…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…

…progressive, and cardiogenic shock may develop rapidly. Ventricular septal rupture VSR typically causes: Recurrent chest pain. Dyspnoea. Hypotension. Rapid development of biventricular failure. Pulmonary oedema…

…atherosclerotic disease. Pathophysiology Mechanisms of acute coronary syndrome The major mechanisms producing acute coronary syndromes are: Plaque rupture with exposure of thrombogenic material. Superficial plaque…

…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…

…atherothrombosis. It is usually precipitated by disruption of an atherosclerotic plaque through rupture or erosion. The relative contributions of plaque disease and thrombus vary considerably…

…in mitral prolapse. Extensive myocardial infarction may lead to papillary muscle rupture. The risk of rupture is greater for the posteromedial papillary muscle, which only…

…physiological effect of a coronary lesion depends on more than its visual diameter reduction. Relevant determinants include: Lesion eccentricity Vessel tortuosity Calcification Plaque rupture or…

…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…

…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…

…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…

…right ventricular free wall is being compressed by the fluid. Video source.gif). ECG changes caused by pericardial effusion and cardiac tamponade Small amounts of…

…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…

…of the most useful signs Low voltage on the ECG, electrical alternans Supportive; it does not exclude Diastolic collapse of the right atrium and right…

…myocardial infarction is the most severe complication of coronary artery disease. The most common initiating mechanism is rupture or erosion of a vulnerable (unstable) atherosclerotic…

…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…

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

…pathophysiology of myocardial infarction injury involves the overlapping of vulnerable plaque and thrombogenic blood, which are critical determinants for infarction occurrence and extension. Plaque rupture…

…injection has gone to the right place — immediate pain relief is a diagnostic finding — and appears to reduce the risk of a post injection flare…

…In patients with pericarditis complicated by constriction, symptoms and signs of right sided heart failure may predominate. Pericardial effusions associated with post infarction pericarditis are…

…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…

…but a substantially higher rupture risk; one guideline summary describes approximately a four fold greater risk. This difference informs the use of sex specific surveillance…

…short term prognosis, although early mortality is usually related to the extent of myocardial injury and its complications—shock, reinfarction, myocardial rupture, and ventricular tachyarrhythmia…

…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…

…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…

…It generally results from accumulation of pericardial fluid, blood, or, less commonly, a mass. Tamponade occurs when intrapericardial pressure equals or exceeds right atrial pressure…

…measure of luminal obstruction. Calcified plaque is generally less likely to rupture than non calcified, lipid rich plaque. CAC nevertheless serves as a marker of…

…blood displacement. OCT is particularly useful for: characterizing the surface of atheroma; measuring fibrous cap thickness; distinguishing thrombus from plaque; evaluating occult plaque rupture; identifying…

…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…

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

…impairment or a large residual volume. A need for accurate measurement of urine output in a critically ill patient. Perioperatively and postoperatively in longer procedures…

…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…

…major haemorrhage protocol early. Protocols improve above all the logistics, the communication and the simultaneous delivery of red cells, plasma and platelets. Observational data from…

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