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…

…assessment of peripheral arterial and aortic disease; planned surgery, especially carotid endarterectomy (CEA), coronary artery bypass grafting (CABG), or major non cardiac surgery. The vascular…

…left ventricular dysfunction, peripheral vascular disease and other manifestations of diffuse atherosclerosis. Percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are revascularization procedures…

…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…

…develop premature CAD. Symptoms therefore depend on the vascular territory involved and may include manifestations of coronary, cerebral or peripheral arterial disease, although the source…

…Mechanism of action Nicardipine is a dihydropyridine calcium channel blocker (CCB). Nicardipine inhibits the influx of extracellular calcium in the myocardial and peripheral vascular smooth…

…peripheral vascular disease. Cancer. Acute coronary syndromes cause symptoms already at rest. Stable ischemic heart disease does not cause symptoms at rest unless the stenosis…

…Mechanism of action Nicardipine is a dihydropyridine calcium channel blocker (CCB). Nicardipine inhibits the influx of extracellular calcium in the myocardial and peripheral vascular smooth…

…Prolapse of mitral valve Aortic stenosis with calcification Mitral disease with calcification Fibrin strands Giant Lambls excrescences Septum Defects — PFO, ASA, ASD SOURCES OF CARDIAC…

…catheter). Measurement of central venous pressure and central venous oxygen saturation. Repeated blood sampling during intensive care. Exhausted peripheral venous access during prolonged intravenous therapy…

…with ECG, central vein catheter and intra arterial catheter (A line) is warranted. Overview of vasopressors and inotropes Inotropes and vasopressors. Table 1. Drug manual…

…with ECG, central vein catheter and intra arterial catheter (A line) is warranted. Overview of vasopressors and inotropes Inotropes and vasopressors. Table 1. Drug manual…

…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…

…largely independent of resting hemodynamics; guideline reference standard. Requires pressure wire + vasodilator (cost, time, patient discomfort); falsely normal in microvascular dysfunction (diabetes, LVH, aortic stenosis…

…Valvular pulmonic stenosis can be caused by dysplastic, bicuspid or unicuspid valves. Table 1 presents common causes of pulmonic stenosis. Table 1. Causes of pulmonic…

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

…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…

…activity, mitral stenosis may become symptomatic already at 2.5 cm 2 . A normal mitral valve has an area of 4 to 6 cm 2 …

…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…

…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…

…valves. Importantly, in the setting of valvular stenosis or regurgitation, the proximal velocity (v 1 ) is very small compared to the distal velocity (v 2 )…

…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…

…Causes of right axis deviation Normal in newborns. Right ventricular hypertrophy. Acute cor pulmonale (pulmonary embolism). Chronic cor pulmonale (COPD, pulmonary hypertension, pulmonary valve stenosis…

…Causes of right axis deviation Normal in newborns. Right ventricular hypertrophy. Acute cor pulmonale (pulmonary embolism). Chronic cor pulmonale (COPD, pulmonary hypertension, pulmonary valve stenosis…

…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…

…with oxygen demands. Depending on several factors– including the severity of the stenosis/occlusion, microvascular function, myocardial oxygen extraction, presence of collateral circulation, etc –ischemia…

Procedurer The value of the exercise test lies not in ST depression alone but in the overall picture : exercise capacity, symptoms, blood pressure response, heart…

…mitral stenosis. Idiopathic degeneration (Barlow's disease), degeneration associated with connective tissue disorders (Marfan syndrome, Ehlers Danlos syndrome), osteogenesis imperfecta typically causes prolapse of P2…

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

…with increased risk of hypotension in patients with autonomic dysfunction, hypovolemia, or severe coronary or valvular disease Recent (<48 hours) use of dipyridamole or dipyridamole…

…rheumatoid arthritis of the neck. Symptomatic carotid stenosis, recent stroke or TIA in the vertebrobasilar territory. Retinal detachment. Relative: Marked cervical restriction of movement or…

…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.

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

…should be suspected when distal coronary perfusion remains reduced despite successful treatment of the apparent epicardial stenosis and without an angiographically evident flow limiting obstruction…

…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…

Enalaprilat Enalaprilat is rarely used in hypertensive crisis due to its slow onset, prolonged duration of effect, and significant individual variations in its effect. Drug…

…the right atrium is commonly a consequence of increased resistance to empty blood into the right ventricle. This may be due to pulmonary valve stenosis…

…it possible to calculate the resistance in the pulmonary vessels (pulmonary vascular resistance, PVR). This parameter is of utmost interest in investigating right ventricular load…

…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…

…to patients with symptoms. Current guidance supports revascularisation for significant left main stenosis irrespective of symptomatic status or the documented ischaemic burden. In chronic coronary…

…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…

…the relationship between diameter stenosis and haemodynamic significance is weak, particularly for intermediate lesions. Even lesions with a visual diameter reduction of 50–70% may…

Info [calc_vernakalant] Indications for vernakalant Vernakalant (Brinavess) is indicated in adults for chemical conversion of recent onset atrial fibrillation to sinus rhythm. Vernakalant is…

…and infarction Definition and pathophysiology Atherosclerosis is a chronic, inflammatory disease of the arterial wall in which lipid accumulation, vascular cell dysfunction, immune cell recruitment…

…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…

…severe the stenosis, the more pronounced the symptoms. Stable angina pectoris is diagnosed by means of exercise stress testing (exercise ECG). The purpose of the…

…Neointimal hyperplasia The principal mechanism of ISR is neointimal hyperplasia following vessel wall injury. PCI and stent implantation produce local vascular injury and initiate a…

…stroke or TIA. The presence of mitral stenosis, a mechanical heart valve or hypertrophic cardiomyopathy. Heart failure, hypertension, diabetes and vascular disease. Age and sex…

…Historically viewed as a simple plumbing problem characterized by the gradual accumulation of inert cholesterol debris, modern vascular biology has redefined atherosclerosis as a dynamic…

…poor healing Ear canal stenosis or exostoses Narrow and hard to reach Ongoing otitis externa Pain, spread of infection A small or uncooperative child Movement…

…promote the release of adhesion molecules, inflammatory cytokines, and vasoconstricting mediators, producing abnormal vascular responses and potentially increasing the future risk of obstructive coronary disease…

…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…

…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…

…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…

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

…coronary blood flow by relaxing vascular smooth muscle. They are contraindicated in patients with bronchospastic lung disease, or a history of significant reactive airway disease…

…in the management of valvular conditions, such as aortic stenosis, aortic regurgitation, mitral valve stenosis, mitral valve regurgitation, etc. The radius of PISA is measured…