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…

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

…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…

…Echocardiography is the first choice for assessing the right side of the heart, despite difficulties in visualizing it. Previously, the PA catheter ( Pulmonary Artery Catheter …

…in patients with suspected or established coronary artery disease (CAD). It combines echocardiographic assessment of left ventricular (LV) structure and function with exercise or pharmacological…

…information Assessment of response to selected medical, revascularization, rehabilitation, ablative or surgical interventions The test does not define the structure or composition of coronary atherosclerotic…

…penetrating arteries) : This is the most common type of ischaemic stroke, resulting from the occlusion of small penetrating arteries that provide blood to deep structures…

…otherwise stable patients. More than 48 hours after onset: routine PCI of an occluded infarct related artery is not recommended in stable, asymptomatic patients without…

…absolute contraindications, but be cautious and consider referral in: Diabetes with neuropathy or peripheral arterial disease — a risk of osteomyelitis and poor healing. Check the…

…s predictive accuracy. The SYNTAX Score remains a cornerstone in the management of complex CAD, providing a structured approach to revascularization strategy. While it has…

…coronary syndrome Reinfarction reduced by approximately 30–40%; death reduced by approximately 35–45% Peripheral artery disease Lower risk of progression to chronic limb threat

…The purpose of standardizing ventricular segmentation, arterial territories and nomenclature is to develop consistency across examinations. This is of utmost importance when assessing myocardial structure…

…blood pool, and vascular structures is limited. CCTA has become an important first line investigation for selected patients with suspected coronary artery disease (CAD), particularly…

…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…

…associated with lower cardiovascular and all cause mortality and with reduced incidence or burden of hypertension, type 2 diabetes, coronary disease, stroke, peripheral arterial disease…

…etc. Cardiac tumors cause nonspecific symptoms that depend on the size of the tumor, localization, hemodynamic effects and possible impact on the coronary arteries. The…

…Relative Oesophageal stricture or a known diverticulum Relative Recent nasal or pharyngeal surgery Signs that should raise the suspicion of a base of skull fracture…

…not function. The tests that reflect the synthetic function of the liver are the prothrombin time (INR) , the albumin and the bilirubin — and they become…

…oedema. Treat the arrhythmia first. Known stricture or tumour of the nose, pharynx or oesophagus. Oesophageal varices. Recent surgery of the nose, pharynx or oesophagus…

…impairment or a large residual volume. A need for accurate measurement of urine output in a critically ill patient. Perioperatively and postoperatively in longer procedures…

…geometry (a large ventricle yields greater afterload and consequently increasing diastolic pressure), sarcomere structure, the composition of extracellular matrix (extracellular fibrosis reduces compliance), pericardial status…

…waves are reflected. This explains why tissue borders appear as brighter structures on the ultrasound image. Figure 2. Visualization of reflected ultrasound waves. It is…

…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…

…system of the heart The sinus node (sinoatrial node) and intrinsic automaticity The sinus node is a small oval structure located near the entrance of…

…relationships, power structures and social expectations. Both influence the prevalence, manifestations, diagnosis, management, treatment response and outcomes of cardiovascular disease. The biological differences between females…

…with reflected sound waves, making it possible to determine the distance of the reflector ( i.e the structure reflecting the sound wave). The pulsed wave…

…Any structure located to the right of the index marker will be shown on the right side of the corresponding image marker in the ultrasound…

…artifacts can be generated on both sides of the true reflector. If many side lobe artifacts are generated, they may appear as a continuous structure…

…to depolarize spontaneously). These structures are as follows: The sinoatrial (SA) node: the sinoatrial node is the primary pacemaker of the heart. It directs the…

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

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

…in the pericardial sac (pericardial fluid) reduces friction between the ventricles and surrounding structures. The pericardium provides some fixation of the heart in the mediastinum…

Echocardiography The Doppler effect When sound waves hit objects some of the sound waves are reflected back to the sound source. If the reflector (i…

…high, as compared with 2D echocardiography. M mode is useful for quantifying the mobility of structures and measuring dimensions. In order to obtain representative measurements…

…Stricter Criteria : These require a QRS duration exceeding 140 msec in males and 130 msec in females , along with slurring or notching of the mid…

…Troponin is a protein complex expressed in cardiac and skeletal muscle. The complex consists of troponin I (TnI) , troponin C (TnC) and troponin T (TnT…

…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…

…HBR) should be assessed in a structured manner. Within the ARC HBR framework, HBR is defined by the presence of at least one major criterion…

…The management of TdP and related malignant ventricular arrhythmias requires a structured approach focusing on rhythm stabilization, relief of triggers, and reduction of sympathetic drive…

…called parasternal long axis view (PLAX). Structures that are closest to the transducer are placed at the top of the image. RV = right ventricle…

…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…

…Delirium is common but often missed. On medical and geriatric wards a substantial proportion of older patients are affected, and the incidence is particularly high…

…be considered anginal equivalents. The emergency evaluation of non traumatic chest discomfort is structured around three principal diagnostic categories: Myocardial ischaemia , particularly acute coronary syndrome…

…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…

…however, that three dimensional (3D) echocardiography offers greater precision in the calculation of ejection fraction, and 3D measurements will presumably replace 2D measurements in the…

…originates in either of the following three structures (discussed in detail in Chapter 1): Specific clusters of atrial myocardium : There are clusters of atrial myocardium…

…Doppler). Tissue Doppler allows for sampling of specific regions or structures. This is done by placing the sample volume (SV) in the region of interest…