…Atherosclerotic disease usually evolves over decades. Intimal thickening may be present during the second and third decades of life, while clinical manifestations commonly emerge much…

…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…

…disruptions of acutely infarcted myocardium occurring most often during the first days after ST elevation myocardial infarction (STEMI). The principal lesions are: Ventricular septal rupture…

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

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

…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…

…chemistry & laboratory medicine Myocardial ischemia and infarction Definition and pathophysiology Myocardial infarction (MI) is a clinical diagnosis that integrates myocardial injury, evidence of acute myocardial…

…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…

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

…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…

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

…affects ventricular relaxation (and thus ventricular filling). This may even lead to compression of the ventricles during diastole; cardiac tamponade occurs if excess pericardial fluid…

…with the T wave apex (the peak of the T wave), which represents an electrically vulnerable phase during the cardiac cycle (see R on T…

…pressure during inspiration; one of the most useful signs Low voltage on the ECG, electrical alternans Supportive; it does not exclude Diastolic collapse of the…

…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…

…novo after delivery. New onset postpartum preeclampsia is increasingly recognized as a significant cause of maternal morbidity and mortality during the postpartum period. Maternal and…

…approximately 5–10%. Only about 10% of patients who develop shock present with it at hospital admission; approximately 90% deteriorate during hospitalization. Patients who develop…

…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…

…A risk of rupture; use sparingly Prepatellar and olecranon bursitis The bursa Exclude septic bursitis first Injection is considered when 4–6 weeks of adequate…

…subacute cardiac rupture, particularly when the effusion develops in the early post infarction period. Clinical presentation and symptoms The characteristic clinical syndrome consists of: Malaise…

…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…

…LV systolic function. The principal mechanisms are the combination of an abnormal thrombogenic endocardial surface and blood stasis. During the acute infarction phase, endocardial inflammation…

…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…

…and subject preparations. We will also discuss the relevance of withholding specific cardioactive medications during exercise testing (exercise ECG). Indications for exercise stress test Indications…

…composition of coronary atherosclerotic plaque, identify plaques at high risk of rupture, or determine whether ischaemia would occur at workloads greater than those achieved during…

…ventricle are compressed, with elevation of their diastolic pressures. Right sided filling becomes increasingly dependent on the fall in intrathoracic pressure during inspiration. The inspiratory…

…of the general population for cardiovascular risk factors has not been shown to improve cardiovascular outcomes, although opportunistic assessment during clinical encounters improves detection 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…

…cells during any continuous hour. This corresponds to the so called critical administration threshold and identifies rapid bleeding better than the retrospective definition of at…

…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…