…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…

…syndrome : 60% of all individuals with Noonan syndrome have pulmonic stenosis. The stenosis is subvalvular, causing a narrowing of the RVOT (right ventricular outflow tract…

…pulmonic stenosis. Heart rate . Synchronicity : Optimal contraction requires the majority of all ventricular myocardium to contract simultaneously. For this to be possible, the right leg…

…of the great arteries, pulmonary valve stenosis, atrial septal defect, ventricular septal defect), tricuspid valve regurgitation are the most common causes. ECG changes in right…

…right ventricle and right atrium, leading to right heart hypertrophy, dilation and ultimately right heart failure. Echocardiography in mitral stenosis Echocardiographic assessment of mitral stenosis…

…significant stenosis. Tricuspid stenosis results in increased right atrial pressure, which subsequently causes right atrial dilation. Vena cava inferior may also dilate secondarily. Principles of…

…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…

…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…

…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…

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

…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 )…

…a persistent foramen ovale (PFO), which enables blood flow from the right to the left atrium. Echocardiography is of importance for cardioembolic stroke, cryptogenic stroke…

…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…

…different position or a different vessel. Choice of site Vessel Advantages Disadvantages : : : Internal jugular vein (right) Best ultrasound conditions, a straight course to the superior…

…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…

…antihypertensives, should prompt clinical suspicion [1]. Cardiac Signs and Symptoms Patients often present with symptoms of predominant right heart failure, including lower extremity edema, ascites…

…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…

…far enough forward that the head will extend beyond the end of the couch when laid down. 2. Turn the head 45° to the right…

…artery is less common but more malignant than an anomalous right coronary artery. Anomalous origin of a coronary artery from the pulmonary artery can result…

…ECG signs of left atrial enlargement 3 Left axis deviation 2 QRS duration ≥90 milliseconds 1 Prolonged R wave peak time: V1 V2 (right ventricle…

…etiologies for axis deviations include: Causes of Right Axis Deviation: Pulmonary hypertension (primary or secondary) [9, 16] Severe pulmonary stenosis [8] Right ventricular hypertrophy [8…

…chest pain the primary task is to exclude or verify the following potentially life threatening causes of chest pain: Ischemic heart disease : stable angina pectoris…

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

…continuity equation All valvular stenoses must be graded in order to optimize management according to disease severity. The most important parameter, for grading of stenoses…

…to calculate stroke volume, cardiac output, pressure conditions, severity of stenoses and regurgitations, etc . These calculations are based on simple mathematical equations, which are based…

…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…

…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…

…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…

…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…

…sufficiently high for targeted screening to be cost effective. For asymptomatic stenosis of at least 70%, the reported 5 year ipsilateral stroke risk is 14…

…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…

…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…

…PAD) is a clinical disorder caused by stenosis or occlusion of the aorta or arteries supplying the limbs. In adults over 40 years of age…

…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.

…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…

…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…

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

…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…

… vascular inflammation; progression of calcific aortic stenosis; enhancement of a prothrombotic state. Its atherogenic and inflammatory effects may be mediated partly by oxidized phospholipids carried…

…edge dissection Incomplete lesion preparation Persistent stenosis within the treated segment Mechanical factors are particularly important because correction of the underlying problem is necessary for…

…pattern does not determine the anticoagulation indication. Previous stroke or TIA. The presence of mitral stenosis, a mechanical heart valve or hypertrophic cardiomyopathy. Heart failure…

…structural stability of the plaque is acutely compromised [7] . Sub group analyses from longitudinal angiographic registries demonstrate that the severity of baseline stenosis does not…

…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…

…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…

…four components: Symptoms suggestive of myocardial ischaemia. Objective evidence of myocardial ischaemia. Absence of obstructive coronary artery disease, defined as no stenosis exceeding 50% diameter…

…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…

…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…