment, and the tendency to recur all support an immunopathological mechanism. The precise cause, however, is not…

…include fixed coronary atherosclerosis without plaque rupture, coronary artery spasm, coronary microvascular dysfunction (encompassing endothelial dysfunction, smooth muscle cell dysfunction, and dysregulation of sympathetic innervation)…

…4 5 cm of the aortic root is covered within the pericardium. Consequently, a proximal dissection can result in hemorrhage within the pericardium. Ventricular rupture :…

…Rupture exposes highly thrombogenic subendothelial matrix components, notably tissue factor and collagen, to the circulating blood [3] . Plaque Erosion: Responsible for up to 30% of…

…saccular aneurysm. Symptomatic isolated lesions may represent early periulcer haemorrhage or developing IMH and carry greater risk of progression or rupture than asymptomatic lesions. Predisposing…

…pulsatile, expansile mass, although absence of a palpable abnormality does not exclude AAA. Plain abdominal radiography has limited sensitivity. A calcified aneurysmal outline may be…

…may include systemic arterial embolic manifestations. The source material does not provide a detailed catalogue of specific embolic syndromes. Clinical suspicion should be heightened after…

…management is different. Takotsubo syndrome and myocarditis should not be classified as MINOCA when they are established as the explanation for the presentation. Clinical presentation…

…ECG Aortic dissection – due to risk of progression and rupture. Acute myocardial infarction (AMI) within 48 hours – due to the risk of aggravating the infarction…

…rehabilitation, ablative or surgical interventions The test does not define the structure or composition of coronary atherosclerotic plaque, identify plaques at high risk of rupture…

…clinical triad consists of: Hypotension Jugular venous distension Muffled or absent heart sounds The triad suggests severe tamponade, but its absence does not exclude the…

…rupture than non calcified, lipid rich plaque. CAC nevertheless serves as a marker of the broader atherosclerotic process, including non calcified plaques that are not…

…mm, and may not show the EEM through substantial plaque or calcium. Blood clearance is required because blood causes strong backscatter of the light signal…

…including older adults, although older patients also have more contraindications and a greater risk of bleeding and myocardial rupture. Late presentation For patients presenting more…

…elevations on ECG. ST elevations are the hallmark of STEMI. However, there are situations with transmural ischemia that do not yield ST elevations. It is…

…catheter is not easier to pass. With a difficult passage it is the shape of the tip and the technique that matter, not the calibre…

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

…access, or rapid central access, but do not delay transfusion or control of the bleeding in order to obtain a central venous catheter. 4. Take…

…Ruptured atherosclerotic lesion with atherotrombosis. Over decades, the lesion progresses from a simple fatty streak to a complex fibroatheroma. Smooth muscle cells (SMCs) migrate from…