…resistance increases, making it more difficult to eject blood into the aorta. In the early stages of aortic stenosis, stroke volume becomes smaller. Reduced stroke…

…40 mm Hg in older and obese patients. References Baumgartner et al : Echocardiographic assessment of valve stenosis: EAE/ASE Recommendations for Clinical Practice (2009. JASE).

…is considered when medical therapy is insufficient, or when concomitant valvular disease (e.g mitral stenosis) requires intervention. Valve replacement can be performed with biological…

…6 0,85 < 0,6 Measured parameters Aortic sclerosis Mild stenosis Moderate stenosis Severe stenosis Mean gradient (mmHg) < 20 20 40 40 Peak…

…Mitral stenosis typically becomes symptomatic at rest when the valve area is reduced to 1.5 cm 2 . During physical activity, mitral stenosis may become…

…opportunity for reperfusion. In addition, some patients present with severe LMCA stenosis exacerbated by other conditions, and these must also be recognized. Prompt identification of…

Abstract Angiographic stenosis severity is a poor surrogate for the hemodynamic significance of a coronary lesion, with anatomic and functional assessment discordant in a substantial…

Cardiology Neurology Definition and Pathophysiology Carotid artery stenosis is an atherosclerotic narrowing of the carotid arteries. It forms part of multisite artery disease, defined as…

Myocardial ischemia and infarction Definition and Pathophysiology No reflow is impaired anterograde myocardial perfusion despite the absence of a flow limiting epicardial coronary stenosis. It…

…medicine Definition and pathophysiology Peripheral artery disease (PAD) is a clinical disorder caused by stenosis or occlusion of the aorta or arteries supplying the limbs…

…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…

…atherosclerotic plaque, and the severity and distribution of coronary stenosis. Modern cardiac CT can acquire a three dimensional cardiac dataset within approximately 5–15 seconds…

…to maximum achievable myocardial perfusion. A pressure reduction across an epicardial stenosis therefore identifies a limitation in potential hyperaemic flow. FFR is consequently a measure…

…and no obstructive stenosis in a major epicardial coronary artery. Non obstructive disease is generally defined as the absence of a stenosis of 50% or…

…occur in patients with severe coronary artery disease, defined in the source material as stenosis greater than 70%, and are an important reason that patients…

…percentage of the population has hypertension, and aortic stenosis is also more common than hypertrophic cardiomyopathy (especially among elderly). Patient characteristics and the degree of…

…exercise due to physical limitations. Contraindications to exercise, such as unstable angina, severe aortic stenosis, decompensated heart failure, or aortic aneurysm. Baseline ECG abnormalities rendering…

…burns or trauma over the insertion site. Thrombosis or known stenosis in the target vessel. Coagulopathy or ongoing anticoagulation: choose a compressible vessel (the internal…

…cervical spine surgery, atlantoaxial instability, severe rheumatoid arthritis of the neck. Symptomatic carotid stenosis, recent stroke or TIA in the vertebrobasilar territory. Retinal detachment. Relative:…

…48 hours, or ongoing unstable angina. Uncontrolled symptomatic arrhythmia. Symptomatic severe aortic stenosis. Decompensated heart failure. Acute pulmonary embolism or deep vein thrombosis. Acute myocarditis…

…head and neck Fragile skin, poor healing Ear canal stenosis or exostoses Narrow and hard to reach Ongoing otitis externa Pain, spread of infection A…

…adherence, pregnancy after the first trimester under specialist care). Rheumatic mitral stenosis with atrial fibrillation. In uncomplicated atrial fibrillation and in ordinary venous thromboembolism, a…

…with acute heart failure. • Clevidipine can cause reflex tachycardia. • Contraindicated in severe aortic stenosis due to risk of hypotension. Clevidipine doses and administration in hypertension.

…hours. Adverse effects Severe hypotension. Contraindications • Contraindicated in pregnancy, severe renal artery stenosis, severe hyperkalemia. • Avoid in acute heart failure and acute myocardial infarction. Enalaprilat…

…failure with preserved ejection fraction (HFpEF) at hospitalization warrants evaluation [5]. Heightened awareness is essential in patients with severe aortic stenosis, particularly the low flow…

…an apparent angiographic narrowing. The narrowing generally improves or disappears during diastole, distinguishing myocardial bridging from a fixed coronary stenosis. However, intravascular ultrasound has shown…

…by itself, establish the presence or haemodynamic significance of a specific stenosis. Clinical Role and Indications CAC scoring is principally a risk stratification tool for…

…eliminate it. Angiographic restenosis—defined in the source material as follow up diameter stenosis greater than 50%—occurred in 20–30% of patients, while clinically…

…associated with extensive premature and progressive ASCVD; CAD and aortic stenosis may occur before the age of 20 years, with death often occurring before age…

…stented segment or at its margins. Angiographic restenosis has traditionally been described as a follow up diameter stenosis exceeding 50%, whereas clinical restenosis refers to…

…information about the artery. The clinical value of these techniques rests on their ability to characterize the anatomy responsible for a stenosis, define plaque morphology…

…depending on coronary dominance. Significant left main stenosis is generally defined as a diameter reduction of at least 50%. Severe proximal disease of both the…

…several interrelated pathological processes: accelerated atherogenesis; vascular inflammation; progression of calcific aortic stenosis; enhancement of a prothrombotic state. Its atherogenic and inflammatory effects may be…

…Absence of obstructive coronary artery disease, defined as no stenosis exceeding 50% diameter reduction and/or an FFR 0.80. Demonstration of reduced CFR and…

…Graft occlusion after CABG No reflow despite removal of an apparent epicardial stenosis The clinical consequences depend on the amount of viable myocardium supplied by…

…myocardial oxygen requirements, principally through increased heart rate and contractility. In the presence of a flow limiting coronary stenosis, supply cannot increase adequately. Ischaemia begins…

…clinical risk factors rather than by the AF pattern. Important predictors include previous stroke or transient ischaemic attack (TIA), mitral stenosis, hypertrophic cardiomyopathy, diabetes mellitus…

…Ischemic cardiomyopathy should be suspected if there is significant stenosis ( 75% luminal obstruction) of the left main coronary artery (LAD) or 2 epicardial coronary arteries…

…and deeper S waves in left sided leads. Left ventricular hypertrophy (LVH) The most common causes of left ventricular hypertrophy are aortic stenosis, aortic regurgitation…

…myocardial perfusion imaging Exercise stress testing is contraindicated in patients with acute myocardial infarction, unstable angina, severe aortic stenosis, decompensated heart failure, and uncontrolled arrhythmias…

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

…blood flow demonstrates marked differences between rest and stress conditions, particularly in significant coronary artery stenosis. Stress can be induced pharmacologically with coronary vasodilatory agents…

…regurgitations. Such area estimations are fundamental in the management of valvular conditions, such as aortic stenosis, aortic regurgitation, mitral valve stenosis, mitral valve regurgitation, etc…

…regional abnormalities in contractile function. The abnormalities affect the myocardial area supplied by the arteries distal to the occlusion or stenosis. If the ischemia persists…

…hypertrophy Lung disease (with increased pulmonary vascular resistance), congenital heart disease (transposition of the great arteries, pulmonary valve stenosis, atrial septal defect, ventricular septal defect)…

…2 An oral anticoagulant is recommended A DOAC is preferred to warfarin except in a mechanical valve prosthesis and in moderate to severe mitral stenosis…

…E/e′ (mean) < 14 < 14 Aortic valve area 3.0–4.0 cm² 3.0–4.0 cm² Grading of aortic stenosis: mild…

…Aortic stenosis (AS) Disease defining parameters Mild stenosis Moderate stenosis Severe stenosis Valve area (cm²) 1.5 1.0 1.5 < 1.0 Normalized…

…If oral anticoagulation is indicated, NOACs should be chosen except in patients with moderate to severe mitral stenosis or mechanical heart valves; for these patients…

…heart failure. • Clevidipine can cause reflex tachycardia. • Contraindicated in severe aortic stenosis due to risk of hypotension. Clevidipine doses and administration in hypertension. Nicardipine Drug…

…as emergency bolus to correct acute hypotension. Hypotension (any) Used to increase MAP during hypotension in aortic stenosis. Used to decrease LVOT gradient in HCM…

…et al. (2009): Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice. In European journal of echocardiography : the journal of the Working Group…

…et al. (2009): Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice. In European journal of echocardiography : the journal of the Working Group…

…– Pubmed Link Tricuspid valve stenosis Mean pressure gradient ≥ 5 mmHg Valve area according to the continuity equation (cm²) ≤ 1 cm² ZTime velocity integral of the…

…– Pubmed Link Tricuspid valve stenosis Mean pressure gradient ≥ 5 mmHg Valve area according to the continuity equation (cm²) ≤ 1 cm² ZTime velocity integral of the…

…years) : No dose adjustments are necessary. Contraindications to vernakalant Severe aortic stenosis Systolic blood pressure < 100 mm Hg. Heart failure with NYHA class III…

…Consequently, a plaque may be biologically advanced despite producing relatively limited angiographic stenosis. Lipid accumulation and plaque architecture The major coronary risk factors—high LDL…

…syndrome (ACS), the angiographic culprit lesion may appear as an eccentric stenosis with scalloped or overhanging margins and a narrow neck. These findings may reflect…

…bradyarrhythmia Increased myocardial oxygen demand Sustained tachyarrhythmia, severe hypertension, hypertensive crisis, critical aortic stenosis, severe hypertrophic cardiomyopathy, extreme exercise Direct myocardial injury Myocarditis, cardiac co

…reserve is the ratio of stress myocardial blood flow to resting myocardial blood flow. It provides an integrated measure influenced by epicardial stenosis, diffuse atherosclerosis…