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

…rupture and compromise of branch vessels. Type A disease may cause cardiac tamponade, severe acute aortic regurgitation, coronary malperfusion, myocardial ischaemia, heart failure, shock and…

…wall rupture Free wall rupture may be catastrophic or subacute. In the catastrophic form, an acute tear causes haemopericardium, tamponade, and sudden: Loss of pulse…

…and spotty calcification. However, the concept has important limitations. Although thin capped fibroatheromas may have imaging characteristics associated with rupture, fewer than 5% of such…

…outcomes. The vast majority of infections with COVID 19 result in mild disease, with symptoms similar to seasonal flu (influenza) and other viral respiratory infections…

…coupled with clinical evidence of acute myocardial ischaemia. The Fourth Universal Definition classifies MI into five distinct subtypes based on pathophysiology and clinical context: Type…

…infarction Definition and pathophysiology Type 1 MI results from acute coronary atherothrombosis. It is usually precipitated by disruption of an atherosclerotic plaque through rupture or…

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

…events Angiographic stenosis severity is an imperfect predictor of future myocardial infarction or sudden death. Lesions causing only mild obstruction may rupture, thrombose and occlude…

…STE ACS (ST Elevation Acute Coronary Syndrome) : STE ACS occurs when plaque rupture, and the ensuing atherothrombosis, causes a complete occlusion of the coronary artery…

…of all ischemic episodes are asymptomatic (refer to The Ischemic Cascade). Acute coronary syndromes occur when atherosclerotic plaques rupture or erode, leading to atherothrombosis and…

…STE ACS (ST Elevation Acute Coronary Syndrome) : STE ACS occurs when plaque rupture, and the ensuing atherothrombosis, causes a complete occlusion of the coronary artery…

…common cause of pericardial effusion is infections, such as viral, bacterial, and tuberculous infections. Post pericardiotomy syndrome. Acute transmural myocardial infarction. Rupture of the free…

…Nonetheless, prompt interventions can reverse cardiac arrest and survivors of traumatic cardiac arrest often exhibit favorable neurological outcomes ( Rawshani et al ). Traumatic cardiac arrests typically…

…be considered in consultation with a cardiothoracic surgeon. Myocardial rupture after myocardial infarction, and traumatic haemopericardium — these require surgery; pericardiocentesis is at best a bridge…

…is rupture or erosion of a vulnerable (unstable) atherosclerotic coronary plaque. Upon such damage, the plaque exposes highly thrombogenic materials which activate circulating platelets and…

…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…

…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…

…overlapping of vulnerable plaque and thrombogenic blood, which are critical determinants for infarction occurrence and extension. Plaque rupture or erosion leads to thrombus formation and…

…often curative Plantar fasciitis The origin of the fascia on the calcaneus A risk of rupture; use sparingly Prepatellar and olecranon bursitis The bursa Exclude…

…post AMI complication, including subacute rupture. Evaluation and physical examination The diagnosis of pericarditis is clinical and is supported by additional findings. A definite diagnosis…

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

…intrapericardial pressure due to the tamponade. The increased pressure causes compression of the atria and the ventricles (particularly the former). Even small pressure elevations on…

…70% of ACS presentations, plaque rupture typically occurs in thin cap fibroatheromas (TCFAs). These vulnerable plaques possess a massive necrotic lipid core and a highly…

…the aortic lumen and the haematoma and without a visible intimal flap or false lumen. It is commonly attributed to rupture of the vasa vasorum…

…associated with increasing likelihood of symptoms, complications and rupture. Aneurysmal sacs may contain mural thrombus, which can contribute to peripheral embolization and may reduce the…

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

…Coronary mechanisms Coronary mechanisms include: Plaque rupture or plaque erosion with thrombosis, despite the absence of an angiographically obstructive lesion Coronary embolism or thrombus Epicardial…

…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…

…increases in heart rate, myocardial contractility and blood pressure. When coronary blood flow cannot increase adequately because of flow limiting disease, myocardial ischaemia may develop…

…termed pulsus paradoxus. Tamponade is therefore characterized haemodynamically by elevation and near equalization of diastolic pressures in the cardiac chambers, with chamber pressures approaching intrapericardial…

…establish the presence or haemodynamic significance of a specific stenosis. Clinical Role and Indications CAC scoring is principally a risk stratification tool for individuals without…

…characterized by angiography. Standard gray scale IVUS demonstrates the principal vessel wall layers and allows quantitative measurements of: minimum and maximum lumen diameter; lumen area…

…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…

…right ventricular free wall rupture and cardiac tamponade. The most common of these are hypotension, low cardiac output and sensitivity to drugs that reduce preload…

…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…

Procedurer For many patients a gynaecological examination is associated with a sense of exposure, and technically correct performance is only half the task. The examination…

…uncontrolled source of bleeding. Minimise the time to surgery, endoscopy, an obstetric procedure or angiographic intervention. Summon anaesthesia, the operating specialty, the blood bank and…

…progressive, and highly complex lipid driven inflammatory disease of the arterial intima that serves as the fundamental pathophysiological substrate for acute coronary syndromes (ACS), including…