Elias B. Hanna

Practical Cardiovascular Medicine


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16Figure 16.1 Action potential of atrial and ventricular myocardium. Phase 0 c...Figure 16.2 Action potential of the SA and AV nodes is characterized by a sp...Figure 16.3 Illustration of reentry as a mechanism of tachyarrhythmia. In or...Figure 16.4 Slowing the conduction across the reentrant cycle reduces the ar...Figure 16.5 Termination of reentrant arrhythmias. The dashed arrows represen...Figure 16.6 VF initiated by R-on-T phenomenon. In a patient with myocardial ...Figure 16.7 Once the EAD (early afterdepolarization) or DAD (delayed afterde...Figure 16.8 Narrow complex tachycardia. A wide complex is seen, likely PVC o...

      17 Chapter 17Figure 17.1 Simultaneous pericardial and RA pressures are recorded in tampon...Figure 17.2 Pulsus paradoxus. Note the drop of systolic and pulse pressure d...Figure 17.3 The normal pericardial pressure is negative and reaches 0 mmHg a...Figure 17.4 General approach to a large, asymptomatic pericardial effusion....Figure 17.5 Heart surfaces in relation to the subxiphoid pericardiocentesis,...Figure 17.6 Various echo views showing the various heart surfaces in a patie...Figure 17.7 Simultaneous RA and LV pressure recordings in constrictive peric...Figure 17.8 Sequence of events occurring during inspiration in constrictive ...Figure 17.9 Simultaneous RV and LV pressure tracings in two different patien...Figure 17.10 Respiratory variations of hepatic venous flow velocities. S flo...Figure 17.11 Hepatic vein Doppler in constrictive pericarditis, with respiro...Figure 17.12 Septal M mode in a patient with constrictive pericarditis. Note...Figure 17.13 Simultaneous LV-RV recordings in a 61-year-old man with no past...

      18 Chapter 18Figure 18.1 Interatrial septum. Embryologically, blood coming from the IVC i...Figure 18.2 Bicaval TEE view showing a PFO between the septum primum (thin, ...Figure 18.3 Types of ASD. Secundum ASD results from excessive involution of ...Figure 18.4 En face view of the interatrial septum. Occasionally, both a PFO...Figure 18.5 Goose-neck deformity of the LVOT in primum ASD.Figure 18.6 Interatrial septum viewed from the side. Various rims are identi...Figure 18.7 Anatomic and echocardiographic localization of VSD. The membrano...Figure 18.8 Gerbode defect on an apical five-chamber view. Perimembranous VS...Figure 18.9 Anatomy in normal patients and in tetralogy of Falllot. In tetra...Figure 18.10 Radiographic cardiac and mediastinal silhouettes in various con...Figure 18.11 CXR in tetralogy with and without right-sided aortic archFigure 18.12 Tricuspid atresia and Fontan procedure (top 2 rows). Hypoplasti...Figure 18.13 D-TGA is characterized by RV–aorta on the right, while l-TGA is...Figure 18.14 Normally, the aorta is more posterior than the PA and to the ri...

      19 Chapter 19Figure 19.1 (a) The peripheral arterial pressure has three phases (1, 2, 3)....Figure 19.2 Three-year patency of percutaneous therapy and 5-year patency of...Figure 19.3 Aortobifemoral bypass grafting.Figure 19.4 (a) SFA is totally occluded all the way from the ostium to the p...Figure 19.5 In the ECST method, the stenosis is measured in reference to the...Figure 19.6 Compare the right and left kidneys. Note the right renal atrophy...

      20 Chapter 20Figure 20.1 In acute aortic dissection, the false lumen (F) is tense with sl...Figure 20.2 Chest X-ray in aortic dissection or dilatation.Figure 20.3 (a) Widening of aortic knob (arrow) indicative of descending aor...Figure 20.4 Axial cut across aortic dissection. True lumen (T) and false lum...Figure 20.5 Mechanisms of aortic insufficiency (AI) with aortic dissection: ...Figure 20.6 Descending aortic dissection with false lumen extending into the...Figure 20.7 Various aortic measurements. The annulus is a stable structure t...Figure 20.8 Pitfalls of aortic measurements by axial CT and TEE. On TEE or T...Figure 20.9 Ascending aortic repair with valve sparing (top) and with compos...Figure 20.10 Throracoabdominal endograft covering the renal arteries, celiac...Figure 20.11 Debranching of the brachiocephalic vessels followed by antegrad...

      21 Chapter 21Figure 21.1 Algorithm for the diagnosis of pulmonary embolism*Most hospita...Figure 21.2 (a) Massive bilateral PEs in the proximal right and left pulmona...

      22 Chapter 22Figure 22.1 Aggressive early therapy of septic shock (the first 3 hours). Ea...Figure 22.2 General approach to cardiogenic shock. Right heart catheterizati...Figure 22.3 Relationship between stroke volume and CVP. A true Frank–Starlin...

      23 Chapter 23Figure 23.1 Effect of ACE-I/ARB on the renal flow and renal function. Angiot...Figure 23.2 Autoregulation curve. Autoregulation of microvascular (mainly ar...

      24 Chapter 25Figure 25.1 Diagnostic approach to distinguish between precapillary PH (pulm...Figure 25.2 Treatment algorithm for patients with PAH. Connective tissue dis...Figure 25.3

      25 Chapter 26Figure 26.1 Management of syncope. Also, consider severe hypovolemia, bleedi...Figure 26.2 Rhythm monitoring in a 63-year-old patient with episodic prolong...Figure 26.3 Episode of complete AV block on loop recorder, with 3 non-conduc...

      26 Chapter 27Figure 27.1 Quick rule-in and rule-out algorithm using hs-troponin (in ng/L,...

      27 Chapter 28Figure 28.1 Aortic or mitral endocarditis can extend into the valvular annul...Figure 28.2 The AV node, and particularly the His bundle coming off the AV n...Figure 28.3 (a) Duration of antibiotic therapy in patients with device infec...

      28 Chapter 30Figure 30.2 (a) Normal posteroanterior chest X-ray. Note that the RV does no...Figure 30.3 Chest X-ray in HF. (1) Cephalization and vessel extension to the...Figure 30.4 Various morphologies of cardiomegaly. LA enlargement is characte...Figure 30.5 The same X-ray is shown (a) without and (b) with annotations. Pr...Figure 30.6 Lateral chest X-ray. Note that the LA shadow is surrounded by th...

      29 Chapter 31Figure 31.1 P–QRS–T complex. P wave represents the atrial depolarization and...Figure 31.2 Arrows show the spread of the electrical depolarization. Ventric...Figure 31.3 Illustration of how the electrical depolarization spreads in the...Figure 31.4 Illustration of how electrical depolarization spreads in the hea...Figure 31.5 Illustration of how electrical depolarization spreads in the hea...Figure 31.6 Frontal view of the precordial leads. Normally, R wave progressi...Figure 31.7 Regular QRS rhythm with a P wave before each QRS complex: sinus ...Figure 31.8 Irregular tachycardia with no repetition of any R–R pattern. No ...Figure 31.9 Narrow complex tachycardia with a pseudo-r’ in lead V1 that repr...Figure 31.10 Wide complex tachycardia: VT vs. SVT with bundle branch block. ...Figure 31.11 Bradycardia with regular P waves and regular QRS complexes, unr...Figure 31.12 Severe bradycardia with regular P waves and regular QRS complex...Figure 31.13 Irregularity with a pattern. Wide premature complexes with ST–T...Figure 31.14 Atrial flutter with variable conduction (3:1, 4:1). The sawtoot...Figure 31.15 There are two groups of beats followed by pauses (asterisks), w...Figure 31.16 Start by looking at leads I and aVF. If QRS is negative in lead...Figure 31.17 Poor R-wave progression probably secondary to LVH with a sudden...Figure 31.18 Normal and abnormal RA and LA deflections. Atrial depolarizatio...Figure 31.19 Right atrial enlargement and left atrial enlargement. Reproduce...Figure 31.20 LVH with secondary ST–T depression in the left lateral leads, d...Figure 31.21 QRS is (–) in lead I and (+) in lead aVF, implying a right-axis...Figure 31.22 In RBBB, the vector of depolarization spreads from the left sep...Figure 31.23 RBBB. rSR’ is seen in V1, notched R wave is seen in V2, and rsR...Figure 31.24 Sinus tachycardia with RBBB (rSR’ in V1–V2, wide and slurred S ...Figure 31.25 LBBB. In the lateral leads, there may be an “M-shaped” R wave (...Figure 31.26 LBBB (slurred R wave in the left leads: V5–V6 and I–aVL) (arrow...Figure 31.27 WPW with short PR segment and slurred R wave. The upslope of R ...Figure 31.28 In LAFB, the vector of depolarization spreads from the posterio...Figure 31.29 LAFB + RBBB. QRS is wide > 120 ms with rSR’ in V1 and a wide...Figure 31.30 RBBB + LPFB. Since QRS is wide > 120 ms, look in V1 and in V6 t...Figure 31.31 (a) Electrical alternans. Note the alternation between two main...Figure 31.32 Wide Q wave (QS or QR) may be normally seen in lead III of a ho...Figure 31.33 Examples of an abnormal Q wave. (a) ECG shows minimal ST elevat...Figure 31.34 Inferior Q waves and anterolateral QS waves (QS waves are wide ...Figure 31.35 QS pattern is seen in leads V1–V2, small R wave is seen in lead...Figure 31.36 In expiration, Q wave is wide and deep in leads III and aVF (ar...Figure 31.37 ST-segment and T-wave morphologies in cases of (a) secondary ab...Figure 31.38 Example of left ventricular hypertrophy