…some patients present with severe LMCA stenosis exacerbated by other conditions, and these must also be recognized. Prompt identification of LMCA involvement is therefore critical…

…flow preserved by the stenosis. Cutoff ≤ 0.80. Deepest outcome trial evidence base of any physiological index; lesion specific and largely independent of resting hemodynamics…

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

…coronary artery stenosis. Stress can be induced pharmacologically with coronary vasodilatory agents or simulated hemodynamically through exercise or the use of chronotropic and inotropic agents…

…overcoming the resistance in the stenosis and maintaining adequate stroke volumes. Thus, ventricular hypertrophy is a compensatory mechanism, the purpose of which is to maint

…of mitral stenosis Mitral stenosis hinders atrial emptying. This results in an increase in left atrial pressure (LAP), which gradually leads to atrial hypertrophy and…

…stenosis) requires intervention. Valve replacement can be performed with biological or mechanical prostheses. The former is preferred due to the lower risk of thrombosis and…

…stenosed. Plaque rupture Plaques prone to rupture characteristically contain a large lipid pool, numerous macrophages or foam cells, and a thin fibrous cap. Disruption of…

…Bernoulli principle can be used to calculate pressure gradients across valvular stenoses and regurgitations. The equation is agnostic to the direction of the blood flow…

…of Echocardiography : official publication of the American Society of Echocardiography 30 (4), pp. 303–371. DOI: 10.1016/j.echo.2017.01.007. Aortic stenosis…

…Figure 1. The electrical axis of the heart (heart axis). As evident from the figure, the normal heart axis is between –30° and 90°. If…

…Figure 38. The electrical axis of the heart (heart axis). As evident from the figure, the normal heart axis is between –30° and 90°. If…

…valve Aortic stenosis with calcification Mitral disease with calcification Fibrin strands Giant Lambls excrescences Septum Defects — PFO, ASA, ASD SOURCES OF CARDIAC EMBOLI AND EMBOLIC…

…For asymptomatic stenosis of at least 70%, the reported 5 year ipsilateral stroke risk is 14.6%, and revascularisation may be beneficial in appropriately selected…

…can refine interpretation. Coronary plaque and future events Angiographic stenosis severity is an imperfect predictor of future myocardial infarction or sudden death. Lesions causing only…

…or stenosis. If the ischemia persists for 20 minutes, myocardial infarction ensues, resulting in permanent wall motion abnormalities. Figure 1. Standardized myocardial segmentation and nomenclature…

…dialysis catheter, not an ordinary triple lumen catheter). Measurement of central venous pressure and central venous oxygen saturation. Repeated blood sampling during intensive care. Exhausted…

…risk of rebound. The referring physician should have made this decision; document which applies. Nitroglycerin is continued; note it in the report. Shaving and careful…

…of mitral regurgitation in low and middle income countries. Rheumatic heart disease typically results in thickening of the leaflets and may coexist with mitral stenosis…

…which the pressure in the aorta is increased) and aortic stenosis (in which the narrowing of the opened aortic valve orifice makes it difficult for…

…in patients with acute myocardial infarction, unstable angina, severe aortic stenosis, decompensated heart failure, and uncontrolled arrhythmias. Pharmacologic stress agents have specific contraindications: Adenosine, Dipyridamole…

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

…The test presupposes that the patient has spontaneous nystagmus at the time of examination and that the examiner is experienced with the head impulse test…

…Warfarin has a narrow therapeutic index, a half life of several days and more than a hundred clinically relevant interactions. What determines whether the treatment…

…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.

…stenosis, particularly the low flow, low gradient phenotype, or those undergoing aortic valve replacement [1, 5, 10]. A history of increasing frequency of hospitalizations and…

…primarily angiographic and clinical. No reflow should be suspected when distal coronary perfusion remains reduced despite successful treatment of the apparent epicardial stenosis and without…

…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…

…of Echocardiography : official publication of the American Society of Echocardiography 30 (4), pp. 303–371. DOI: 10.1016/j.echo.2017.01.007. Aortic stenosis…

…onset, prolonged duration of effect, and significant individual variations in its effect. Drug Enalaprilat Brand names Vasotec IV ® Indications Hypertension and hypertensive emergency. Acute…

…mitral valve stenosis) it becomes enlarged (hypertrophy) which amplifies its contribution to the P wave. The second hump in lead II becomes larger and the…

…echocardiography. A common question is the presence of right ventricular load. This condition implies that the right ventricle is pressure and/or volume loaded. The…

…of a stenosis of 50% or more in any potential infarct related artery. MINOCA is not a definitive disease diagnosis. It is a descriptive and…

…and revascularisation recommendations are not restricted to patients with symptoms. Current guidance supports revascularisation for significant left main stenosis irrespective of symptomatic status or the…

…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…

…they supply a larger myocardial territory. The response of the coronary circulation reflects both epicardial stenosis and the coronary microcirculation. Microvascular dysfunction may impair maximal…

…doses of more than 5 mg/kg should not be given within 24 hours. If conversion to sinus rhythm is not successful, blood pressure and…

…inflammatory disease of the arterial wall in which lipid accumulation, vascular cell dysfunction, immune cell recruitment, extracellular matrix remodelling, and thrombosis interact to produce focal…

…diastole, distinguishing myocardial bridging from a fixed coronary stenosis. However, intravascular ultrasound has shown that delayed opening of the bridged segment may extend into diastole…

…or stenosis. Diagnostics Electrocardiogram and Cardiac Monitoring An ECG should be performed if there is suspicion of syncope due to an arrhythmia or underlying cardiac…

…increased workload STATUS OF CORONARY ARTERY SETTING EFFECT ECG REACTION Normal coronary artery (no atherosclerosis) At rest Oxygen supply is adequate and ischemia cannot occur…

…valve stenosis. Lp(a) is not associated with venous thromboembolism in prospective epidemiological studies. Its biological effects appear to differ from those of LDL, and…

…diameter A high degree of residual stenosis Long lesion length Diabetes Untreated edge dissection DES have reduced restenosis compared with BMS, and newer generation DES…

…strongest established predictors of ischaemic stroke and systemic embolism are previous stroke or TIA and mitral stenosis. In patients with AF and previous ischaemic stroke…

…the severity of baseline stenosis does not reliably predict the site of future STEMI; rather, it is the biological composition and inflammatory activity of the…

…of necrotising otitis externa Anticoagulant treatment Bleeding into the ear canal Previous radiotherapy to the head and neck Fragile skin, poor healing Ear canal stenosis…

…and progressive ASCVD; CAD and aortic stenosis may occur before the age of 20 years, with death often occurring before age 30. Clinical presentation and…

…suggestive of myocardial ischaemia. Objective evidence of myocardial ischaemia. Absence of obstructive coronary artery disease, defined as no stenosis exceeding 50% diameter reduction and/or…

…defined in the source material as stenosis greater than 70%, and are an important reason that patients are referred for coronary artery bypass grafting rather…

…and coronary blood supply. Stress increases myocardial oxygen requirements, principally through increased heart rate and contractility. In the presence of a flow limiting coronary stenosis…

…adult patients with severe pulmonary stenosis, alongside right ventricular hypertrophy (RVH) and right atrial enlargement [8]. RAD is present in most cases of significant RVH…

…threatening causes of chest pain: Ischemic heart disease : stable angina pectoris, unstable angina pectoris, acute myocardial infarction (AMI). Note that unstable angina pectoris and acute…

…aortic stenosis, there is increased resistance in the aortic valve itself, due to the reduced area of the valvular orifice. Both aortic stenosis and hypertension…

…which can dilate more than stenotic arteries, which are already dilated. This results in flow heterogeneity and perfusion defects in areas supplied by the disease…

…to calculate the diameter of the orifice. This has fundamental clinical implications as it enables the investigator to calculate the area of stenoses and regurgitations…

…valve stenosis, atrial septal defect, ventricular septal defect), tricuspid valve regurgitation are the most common causes. ECG changes in right ventricular hypertrophy V1 and V2…

…it bulges into the artery lumen and causes stenosis (reduction of the artery lumen). The reduction of the artery lumen causes limitations to the blood…

…official publication of the American Society of Echocardiography 30 (4), pp. 303–371. DOI: 10.1016/j.echo.2017.01.007. Mitral valve stenosis Primary…

…for the assessment of valvular regurgitation. Part 1: aortic and pulmonary regurgitation (native valve disease). In European journal of echocardiography : the journal of the Working…

…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…