Elias B. Hanna

Practical Cardiovascular Medicine


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...Figure 1.7 Duration of dual antiplatelet therapy (DAPT) according to ACC gui...Figure 1.8 Antiplatelet therapy after PCI in patients who also require antic...Figure 1.9 The concentric and eccentric lesions with smooth borders are pred...Figure 1.10 NSTEMI in a healthy 47-year-old woman. Chest pain started during...

      2 Chapter 2Figure 2.1 Phases of STEMI.Phase 3 does not imply that MI has already been...Figure 2.2 The patient presents with chest discomfort that has lasted 3 hour...Figure 2.3 Fibrinolysis cascade and mechanism of action of fibrinolytics. Fi...Figure 2.4 The timing of PCI in relation to thrombolysis in the pharmacoinva...Figure 2.5, Stages of negative LV remodeling post-MI, also called infarct ex...Figure 2.6 Dynamic left ventricular outflow tract obstruction in apical infa...Figure 2.7 LV aneurysm and LV pseudoaneurysm.In comparison with the normal...

      3 Chapter 3Figure 3.1 Clinical probability of CAD.Figure 3.2 Proposed diagnostic approach to chronic chest pain. Note that CTA...

      4 Chapter 4Figure 4.1 Diagnosis of HFpEF by catheterization, echo, or BNP features, acc...Figure 4.2 Diagnosis of HFpEF in subtle cases of dyspnea with no overt conge...Figure 4.3 Change of LV filling pattern between compensated and decompensate...Figure 4.4 (Top) The worsening of a resting defect is indicative of ischemia...Figure 4.5 Case of chronic HF with LV dilatation and mild increase in PCWP....Figure 4.6 Diuretic response in a normal individual and in HF. Note that no ...Figure 4.7 Hemodynamic decompensation starts several weeks before clinical d...Figure 4.8 Effect of HF on renal blood flow and GFR. Renal blood flow is aff...Figure 4.9 Mechanisms through which diuresis and inotropes initiate a benefi...Figure 4.10 Septal motion and LV-RV interdependence in various disease state...

      5 Chapter 5Figure 5.1 Diagnosis of amyloid cardiomyopathy. If both tests are positive, ...Figure 5.2 Simultaneous LA and LV pressure recordings in diastole. Normal...Figure 5.3 Cardiac output–preload relationship (Frank–Starling curve = lengt...Figure 5.4 Force (afterload)- velocity relationship. The failing LV is exqui...Figure 5.5 Compliance curve, i.e., pressure–volume relationship in diastole....Figure 5.6 Important HF figure, showing a diastolic superimposition of the F...Figure 5.7 Pressure-volume loops Normal individuals, with pressure–volume...

      6 Chapter 6Figure 6.1 (a) Illustration of a horizontal cut across the mitral plane on t...Figure 6.2 Carpentier’s classification of the mechanisms of mitral regurgita...Figure 6.3 Mitral valve prolapse. The long-axis view defines prolapse, while...Figure 6.4 Illustration of ischemic MR on longitudinal views. (a) Normal val...Figure 6.5 (a) Horizontal cut across the mitral valve. Normal structure of t...Figure 6.6 Atrial functional MR vs LV functional MR. In atrial functional MR...Figure 6.7 Difference in V wave and LV diastolic pressure between (1) chroni...Figure 6.8 Unlike (a), the chordae are tied to the mitral annulus before imp...Figure 6.9 Difference between rheumatic MS and MAC MS. In rheumatic MS, the ...Figure 6.10 (a) Long-axis view in diastole. See the hockeystick shape of the...Figure 6.11 Two examples of mitral stenosis with a diastolic pressure gradie...Figure 6.12 False impression of MS resulting from the use of PCWP as a surro...Figure 6.13 Illustration of the difference between rheumatic MS and MAC-MS. ...Figure 6.14 β-blockers slow the heart rate and allow more LA emptying, which...Figure 6.15 Aortic leaflets and their relation to the ascending aorta. A nor...Figure 6.16 1. In acute AI, LV volume is normal and the regurgitant volume l...Figure 6.17 (a) Difference in aortic orifice shape between the tricuspid and...Figure 6.18 Left image- Axial cut of the LVOT, which is elliptical rather th...Figure 6.19 Peak-to-peak gradient is the difference between the two peaks (h...Figure 6.20 Pressure recovery phenomenon. Pressure (potential or static ener...Figure 6.21 TAVR valves and relation to the coronary ostia. TAVR valves cons...Figure 6.22 Normal tricuspid anatomy as viewed from the RA (surgeon’s view)...Figure 6.23 The tricuspid valve is normally oval-shaped in a horizontal plan...Figure 6.24 Repair of functional TR:(i) Kay bicuspidization: plication of ...Figure 6.25 Prosthetic valves. Surgical bioprostheses typically contain meta...Figure 6.26 Left image- Bioprosthetic valve as seen on fluoroscopy. The ring...Figure 6.27 Choice of a mechanical prosthesis vs. bioprosthesis vs TAVR, acc...Figure 6.28 Figure 6.29 Figure 6.30 Figure 6.31

      7 Chapter 7Figure 7.1 (a) Asymmetric septal hypertrophy with increased velocity across ...Figure 7.2 Parasternal long-axis view of a patient with HOCM, showing SAM of...Figure 7.3 M-mode of SAM. The star corresponds to the gap between the anteri...Figure 7.4 HOCM hemodynamics.Note the early aortic pressure peaking (blue ...Figure 7.5 Brockenbrough phenomenon after a premature beat in HOCM. Note the...Figure 7.6 LVOT velocity in HOCM: late-peaking dagger-shape LVOT velocity (a...Figure 7.7 In the elderly, elongation of the aorta sharpens the angle betwee...

      8 Chapter 8Figure 8.1 Approach to narrow QRS complex tachycardias.Figure 8.2 Narrow complex tachycardia, regular, rate ~200 bpm. Differential ...Figure 8.3 Explanation of how a wide QRS complex (aberrancy) may occur with ...Figure 8.4 There are two types of SVT with pre-excitation, i.e., SVT with an...Figure 8.5 Difference in QRS morphology between bundle branch block and VT. ...Figure 8.6 QRS morphology when VT originates in the posterior wall or the ap...Figure 8.7 Differences in morphology between SVT with aberrancy and VT. SVT ...Figure 8.8 Run of wide complex tachycardia on a telemetry strip: is it VT or...Figure 8.9 Wide complex tachycardia: VT or SVT? Look for P waves, i.e., l...Figure 8.10 Two short tachycardia runs. The tachycardia starts after a regul...Figure 8.11 Wide complex, regular tachycardia, at a rate of ~135 bpm. QRS lo...Figure 8.12 The baseline rhythm is sinus, consisting of QRS complexes (R) pr...Figure 8.13 Very wide QRS complex tachycardia (particularly wide in lead I, ...Figure 8.14 Short RP narrow complex tachycardia, initially suggestive of AVN...Figure 8.15 Two types of QRS complexes are seen: (1) narrow complexes preced...Figure 8.16 Again, two types of QRS complexes are seen: (1) narrow complexes...Figure 8.17 Alternation between wide and narrow QRS complexes. Both QRS comp...Figure 8.18 A run of wide complex tachycardia. It is irregular, but this doe...Figure 8.19 Regular wide complex tachycardia, QRS width ~180 ms (lead II)....Figure 8.20 Wide complex tachycardia, regular, at a rate of ~155 bpm. The QR...Figure 8.21 This is the baseline ECG of the patient in Figure 8.20. It shows...Figure 8.22 Wide complex tachycardia on telemetry or Holter monitoring. Is i...Figure 8.23 Run of wide complex tachycardia. Is it VT or SVT? Look at how...Figure 8.24 The baseline rhythm is AF and the baseline QRS is marked by line...Figure 8.25 Baseline sinus rhythm with LBBB morphology. Two runs of wide com...

      9 Chapter 9Figure 9.1 Wide premature complexes