…laboratory medicine Definition and structure Lipoprotein(a), abbreviated Lp(a), is an LDL like circulating lipoprotein particle. It contains one molecule of apolipoprotein B covalently…

…ischaemia and to estimate prognosis in patients with suspected or established coronary artery disease (CAD). It combines echocardiographic assessment of left ventricular (LV) structure and…

…and/or volume loaded. The load itself leads to impaired right ventricular function, especially if the load becomes prolonged. However, most often the cause of…

…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…

…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…

…catheter is not easier to pass. With a difficult passage it is the shape of the tip and the technique that matter, not the calibre…

…most often enzyme induction by alcohol or drugs and is often of no clinical significance. Synthetic function and prognosis Child–Pugh Parameter 1 point 2…

…5. Ask the patient to flex the head forward and swallow repeatedly , preferably with sips of water if swallowing is safe. Advance the tube in…

…and makes it visible even when it lies buried in the QRS complex or the T wave. The whole value of the investigation lies in…

Echocardiography Structure and contractile function of myocardial fibers The left ventricular wall can be subdivided into several layers. These layers are similar to those seen…

…organ structure and function. Ultrasound imaging, including echocardiography, has become a standard tool for clinicians worldwide (Narula et al). This chapter discusses the principles of…

…Figure 2 . Schematic illustration of the myocardial syncytium. Note the branched cell structure and the connections between the cells. The cardiac action potential The action…

…This is of utmost importance when assessing myocardial structure, perfusion and wall motion. Cardiac planes All imaging modalities define, orient and display the heart using…

…Prognostic and risk stratification information Assessment of response to selected medical, revascularization, rehabilitation, ablative or surgical interventions The test does not define the structure or…

…of His and the Purkinje fibers . These structures transmit the atrial pulse to the ventricles. Impulse transmission is rapid through the bundle of His and…

…Definition and pathophysiology Chronic kidney disease (CKD) is defined by abnormalities of renal structure or function that persist for more than 3 months and have…

…of cardiovascular health. Sex refers principally to biological characteristics, including chromosomal complement, anatomy, physiology and hormonal influences. Gender encompasses sociocultural roles, behaviours, relationships, power structures…

…greater afterload and consequently increasing diastolic pressure), sarcomere structure, the composition of extracellular matrix (extracellular fibrosis reduces compliance), pericardial status, etc . Diastolic Dysfunction and Diastoli

…structures enables the use of greater pulse repetition frequency, which results in greater resolution. PRF must be high in order to assess the velocity and…

…to the transducer and produce a copy of the reflector on the image. Hence, the ultrasound image may display multiple copies of a dense structure…

…characteristics of ultrasound waves (e.g. frequency) . This is actually exploited to calculate the direction and speed of tissue and fluid movements. All structures in…

…Thus, with regards to measuring ventricular dimensions, trabeculae and papillary muscles are considered part of the left ventricular cavity. Other dimensions– including atrial dimensions, mitral…

…medicine is the systematic assessment of relatives and other individuals who may carry an inherited predisposition to cardiovascular disease. It combines a structured family history…

…and evidence based interventions. Many tachyarrhythmias carry a potential risk of serious morbidity or mortality, underscoring the need for a structured and guideline directed approach…

…a structured approach focusing on rhythm stabilization, relief of triggers, and reduction of sympathetic drive [4]. Rhythm Stabilization In addition to defibrillation , several pharmacological and…

…risk. The optimal regimen therefore requires individualized balancing of ischemic and bleeding hazards. High bleeding risk (HBR) should be assessed in a structured manner. Within…

…the sound waves are compressed, which leads to a shortening of the wavelength and thus increased frequency. When the sound source moves away from the…

…indicator of increased cardiovascular risk and a setting in which secondary hypertension is relatively common. Patients presumed to have resistant hypertension should undergo a structured…

…The anatomy of the nail apparatus The terminology is hard to follow without a picture, and several of the steps below refer to structures that…

…leads [7]. These stricter parameters correlate more closely with abnormal LV mechanical function and the potential benefit of resynchronization pacemaker therapy [7]. R Wave Peak…

…infarction and limb threatening complications. Among patients with established peripheral artery disease, those who stop smoking have approximately twice the five year survival of those…

…Evaluation and Physical Examination The initial evaluation should be structured to establish a working diagnosis of STEMI rapidly, identify haemodynamic or electrical instability and determine…

…to higher levels than cTnT during acute myocardial infarction. cTnI and cTnT have different molecular structures, which may affect their release into the blood as…

…Myocardial motion and velocity can be measured with pulsed tissue Doppler (see Pulsed Wave Doppler). Tissue Doppler allows for sampling of specific regions or structures…

…following three structures (discussed in detail in Chapter 1): Specific clusters of atrial myocardium : There are clusters of atrial myocardium that possess automaticity and thus…

Arrhythmias and arrhythmology ECG Mechanisms of cardiac arrhythmias: from automaticity to re entry This section introduces the most common arrhythmias encountered in clinical practice, beginning…

…household tasks, active commuting and recreational activities. Exercise is a more structured form of physical activity undertaken to maintain or improve physical fitness. Regular physical…

…and mortality The modern concept of rehabilitation has evolved from early post infarction physical activity programmes into a structured centre of secondary cardiovascular prevention in…

…and other symptoms may occur without chest pain and should be considered anginal equivalents. The emergency evaluation of non traumatic chest discomfort is structured around…

…ventricles and surrounding structures of the mediastinum. Friction is reduced because the fluid in the pericardial sac (pericardial fluid) reduces friction between the ventricles and…

…the patient to recite the months of the year backwards. A normal result does not exclude delirium, however, and an abnormal result is not specific…

…interpretation requires a structured assessment of the waves and intervals. Before discussing each component in detail, a brief overview of the waves and intervals is…

…waves through structures to be visualized. Ultrasound waves are emitted rapidly from the transducer. These sound waves travel through tissues and fluids. Some of the…

…explained in Figure 3. Figure 3. Axial and lateral resolution of the ultrasound image. Axial resolution is constant along the ultrasound lines. Lateral resolution depends…

…its temporal and axial resolution is very high, as compared with 2D echocardiography. M mode is useful for quantifying the mobility of structures and measuring…

…the management of complex CAD, providing a structured approach to revascularization strategy. While it has limitations, its evolution into SYNTAX Score II and potential future…

…percentage (%). Normal FS 25% (M Mode) 18% (Direct 2 D measurement) Tissue Doppler Tissue Dopplerrecords the speed and direction of myocardial motion. This is possible…

…15 20% of cases, the tumor is localized in the right atrium. Myxoma is rare in the valves and ventricles. Myxoma, generally, is mobile structures…