Imaging of Coronary Artery Disease: II
|
|
- Kerrie Boone
- 5 years ago
- Views:
Transcription
1 Acta Radiológica Portuguesa, Vol.XIX, nº 74, pág , Abr.-Jun., 2007 Imaging of Coronary Artery Disease: II Jean Jeudy University of Maryland School of Medicine Department of Diagnostic Radiology Armed Forces Institute of Pathology Necrosis starts to develop in the subendocardium, about min after coronary occlusion The necrotic region grows outward towards the epicardium over the next 3 6 h, eventually spanning the entire ventricular wall. Coronary thrombosis is the critical event resulting in infarction If occlusion occurs >30min, damage is irreversible Overview Some portions of the myocardium are reversibly damaged (stunned) and will eventually recover if blood flow is restored Contractility in the remaining viable myocardium become hyperkinetic The pathological hallmark of myocardial infarction is coagulative necrosis of the myocardium Ischemia causes immediate loss of contractility Between 4-12 h after cell death starts, the infarcted myocardium begins to undergo coagulation necrosis cell swelling, organelle breakdown and protein denaturation After about 18 h, neutrophils enter the infarct numbers reach a peak after about 5 days, and then decline ARP 45
2 After 3 4 days, granulation tissue appears at the edges of the infarct zone macrophages, fibroblasts, which lay down scar tissue, and new capillaries The infarcted myocardium is especially soft between 4 and 7 days, and is therefore maximally prone to rupturing may occur at any time during the first 2 weeks and is responsible for about 10% of MI mortality Abnormalities of perfusion have been well described on MDCT. Perfusion As the granulation tissue migrates inward toward the centre of the infarct over several weeks, the necrotic tissue is engulfed and digested by the macrophages granulation tissue progressively matures, with an increase in scar tissue and loss of capillaries Etiology of ischemia Role of imaging Identify viable vs nonviable myocardium Evaluate for complications associated with infarction Perfusion First pass MRI perfusion is emerging as a very capable alternative for non invasive assessment Excellent spatial resolution allows for detection of subendocardial ischemia 46 ARP
3 Viability Hypoperfused, but viable myocardium should be revascularized whereas nonviable myocardium should not Delay in restoring perfusion to at-risk myocardium increases mortality Accurate and reproducible noninvasive method of evaluating cardiac function. Excellent depiction of endocardial and epicardial borders allows accurate assessment of wall thickness and wall thickening. Global Function Cardiac MR Assessment Anatomic Assessment Chamber size Cardiac Wall motion Myocardial wall thickness Functional Assessment LV Ejection Fraction Myocardial Perfusion Viability Sequences Global Function Limitations Cannot determine precise size of myocardial infarction Discrimination between transmural and nontransmural infarct cannot be assessed. ARP 47
4 Delayed Enhancement Fast gradient echo MR sequences Imaging performed after rapid intravenous injection at a rate of 4-5 ml/sec Hypoperfusedareas will be hypointense 1 st Pass Perfusion Myocardial Ischemia ACUTE PHASE First few weeks after infarction extensive capillary damage resulting in microvascular obstruction LATE PHASE replacement of infarcted myocardium by scar Delayed Enhancement MR Inversion recovery Performed 10 to 30 minutes after administration of gadolinium Both acute and chronic infarct demonstrate hyperintense signal Vogel-Claussen et al, 2006 Myocardial Ischemia Delayed enhancement due to loss of cellular wall integrity and edema Size of acute infarct correlates with peak levels of creatine kinase Large q wave acute MI leads to microvascular obstruction Myocardial Ischemia Serial evaluation shows infarct size gradually decreases over time Overestimation of infarct size because of associated edema without myonecrosis Compensatory hypertrophy of noninfarcted myocardium during recovery phase Vogel-Claussen et al, ARP
5 Microvascular Obstruction Severely injured myocardium Occlusion of capillaries in association with recent myocardial infarction denotes poor prognosis Kim et al, 2001 Late (viability): Hyper-enhancement indicates scar/fibrosis in association with chronic MI Functional recovery inversely related to transmural extent of hyper-enhancement Early (perfusion): acute MI myocardial necrosis and microvascular obstruction, edema chronic MI corresponds to poorly perfused myocardial scar In both cases abnormalities depict most severely damaged myocardial tissue which is infarct core Late (viability): 90% of patients with transmural hyperenhancement >50% showed no improvement in wall motionafter revascularization. Kim et al 2000 Microvascular Obstruction Severely injured myocardium Viability using MDCT Occlusion of capillaries in association with recent myocardial infarction denotes poor prognosis Mahnken et al, 2005 ARP 49
6 Complications of Myocardial Infarction Cardiac rupture LV aneurysm Ventricular pseudoaneurysm Mitral regurgitation Pericarditis Cardiogenic shock Pulmonary hemorrhage Pulmonary edema Arrhythmia LV DILATION AND APICAL THROMBUS LEFT VENTRICULAR ANEURYSM Usually occurs in left anterior distribution in association with LAD occlusion Often denotes a wide infarcted area Complications VENTRICULAR PSEUDOANEURYSM Rare complication Occurs due to rupture of ventricular free wall which subsuquently becomes contained by overlying pericardium Most occur within 7 days after the acute event and have increased risk of rupture Complications 50 ARP
7 ARP 51
Myocardial Infarction
Myocardial Infarction MI = heart attack Defined as necrosis of heart muscle resulting from ischemia. A very significant cause of death worldwide. of these deaths, 33% -50% die before they can reach the
More information1) Severe, crushing substernal chest pain 2) radiate to the neck, jaw, epigastrium, or left arm. 3- rapid and weak pulse 4- nausea (posterior MI).
1) Severe, crushing substernal chest pain 2) radiate to the neck, jaw, epigastrium, or left arm. 3- rapid and weak pulse 4- nausea (posterior MI). 5- cardiogenic shock (massive MIs >40% of the left ventricle)
More informationIschemic heart disease
Ischemic heart disease Introduction In > 90% of cases: the cause is: reduced coronary blood flow secondary to: obstructive atherosclerotic vascular disease so most of the time it is called: coronary artery
More informationEcho in CAD: Wall Motion Assessment
Echo in CAD: Wall Motion Assessment Joe M. Moody, Jr, MD UTHSCSA and STVHCS October 2007 Relevant References ACC/AHA/ASE 2003 Guideline Update for the Clinical Application of Echocardiography Bayes de
More informationThe Value of Stress MRI in Evaluation of Myocardial Ischemia
The Value of Stress MRI in Evaluation of Myocardial Ischemia Dr. Saeed Al Sayari, MBBS, EBCR, MBA Department of Radiology and Nuclear Medicine Mafraq Hospital, Abu Dhabi United Arab Emirates Introduction
More informationRadiologic Assessment of Myocardial Viability
November 2001 Radiologic Assessment of Myocardial Viability Joshua Moss, Harvard Medical School Year III Patient EF 66yo female with a 3-year history of intermittent chest pain previously relieved by sublingual
More informationMRI ACS-ben. Tamás Simor MD, PhD, Med Hab. University of Pécs, Heart Institute
MRI ACS-ben Tamás Simor MD, PhD, Med Hab Time Course of Changes in Infarct Size, Viable Myocardium, and LV Mass After Reperfused and Nonreperfused MI Blue lines denote reperfused myocardial infarction
More informationMI Acute occlusion of the proximal left anterior descending (LAD) artery is the cause of 40% to 50% of all MIs. *
MI *33% -50% die before hospital lethal arrhythmia Sudden Cardiac Death. * Arrhythmias are caused by electrical abnormalities of the ischemic myocardium and conduction system. *Acute occlusion of the proximal
More informationDetection and Assessment of MI: Use of Imaging Methods. Robert O. Bonow, M.D.
Detection and Assessment of MI: Use of Imaging Methods Robert O. Bonow, M.D. Detection and Assessment of MI: Use of Imaging Methods Robert O. Bonow, M.D. No Relationships to Disclose Expert Consensus Document
More informationMyocardial viability testing. What we knew and what is new
Myocardial viability testing. What we knew and what is new Dr B K S Sastry, MD, DM. CARE Hospitals, Hyderabad What is Viability Viability Dysfunctional myocardium subtended by diseased coronary arteries
More informationCardiovascular manifestations of HIV
Cardiovascular manifestations of HIV Prabhakar Rajiah, MBBS, MD, FRCR Associate Professor of Radiology Associate Director, Cardiac CT and MRI University of Texas Southwestern Medical Center, Dallas, USA
More informationMR Assessment of Myocardial Viability
MR Assessment of Myocardial Viability Definition of Viability Clinical Metabolism: Presence of glucose uptake Perfusion / Perfusion reserve Morphology: Wall thickness, wall thickening Contractility: Recovery
More information3/27/2014. Introduction.
Introduction. Myocardial perfusion & contractility becomes abnormal immediately after the onset of ischaemia, even before the development of the symptoms & ST segment changes. 1 Myocardial Wall Motion
More informationCardiac Imaging Tests
Cardiac Imaging Tests http://www.medpagetoday.com/upload/2010/11/15/23347.jpg Standard imaging tests include echocardiography, chest x-ray, CT, MRI, and various radionuclide techniques. Standard CT and
More informationCardiac MRI: Cardiomyopathy
Cardiac MRI: Cardiomyopathy Laura E. Heyneman, MD I do not have any relevant financial relationships with any commercial interests Cardiac MRI: Cardiomyopathy Laura E. Heyneman, MD Duke University Medical
More informationThe role of Magnetic Resonance Imaging in the diagnosis of viability & Coronary Artery Disease
The role of Magnetic Resonance Imaging in the diagnosis of viability & Coronary Artery Disease G.P. Spanos, MSc, Phd Head of CardioVascular Imaging Tomographia Diagnostic Center Cardiovascular magnetic
More informationGated blood pool ventriculography: Is there still a role in myocardial viability?
Gated blood pool ventriculography: Is there still a role in myocardial viability? Oliver C. Alix, MD Adult Clinical and Nuclear Cardiology St. Luke s Medical Centre - Global City Case Presentation A 62-year-old
More informationCardiac Imaging. Kimberly Delcour, DO, FACC. Mahi Ashwath, MD, FACC, FASE. Director, Cardiac CT. Director, Cardiac MRI
Cardiac Imaging Kimberly Delcour, DO, FACC Director, Cardiac CT Mahi Ashwath, MD, FACC, FASE Director, Cardiac MRI Cardiac Imaging Discuss the clinical applications of and indications for: Cardiac CT Nuclear
More informationEAE Teaching Course. Magnetic Resonance Imaging. Competitive or Complementary? Sofia, Bulgaria, 5-7 April F.E. Rademakers
EAE Teaching Course Magnetic Resonance Imaging Competitive or Complementary? Sofia, Bulgaria, 5-7 April 2012 F.E. Rademakers Complementary? Of Course N Engl J Med 2012;366:54-63 Clinical relevance Treatment
More informationCurrent Indications for Cardiac MRI: What You See is What You Get?
Current Indications for Cardiac MRI: What You See is What You Get? Javier Ganame, MD, PhD, FASE No disclosures Cardiology Update, Niagara, Sept 24th, 2016 The Ideal Diagnostic Technique Easy to apply Accurate
More informationCurrent Guidelines for Diagnosis of AMI Chest pain ST change on EKG Cardiac Enzymes
Noninvasive Cardiac Imaging in Myocardial Infarction Sangchol Lee Sungkyunkwan University Samsung Medical Center Current Guidelines for Diagnosis of AMI Chest pain ST change on EKG Cardiac Enzymes Do We
More informationWhy Cardiac MRI? Presented by:
Why Cardiac MRI? Presented by: Lisa G. Carkner, MD, FACC 1 Disclosures I have no financial disclosures Objectives Review basic principles of Cardiac MRI. What patient characteristics do I need to consider
More informationNoncoronary Cardiac MDCT
Noncoronary Cardiac MDCT David A. Bluemke, M.D., Ph.D. Professor, of Radiology and Medicine Johns Hopkins University School of Medicine Baltimore, Maryland Toshiba Disclosures Grant support Noncoronary
More informationPerfusion, Viability, Edema and Hemorrhage: How it Can (and Should) Change Clinical Practice. Rohan Dharmakumar, Ph.D.
Perfusion, Viability, Edema and Hemorrhage: How it Can (and Should) Change Clinical Practice Rohan Dharmakumar, Ph.D. Director, Translational Cardiac Imaging Research Associate Director, Biomedical Imaging
More informationSung A Chang Department of Internal Medicine, Division of Cardiology, Sungkyunkwan University School of Medicine, Samsung Medical Center
CMR Perfusion and Viability A STICH Out of Time? Sung A Chang Department of Internal Medicine, Division of Cardiology, Sungkyunkwan University School of Medicine, Samsung Medical Center Can Imaging Improve
More informationAcute Myocardial Infarction
Acute Myocardial Infarction Hafeza Shaikh, DO, FACC, RPVI Lourdes Cardiology Services Asst.Program Director, Cardiology Fellowship Associate Professor, ROWAN-SOM Acute Myocardial Infarction Definition:
More informationCase based learning: CMR in Heart Failure
Case based learning: CMR in Heart Failure Milind Y Desai, MD FACC FAHA FESC Associate Professor of Medicine Heart and Vascular Institute, Cleveland Clinic Cleveland, OH Disclosures: none Use of Gadolinium
More informationRole of echocardiography in the assessment of ischemic heart disease 분당서울대학교병원윤연이
Role of echocardiography in the assessment of ischemic heart disease 분당서울대학교병원윤연이 Outline Evaluation of Chest pain Evaluation of MI complications Prediction of Outcomes Evaluation of Chest pain Evaluation
More informationIschemic Heart Diseases. Dr. Nabila Hamdi MD, PhD
Ischemic Heart Diseases Dr. Nabila Hamdi MD, PhD ILOs Compare and contrast the different types of angina regarding their pathogenesis, clinical manifestations and evolution. Discuss myocardial infarct,
More informationHeart failure congestive heart failure, or CHF
Heart failure Heart failure (also called congestive heart failure, or CHF) is a frequent end point of many of the conditions In the United States alone, CHF affects nearly 5 million individuals annually,
More informationMYOCARDIALINFARCTION. By: Kendra Fischer
MYOCARDIALINFARCTION By: Kendra Fischer Outline Definition Epidemiology Clinical Aspects Treatment Effects of Exercise Exercise Testing Exercise Rx Summary and Conclusions References Break it down MYOCARDIAL
More informationI have no financial disclosures
Manpreet Singh MD I have no financial disclosures Exercise Treadmill Bicycle Functional capacity assessment Well validated prognostic value Ischemic assessment ECG changes ST segments Arrhythmias Hemodynamic
More informationCardiac MRI: Clinical Application to Disease
Cardiac MRI: Clinical Application to Disease Jessi Smith, MD Cardiothoracic imaging, Indiana University Slides courtesy of Stacy Rissing, MD Outline Imaging planes Disease findings Pulse sequences used
More informationRole of CMR in heart failure and cardiomyopathy
Role of CMR in heart failure and cardiomyopathy Hajime Sakuma Department of Radiology, Mie University Late gadolinium enhancement (LGE) LGE MRI can demonstrate site of necrosis, fibrosis or deposition
More informationThe use of Cardiac CT and MRI in Clinical Practice
The use of Cardiac CT and MRI in Clinical Practice Matthew W. Martinez, MD Assistant Professor of Medicine LVPG - Lehigh Valley Heart Specialists Lehigh Valley Health Network Oct. 3, 2009 DISCLOSURE Relevant
More informationUse of Nuclear Cardiology in Myocardial Viability Assessment and Introduction to PET and PET/CT for Advanced Users
Use of Nuclear Cardiology in Myocardial Viability Assessment and Introduction to PET and PET/CT for Advanced Users February 1 5, 2011 University of Santo Tomas Hospital Angelo King A-V Auditorium Manila,
More informationIschemic Heart Disease
Ischemic Heart Disease Dr Rodney Itaki Lecturer Division of Pathology University of Papua New Guinea School of Medicine & Health Sciences Division of Pathology General Consideration Results from partial
More informationCardial MRI; Approaching the Level of Gold Standard for Viability Assessment
Cardial MRI; Approaching the Level of Gold Standard for Viability Assessment 용환석 고려대학교구로병원영상의학과 Viability Hibernating myocardium a state of myocardial hypocontractility during chronic hypoperfusion, in
More informationFunctional aspects of anatomical imaging techniques
Functional aspects of anatomical imaging techniques Nilendu Purandare Associate Professor & Consultant Radiologist Tata Memorial Centre Functional/metabolic/molecular imaging (radioisotope scanning) PET
More informationIschemic heart disease (IHD) Dr: Salah Ahmed
Ischemic heart disease (IHD) Dr: Salah Ahmed The coronaries: 1- Left anterior descending coronary artery: - supplies anterior portion of LV, anterior 2/3 of IVS - accounts for 40-50% of coronary artery
More informationQualitative and Quantitative Assessment of Perfusion
APCDE 2011 Qualitative and Quantitative Assessment of Perfusion Hyun Ju Yoon Chonnam National University Hospital Gwangju, Korea ISCHEMIC CASCADE Blood flow mismatch Perfusion defects on nuclear imaging,
More informationAdvanced Imaging MRI and CTA
Advanced Imaging MRI and CTA Who and why may benefit. Matthew W. Martinez, M.D. FACC Lehigh Valley Health Network Director, Cardiovascular Imaging Learning Objectives Review basics of CMR and CTA Review
More informationCoronary arteriography in complicated acute myocardial infarction; clinical and angiographic correlates
Coronary arteriography in complicated acute myocardial ; clinical and angiographic correlates Luis M. de la Fuente, M.D. Buenos Aires, Argentina From January 1979 to June 30, 1979, we performed coronary
More informationHeart disease remains the leading cause of morbidity and mortality in industrialized nations. It accounts for nearly 40% of all deaths in the United
Heart disease remains the leading cause of morbidity and mortality in industrialized nations. It accounts for nearly 40% of all deaths in the United States, totaling about 750,000 individuals annually
More informationImaging congestive heart failure: role of coronary computed tomography angiography (CCTA)
Imaging congestive heart failure: role of coronary computed tomography angiography (CCTA) Gianluca Pontone, MD, PhD, FESC, FSCCT Director of MR Unit Deputy Director of Cardiovascul CT Unit Clinical Cardiology
More informationCardiac MRI: Clinical Application to Disease
Cardiac MRI: Clinical Application to Disease Stacy Rissing, MD! Cardiothoracic imaging, Indiana University! Outline Imaging planes Disease findings Pulse sequences used for each indication Pathophysiology
More informationRational use of imaging for viability evaluation
EUROECHO and other imaging modalities 2011 Rational use of imaging for viability evaluation Luc A. Pierard, MD, PhD, FESC, FACC Professor of Medicine Head, Department of Cardiology, CHU Liège, Belgium
More informationCORONARY ARTERY DISEASES
CORONARY ARTERY DISEASES It has been estimated that over one third of the population eventually will die of CAD, and 20% will develop symptoms when younger than age 60 years. ANATOMY OF THE CORONARY ARTERIES
More informationDisclosures. GETTING TO THE HEART OF THE MATTER WITH MULTIMODALITY CARDIAC IMAGING Organ Review Meeting 25 September. Overview
GETTING TO THE HEART OF THE MATTER WITH MULTIMODALITY CARDIAC IMAGING Organ Review Meeting 25 September Disclosures None relevant to this presentation Mini Pakkal Assistant Professor of Radiology University
More informationAortic regurgitation. Physiopathology. Dr Pilar Tornos Hospital Vall d Hebron. Barcelona Eurovalve 2014
Aortic regurgitation. Physiopathology Dr Pilar Tornos Hospital Vall d Hebron. Barcelona Eurovalve 2014 Faculty disclosure Pilar Tornos I have no financial relationships to disclose. Acute AR Etiology:
More informationSection V. Objectives
Section V Landscape of an MI Objectives At the conclusion of this presentation the participant will be able to Outline a systematic approach to 12 lead ECG interpretation Demonstrate the process for determining
More informationCoronary heart disease (CHD)
1 Coronary heart disease (CHD) 2 Institute of Pathological Physiology Martin Vokurka mvoku@lf1.cuni.cz Winter Semester 3 CORONARY CIRCULATION AND MYOCARDIAL METABOLISM 4 Blood flow: resting: 250 ml/min
More informationImaging in Heart Failure: A Multimodality Approach. Thomas Ryan, MD
Imaging in Heart Failure: A Multimodality Approach Thomas Ryan, MD Heart Failure HFrEF HFpEF EF50% Lifetime risk 20% Prevalence 6M Americans Societal costs - $30B 50% 5-year survival 1 Systolic
More informationBEDSIDE ASSESSMENT OF PATIENTS WITH STEMI
BEDSIDE ASSESSMENT OF PATIENTS WITH STEMI Prof. Maria Dorobantu, PhD, FESC, FACC Emergency Hospital of Bucharest, Romania Presenter Disclosures There are no conflicts/ grants/ disclosures for this presentation.
More informationA case of post myocardial infarction ventricular septal rupture CHRISTOFOROS KOBOROZOS, MD
A case of post myocardial infarction ventricular septal rupture CHRISTOFOROS KOBOROZOS, MD NAVAL HOSPITAL OF ATHENS case presentation Female, 81yo Hx: diabetes mellitus, hypertension, chronic anaemia presented
More informationManaging Hypertrophic Cardiomyopathy with Imaging. Gisela C. Mueller University of Michigan Department of Radiology
Managing Hypertrophic Cardiomyopathy with Imaging Gisela C. Mueller University of Michigan Department of Radiology Disclosures Gadolinium contrast material for cardiac MRI Acronyms Afib CAD Atrial fibrillation
More informationFFR in unstable angina and after MI F
FFR in unstable angina and after MI F June-Hong Kim, MD. PhD Cardiovascular center Pusan National University Yangsan Hospital FFR tells you physiologic stenosis severity rather than anatomical stenosis
More informationImaging in Ischemic Heart Disease: Role of Cardiac MRI
Imaging in Ischemic Heart Disease: Role of Cardiac MRI Chiara Bucciarelli Ducci MD, PhD, FESC, FRCP Consultant Senior Lecturer Cardiologist Bristol Heart Institute, University of Bristol, UK Chair elect,
More informationImaging and heart failure
Imaging and heart failure Jeroen J Bax Dept of Cardiology Leiden Univ Medical Center The Netherlands Davos, feb 2013 Research grants: Medtronic, Biotronik, Boston, St Jude, BMS imaging, GE Healthcare,
More information1. LV function and remodeling. 2. Contribution of myocardial ischemia due to CAD, and
1 The clinical syndrome of heart failure in adults is commonly associated with the etiologies of ischemic and non-ischemic dilated cardiomyopathy, hypertrophic cardiomyopathy, hypertensive heart disease,
More informationAssessment of myocardial viability by cardiovascular magnetic resonance imaging
European Heart Journal (2002) 23, 602 619 doi:10.1053/euhj.2001.3038, available online at http://www.idealibrary.com on Review Article Assessment of myocardial viability by cardiovascular magnetic resonance
More informationAdult Echocardiography Examination Content Outline
Adult Echocardiography Examination Content Outline (Outline Summary) # Domain Subdomain Percentage 1 2 3 4 5 Anatomy and Physiology Pathology Clinical Care and Safety Measurement Techniques, Maneuvers,
More informationMechanisms and role of contrast echocardiography
Mechanisms and role of contrast echocardiography Seol Sang-Hoon Inje University College of Medicine, Haeundae Paik Hospital, Busan, Korea Physical Principles of Contrast Ultrasound Contrast echocardiography
More informationCardiac Pathology & Rehabilitation
Cardiac Pathology & Rehabilitation Which of the following best describes the physical activity performed in my leisure time? A. I perform vigorous physical activity 3X/week for 20 minutes each time B.
More informationLV FUNCTION ASSESSMENT: WHAT IS BEYOND EJECTION FRACTION
LV FUNCTION ASSESSMENT: WHAT IS BEYOND EJECTION FRACTION Jamilah S AlRahimi Assistant Professor, KSU-HS Consultant Noninvasive Cardiology KFCC, MNGHA-WR Introduction LV function assessment in Heart Failure:
More information12 Lead EKG Chapter 4 Worksheet
Match the following using the word bank. 1. A form of arteriosclerosis in which the thickening and hardening of the vessels walls are caused by an accumulation of fatty deposits in the innermost lining
More informationCARDIAC MRI. Cardiovascular Disease. Cardiovascular Disease. Cardiovascular Disease. Overview
CARDIAC MRI Dr Yang Faridah A. Aziz Department of Biomedical Imaging University of Malaya Medical Centre Cardiovascular Disease Diseases of the circulatory system, also called cardiovascular disease (CVD),
More informationIschemic Mitral Regurgitation
Ischemic Mitral Regurgitation 1 / 6 2 / 6 3 / 6 Ischemic Mitral Regurgitation Background Myocardial infarction (MI) can directly cause (IMR), which has been touted as an indicator of poor prognosis in
More informationCardiogenic Shock. Carlos Cafri,, MD
Cardiogenic Shock Carlos Cafri,, MD SHOCK= Inadequate Tissue Mechanisms: Perfusion Inadequate oxygen delivery Release of inflammatory mediators Further microvascular changes, compromised blood flow and
More informationPathophysiology of Cardiovascular System. Dr. Hemn Hassan Othman, PhD
Pathophysiology of Cardiovascular System Dr. Hemn Hassan Othman, PhD hemn.othman@univsul.edu.iq What is the circulatory system? The circulatory system carries blood and dissolved substances to and from
More informationAdvanced Multi-Layer Speckle Strain Permits Transmural Myocardial Function Analysis in Health and Disease:
Advanced Multi-Layer Speckle Strain Permits Transmural Myocardial Function Analysis in Health and Disease: Clinical Case Examples Jeffrey C. Hill, BS, RDCS Echocardiography Laboratory, University of Massachusetts
More informationEchocardiographic Evaluation of the Cardiomyopathies. Stephanie Coulter, MD, FACC, FASE April, 2016
Echocardiographic Evaluation of the Cardiomyopathies Stephanie Coulter, MD, FACC, FASE April, 2016 Cardiomyopathies (CMP) primary disease intrinsic to cardiac muscle Dilated CMP Hypertrophic CMP Infiltrative
More informationCHRONIC CAD DIAGNOSIS
CHRONIC CAD DIAGNOSIS Chest Pain Evaluation 1. Approach to diagnosis of CAD 2. Classification of chest pain 3. Pre-test likelihood CAD 4. Algorithm for chest pain evaluation in women 5. Indications for
More informationVentricular tachycardia and ischemia. Martin Jan Schalij Department of Cardiology Leiden University Medical Center
Ventricular tachycardia and ischemia Martin Jan Schalij Department of Cardiology Leiden University Medical Center Disclosure: Research grants from: Boston Scientific Medtronic Biotronik Sudden Cardiac
More informationOld and new insights into viability:perfusion and Perfusion Reserve
Old and new insights into viability:perfusion and Perfusion Reserve R.Senior Professor of Clinical Cardiology Consultant Cardiologist and Director of Echo,Royal Brompton Hospital,London and Northwick Park
More informationPathophysiology of Coronary Microvascular Dysfunction
Pathophysiology of Coronary Microvascular Dysfunction Cheol Woong Yu, MD, PhD Cardiology Department Division of Internal Medicine Korea University Anam Hospital. Etiologies of Chest Pain without obstructive
More informationIndex of subjects. effect on ventricular tachycardia 30 treatment with 101, 116 boosterpump 80 Brockenbrough phenomenon 55, 125
145 Index of subjects A accessory pathways 3 amiodarone 4, 5, 6, 23, 30, 97, 102 angina pectoris 4, 24, 1l0, 137, 139, 140 angulation, of cavity 73, 74 aorta aortic flow velocity 2 aortic insufficiency
More informationECG in coronary artery disease. By Sura Boonrat Central Chest Institute
ECG in coronary artery disease By Sura Boonrat Central Chest Institute EKG P wave = Atrium activation PR interval QRS = Ventricle activation T wave= repolarization J-point EKG QT interval Abnormal repolarization
More informationObjectives. Diastology: What the Radiologist Needs to Know. LV Diastolic Function: Introduction. LV Diastolic Function: Introduction
Objectives Diastology: What the Radiologist Needs to Know. Jacobo Kirsch, MD Cardiopulmonary Imaging, Section Head Division of Radiology Cleveland Clinic Florida Weston, FL To review the physiology and
More information12 Lead ECGs: Ischemia, Injury & Infarction. Kevin Handke NRP, FP-C, CCP, CMTE STEMI Coordinator Flight Paramedic
12 Lead ECGs: Ischemia, Injury & Infarction Kevin Handke NRP, FP-C, CCP, CMTE STEMI Coordinator Flight Paramedic None Disclosures Objectives Upon completion of this program the learner will be able to
More informationAcute Myocarditis Mimicking ST-segment Elevation Myocardial Infarction: Relation Between ECG Changes And Myocardial Damage As Assessed By CMR
Acute Myocarditis Mimicking ST-segment Elevation Myocardial Infarction: Relation Between ECG Changes And Myocardial Damage As Assessed By CMR G. Nucifora 1, A. Di Chiara 2, D. Miani 1, G. Piccoli 3, M.
More informationCT for Myocardial Characterization of Cardiomyopathy. Byoung Wook Choi, Yonsei University Severance Hospital, Seoul, Korea
CT for Myocardial Characterization of Cardiomyopathy Byoung Wook Choi, Yonsei University Severance Hospital, Seoul, Korea Cardiomyopathy Elliott P et al. Eur Heart J 2008;29:270-276 The European Society
More information12 Lead ECG Interpretation
12 Lead ECG Interpretation Julie Zimmerman, MSN, RN, CNS, CCRN Significant increase in mortality for every 15 minutes of delay! N Engl J Med 2007;357:1631-1638 Who should get a 12-lead ECG? Also include
More informationMyocardial infarction
CHAPTER-I CARDIOVASCULAR SYSTEM Myocardial infarction SUB: PHARMACOTHERAPEUTICS-I CODE:T0820006 Dr. Venugopal Pharm.D Assistant Professor Department of Pharm.D Kriahna Teja Pharmacy College,Tirupati. Definition
More informationCNR, G. Monasterio Foundation, Clinical Physiology Institute Pisa
CNR, G. Monasterio Foundation, Clinical Physiology Institute Pisa Stockholm Aug 29, 2010 Role of MRI in the acute Myocardial Infarction? massimo lombardi Two days after infarct (top row), the T2 hyperintense
More informationBIOCHEMICAL INVESTIGATIONS IN THE DIAGNOSTICS OF CARDIOVASCULAR DISORDERS. As. MARUSHCHAK M.I.
BIOCHEMICAL INVESTIGATIONS IN THE DIAGNOSTICS OF CARDIOVASCULAR DISORDERS As. MARUSHCHAK M.I. Heart attack symptoms Acute MI Measurement of cardiac enzyme levels Measure cardiac enzyme levels at regular
More informationMultimodality Imaging of Anomalous Left Coronary Artery from the Pulmonary
1 IMAGES IN CARDIOVASCULAR ULTRASOUND 2 3 4 Multimodality Imaging of Anomalous Left Coronary Artery from the Pulmonary Artery 5 6 7 Byung Gyu Kim, MD 1, Sung Woo Cho, MD 1, Dae Hyun Hwang, MD 2 and Jong
More informationCardiology for the Practitioner Advanced Cardiac Imaging: Worth the pretty pictures?
Keenan Research Centre Li Ka Shing Knowledge Institute Cardiology for the Practitioner Advanced Cardiac Imaging: Worth the pretty pictures? Howard Leong-Poi, MD, FRCPC Associate Professor of Medicine St.
More informationcardiac imaging planes planning basic cardiac & aortic views for MR
cardiac imaging planes planning basic cardiac & aortic views for MR Dianna M. E. Bardo, M. D. Assistant Professor of Radiology & Cardiovascular Medicine Director of Cardiac Imaging cardiac imaging planes
More informationAcute Myocardial Infarction. Willis E. Godin D.O., FACC
Acute Myocardial Infarction Willis E. Godin D.O., FACC Acute Myocardial Infarction Definition: Decreased delivery of oxygen and nutrients to the myocardium Myocardial tissue necrosis causing irreparable
More informationCardiac Ischemia (is-kē-mē-uh)
Chapter 21 Cardiac Ischemia (is-kē-mē-uh) By: Alejandra & Lindsay I. Cardiac Ischemia =the most common cause of death in Western Culture ~35% of deaths. -Suddenly from acute coronary occlusion or fibrillation
More informationTHE first objective of this thesis was to explore possible shape parameterizations
8 SUMMARY Columbus is not the only person who has discovered a new continent. So too have I. Anak Semua Bangsa (Child of All Nations) PRAMOEDYA ANANTA TOER 8.1 Myocardial wall motion modeling THE first
More informationResults of Ischemic Heart Disease
Ischemic Heart Disease: Angina and Myocardial Infarction Ischemic heart disease; syndromes causing an imbalance between myocardial oxygen demand and supply (inadequate myocardial blood flow) related to
More informationCardiovascular magnetic resonance in acute myocardial infarction
European Society of Cardiology Paris, France 2011 Session: Myocardial oedema - a new diagnostic target? Cardiovascular magnetic resonance in acute myocardial infarction Andrew E. Arai, MD National Heart,
More informationTransmural, haemorrhagic myocardial infarction. Clinical, angiographic, and necropsy findings. after intracoronary streptokinase
BrHeartj 1982; 48: 546-51 Transmural, haemorrhagic myocardial infarction after intracoronary streptokinase Clinical, angiographic, and necropsy findings DETLEF G MATHEY, JOACHIM SCHOFER, KARL-HEINZ KUCK,
More informationGd-enhanced cardiovascular MR imaging to identify left ventricular pseudoaneurysm
Journal of Cardiovascular Magnetic Resonance (2005) 7, 717 721 Copyright D 2005 Taylor & Francis Inc. ISSN: 1097-6647 print / 1532-429X online DOI: 10.1081/JCMR-200065641 CASE REPORT Gd-enhanced cardiovascular
More informationNon Invasive Diagnostic Modalities for Coronary Artery Disease. Dr. Amitesh Aggarwal
Non Invasive Diagnostic Modalities for Coronary Artery Disease Dr. Amitesh Aggarwal Ebers papyrus, ca. 1555 BCE If thou examine a man for illness in his cardia, and he has pains in his arms, in his breasts
More informationCase Report. Case Report. Ana Lúcia Martins Arruda, Altamiro Ozório, Eloisa Mattos, José Lázaro de Andrade, Thomas Porter, Wilson Mathias Jr
Case Report Hypoperfusion of the Left Ventricle in the Absence of Changes in Segmental Contractility as Observed through Echocardiography by Using Microbubbles During Dobutamine Infusion Ana Lúcia Martins
More informationCoronary Artery Anomalies from Birth to Adulthood; the Role of CT Coronary Angiography in Sudden Cardiac Death Screening
Coronary Artery Anomalies from Birth to Adulthood; the Role of CT Coronary Angiography in Sudden Cardiac Death Screening E O Dwyer 1, C O Brien 1, B Loo 1, A Snow Hogan 1, O Buckley1 2, B 1. Department
More information