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This publication examines the special characteristics of the pathophysiology of coronary artery disease (CAD) and its clinical presentation in women, which differ from those of men. While coronary obstruction and multi-vessel disease are more common in men, non-ischemic heart disease (IHD) best encompasses the spectrum of the disease in women. The publication provides a critical review of the existing literature, covering some general aspects of the disease as well as how to make a diagnosis/prognosis of IHD, both clinical and by means of cardiac imaging. The specific situation of cardiac imaging in the management of IHD in low- or middle- income countries is surveyed. In addition, reference is made to cardiotoxicity and radiotherapy-induced disease in breast cancer.

The current book on “Coronary Artery Disease” is topical and all encompassing. From Metabolic Syndrome to Renal Disease and from Hypertension to Lifestyle Intervention, it covers the relevant topics with assurance and adds significantly to current scientific knowledge. The text has a spectrum of International authorship which gives a bird's eye view of heart disease world over.

On average, 50% of all heart attacks are silent – that is, they are painless and leave behind damage that remains undetected – unless the patient and his or her doctor are looking for it. Silent heart disease is a significant cause of sudden death – American's number one public health problem with more than 600,000 sudden deaths and 1.5 million heart attacks occurring in the U.S. each year.This book tells you everything you need to know in the order to detect and treat this silent killer. Written by a celebrated cardiologist who has successfully treated thousands of patients in his career spanning 50 years, it offers practical advice for all readers and provides insight into a type of asymptomatic cardiac condition that affects almost half of all those afflicted with heart disease.

Atrial fibrillation is a common supraventricular arrhythmia characterized by rapid and irregular atrial activation without a clear P-wave on an electrocardiogram. New Research on Atrial Fibrillation and Ischemic Heart Disease begins by discussing the risk factors, symptoms, and treatment of atrial fibrillation. Following this, the authors review the recently established relationship of atrial fibrillation with endurance sports activities in middle-aged athletes, connecting findings from various evidence in order to investigate this phenomenon since the pathophysiology of atrial fibrillation in middle-aged athletes is still unclear. Also explored are the associations between cerebrovascular risk factors and abnormal carotid and transcranial Doppler sonography and brain magnetic resonance imaging findings in individuals aged between 44 and 71 years without preceding neurological and psychiatric disorders. The association between perceived occupational noise exposure and hypertension among hospital nurses is examined, as hospital noise pollution is increasing worldwide. The concluding study aims to update and extend the existing burden of disease calculations by the WHO for road traffic noise-attributed myocardial infarction and stroke. All analyses were limited to 24 European countries and the year 2012.

This book provides an overview of the etiology of coronary artery disease and focuses on the main therapies and drug interventions currently available. It highlights drug pharmacology and therapeutic challenges, with a special emphasis on the underlying principles of available therapeutics and the on-going development of drugs for coronary artery disease.The book is divided into eight chapters, the first of which describes the classical mechanism of coronary artery disease and its clinical presentations. Chapter 2 lists the principles of and related evidence on the prevention and treatment of coronary artery disease. This includes diet and lifestyle management, and guidelines for the treatment of acute coronary syndrome and stable coronary artery disease. In turn, Chapter 3 describes revascularization treatments, covering percutaneous coronary interventions, coronary artery bypass grafts and thrombolysis. This chapter also addresses the main therapeutic challenges.The following chapters provide an overview of three major categories of coronary artery disease drugs, which target thrombosis (Chapter 4), lipid metabolism (Chapter 5), and hypertension (Chapter 6). Heart failure constitutes the major health burden in the late stage of coronary artery disease; accordingly, current heart failure therapeutics and related drug pharmacology are described in Chapter 7. In closing, Chapter 8 provides a summary of on-going clinical trials for coronary artery disease drug development and discusses a number of promising areas in which intensive research into new therapeutics is being pursued.Given its scope, the book will be of interest to clinicians, medical students and research scientists, as well as to pharmaceutical professionals who are seeking new therapies and drugs for coronary artery disease and related disorders.

In this concise but authoritative book, the authors take the reader through the epidemiology, risk factors and the basic mechanism of coronary artery disease. In addition, they explain how coronary microvascular dysfunction can lead to angina, even after successful angioplasty following a heart attack. The methods for diagnosis and the options for treatment are explained, ending with a discussion of the evolution of coronary angioplasty from balloon catheters to novel, fully resorbable polymeric drug eluting stents. Enclosed is a list of currently available commercial devices, as well as a listing of experimental products under research and development, so that readers can appreciate the serious nature of this disease and have an understanding of how the medical device sector is attempting to address this major healthcare problem. Globally in 2010, ischemic heart disease was the cause of 13.3% of all deaths. In the US alone, the direct medical costs from coronary artery disease andstroke are currently estimated to be $126 billion per year, and are expected to rise to $309 billion by 2035.

Coronary Artery Disease: From Biology to Clinical Practice links the most important basic concepts of atherosclerosis pathophysiology to treatment management of coronary artery disease. Comprehensive coverage starts with the basic pathophysiologic mechanisms of the disease, including molecular and genetic mechanisms, cells interaction and inflammation. In addition, sections on novel anti-atherosclerotic therapies and a thorough understanding of the recent trends in clinical management round out this comprehensive tome that is ideal for practitioners and researchers. By summarizing this novel knowledge and changes in diagnostic algorithm and treatment options, this is the perfect reference for cardiology researchers who want a volume with the most up-to-date experimental trends in the field of atherosclerosis, for cardiologists and physicians who manage patients with atherosclerotic risk factors and established coronary artery disease, and medical students who want to learn the basic concepts of atherosclerosis. - Delivers a comprehensive connection between basic pathophysiologic mechanisms and the clinical context of coronary artery disease - Provides a focus on the most important novel evidence in the management of atherosclerosis and coronary artery disease - Includes sum-up tables at the end of each chapter and clinical scenarios that focus on diagnosis and treatment - Conveys an understanding of upcoming, novel, experimental and clinical treatments

This book discusses the benefits of application of different psychotherapy techniques, in addition to optimal medical approaches, in patients with ischemic heart disease. It explains the theoretical basis for use of these techniques, discusses the scientific evidence for their efficacy, and identifies important practical issues. Detailed attention is devoted to both well-established and recently developed approaches of proven value, as well as to future applications. In addition, practical insights are provided into the most effective ways of integrating psychotherapy with medical activities in hospitals, outpatient clinics, and rehabilitation centers. The authors are world experts in the fields of psychotherapy, pharmacology, and cardiology, who collectively provide a sound foundation for an interdisciplinary approach to patients with ischemic heart disease. Psychotherapy for Ischemic Heart Disease is both a textbook and a practical manual aimed particularly at cardiologists, psychologists, psychotherapists, and psychiatrists, but also internal medicine specialists, cardiac surgeons, general practitioners, rehabilitation doctors, students, nurses, and patients.

Acute Coronary Syndrome: Urgent and Follow-up Care is a must-read for all those involved in the care of ACS, including EMS, nurses, advanced practice providers as well as physicians. This book not only reviews the causes of ACS, but also provides evidence-based acute and follow-up treatment recommendations that incorporate the perspectives of all those involved in the care of these patients. Epidemiology, pathophysiology, and outcomes of acute coronary syndromes The role of EMS in the triage of the ACS patient Evaluation and treatment of the ACS patient in the emergency department Pharmacologic management of the ACS patient Follow-up care of the ACS patient The role of the team in carrying out successful guideline-driven care

This title discusses the magnitude of the problem of angina pectoris. The author also goes on to describe the characteristics and clinical profile of patients with angina in a contemporary population. The different types and multiple mechanisms of angina pectoris are described, while the clinical presentation, typical and atypical features and complications (MI, HF) and clinical management and outcomes are evaluated. The author also evaluates the various antianginal therapies used in special populations: the elderly, post revascularised patients, patients with LVSD or HF, patients with CKD, patients with diabetes.

This book covers ACS and Heart Failure, the chapters represent the most current, up to date and knowledgeable content on the topic available. It is written by the worlds most respected leaders in biomarkers, with a majority emphasis on what clinicians need to know.The Editors and their contributors have provided algorithms, annotated case discussions and caveats. They cover biomarkers to predict risk of heart disease, biomarkers of cardiorenal disease, and conclude with a section on new and emerging biomarkers. It be genuinely helpful and practical to those in the field, including not just people working in the field, but nurses, doctors, etc who practice medicine in the clinic, the emergency department and the hospital.​

Coronary artery disease continues to be a major cause of morbidity and mortality in the United States and throughout the world. This issue of the Heart Failure Clinics provides a contemporary and concise, yet extensive, review on all aspects of the management of patients with coronary artery disease. Topics include but are not limited to: Epidemiology, Traditional and Novel Risk Factors in Coronary Artery Disease; Acute Coronary Syndromes: Unstable Angina and Non–ST Elevation Myocardial Infarction; Calcium Scoring and Cardiac Computed Tomography; Coronary Artery Disease and Diabetes Mellitus; Cardiac Syndrome X; and Revascularization Options: Coronary Artery Bypass Surgery and Percutaneous Coronary Intervention.

Coronary artery bypass surgery has been developed since 1960s to overcome proximal coronary artery disease. Worldwide, the number of patients that are undergoing coronary artery bypass surgery is steadily increasing. Depending on diverse risk factors, one fifth of grafts are occluded at 1 year. For the remaining, graft patency last usually 8–15 years. This book brings together the main specialists in the field to review the current evidence on epidemiology, pathophysiology, diagnostic, new imaging techniques and specific therapeutic modalities. This volume aims to update a complex subject represented by coronary graft failure. The authors of this monograph are interventional cardiologists, cardiovascular surgeons and research scientists, who will be creating four parts and 71 chapters that are divided in order to give a uniform interpretation of this condition including all aspects of coronary graft failure This book not only provides the most up-to-dated scientific evidence in the field but in a two-step manner. Each chapter is divided into a at a glance part that reflects the basic evidence on the topic, and a “full picture” part that brings all what the advanced reader should be brought with.

This issue of Cardiac Electrophysiology Clinics, edited by Drs. Mohammad Shenasa and Stanley Nattel, will review Cardiac Potassium Channel Disorders in depth. Topics covered include but are not limited to: Molecular Biology of Cardiac Potassium Channels; Genetic Control of Potassium Channels; Potassium Channel Remodeling in Heart Disease; Gender-specific Effects of Potassium Channel Blockers; Pharmacogenetics of Potassium Channel Blockers; Multichannel Blockers; Selective Potassium Channel Blockers; and Proarrhythmic and Torsadogenic Effects of Potassium Channel Blockers in Patients.

In der vorliegenden Arbeit wurde 1) die Rolle des mitochondrialen STAT3 und der Mitochondrienfunktion bei dem Schutz durch PoCo und 2) der Einfluss von CsA auf die Phosphorylierung von kardioprotektiven Proteinen und auf die Mitochondrienfunktion in einem klinisch relevanten Tiermodell, dem Schwein mit regionaler Ischämie und Reperfusion, untersucht.Ischämische Postkonditionierung (PoCo), mehrere Zyklen von Ischämie/Reperfusion oder eine Cyclosporin A (CsA)-Infusion vor/zu Beginn der Reperfusion verringern die Infarktgröße am Herzen.PoCo reduzierte die Infarktgröße, erhöhte die STAT3-Phosphorylierung am Tyrosin705 in Myokardbiopsien und in isolierten Mitochondrien, verbessert die mitochondriale Komplex I Respiration und die Calcium-Retentionskapazität (CRC). Die STAT3-Blockade hob alle Effekte von PoCo auf. CsA reduzierte die Infarktgröße; die Proteinphosphorylierung und die Komplex I Respiration war vergleichbar mit der Kontrolle und die CRC erhöht.Die Ergebnisse dieser Arbeit weisen auf eine kausale Beteiligung der mitochondrialen STAT3-Aktivierung bei der Vermittlung der Kardioprotektion durch PoCo über eine verbesserte Mitochondrienfunktion hin. Der Schutz durch CsA wird über eine Hemmung der mitochondrialen Permeabilitäts-Transitions-Pore und nicht über eine besser erhaltene Proteinphosphorylierung vermittelt.

Die Diagnose koronare Herzkrankheit wirft für den Patienten und dessen Angehörige viele Fragen auf: Welche Eingriffe wie z.B. Stenting oder Bypass Operation sind notwendig? Wie wirken die verschiedenen Medikamente? Wie verläuft die R'ehabilitation? Die Autoren wollen Betroffene auf Schutzfaktoren aufmerksam machen, die das Fortschreiten der Erkrankung verhindern können, und sie zu einem gesunden Lebensstil motivieren.

Cardiovascular Medicine: Coronary Artery Disease will offer today's most up-to-date, user-friendly guidance on the evaluation, diagnosis, and medical and surgical treatment of this most important aspect of cardiovascular disease and will be on the wish list for every trainee and practicising cardiologist, cardiac surgeon, vascular surgeon, diabetologist, cardiac radiologist and any physician who manages cardiac patients. The book is dedicated to providing comprehensive coverage of every aspect of coronary arterial medicine from cardiac signs and symptoms through imaging and the genetic basis for coronary disease to surgery, interventions, treatment and also to preventive cardiology. The Editor – and a group of contributing world authorities – offer their decades of scientific and clinical experience. A major selling point is the consistent chapter organization, clear design, and engaging text that includes user-friendly features such as tables, lists and treatment boxes. The readerwill have all the guidance to diagnose and manage a full range of conditions in a series of textbook resources, while also having access to additional video material from the integral website.

Make optimal use of the latest coronary stenting techniques and adjunctive devices with well-rounded guidance from Coronary Stenting, a companion volume to Dr. Topol's Textbook of Interventional Cardiology. This comprehensive, up-to-date interventional cardiology book keeps you abreast of the latest trial data on efficacy and safety as well as cutting-edge clinical applications in coronary stenting. - Achieve optimal outcomes and minimize complications with expert guidance from the foremost teachers and writers in the field of interventional cardiology. - Implement the latest knowledge on cutting-edge topics such as drug-eluting stent design; appropriate interpretation of randomized clinical trials and comparative effectiveness studies of coronary stents; the use of fractional flow reserve, intravascular ultrasound and optical coherence tomography to optimize lesion selection and stent implantation; anterograde and retrograde approaches to chronic total occlusions; and percutaneous revascularization of diabetics and patients with left main or multivessel disease. - Quickly and easily find the coronary stenting information you need thanks to highly templated chapters and high-quality full-color illustrations that incorporate the latest clinical trial data into recommendations for proper patient and device selection.

Coronary artery disease is the number one killer in the United States, affecting more than 13 million Americans each year. This issue of Cardiology Clinics comprehensively examines the epidemiology, traditional and novel risk factors, and management of coronary artery syndromes; invasive and noninvasive testing; CT angiography; medically refractory angina; diabetes and coronary artery disease, revascularization options, and Syndrome X.

All patients arriving at hospital with chest pain suggestive of myocardial ischemia require an immediate 12-lead ECG and medical assessment. Management will depend on the type of acute coronary syndrome (ACS) diagnosed.'Fast Facts: Acute Coronary Syndromes'is an international evidence-based primer that focuses on optimizing patient outcomes via accurate initial diagnosis, appropriate risk stratification and proper therapeutic decision-making in line with both American and European management guidelines. This refreshingly readable handbook simplifies the complexities involved in the care of patients with ACS by: • Familiarizing readers with the common pathophysiology underlying all ACS • Detailing the specifics of clinical assessment (targeted history, symptom-oriented physical exam, electrocardiography, cardiac biomarkers and imaging) • Assisting best practice in ischemic risk stratification and assessment of bleeding risk • Outlining coronary revascularization techniques, reperfusion strategies and preventive measures • Providing an update on potent antithrombotic therapy (antiplatelet agents and anticoagulants) • Clearly explaining the latest developments that are likely to be implemented in the near future. In this fast-changing field it is difficult for healthcare professionals to remain current and virtually impossible to fully understand all of the subtle nuances of the available clinical trial data. This comprehensive handbook is therefore the essential resource for all healthcare professionals looking for up-to-date, easy-to read information that will assist best practice in the identification and management of all patients with ACS. Contents: • Pathophysiology • Diagnosis • Risk stratification and decision-making • Coronary revascularization • Unstable angina/non-ST-segment elevation myocardial infarction • ST-segment elevation myocardial infarction • Secondary prevention of coronary artery disease • Developments • Useful resources

Atherothrombosis refers to the coupling of atherosclerosis and thrombosis, and it is the leading cause of the majority of preventable deaths in the modern world. The medical, economic, social, and societal consequences or atherothrombosis are enormous, which make it a dynamic area for development of new pharmacologic agents. Atherothrombosis in Clinical Practice focuses upon the many clinical manifestations of atherothrombosis and therapies that presently exist, with a focus on evolving therapeutic approaches. First, atherothrombosis is defined and the epidemiology is explored. Then, the specific manifestations of atherothrombosis (coronary artery disease, valvular heart disease, cerebrovascular disease, atrial fibrillation, peripheral artery disease) are concisely covered by distinguished experts in the field. Next, specific medications are discussed, with an emphasis on innovative therapies and investigational agents including experimental lipid-modifying, anti-inflammatory, antiplatelet, and anticoagulant agents. State-of-the-art treatment of hypertension and diabetes is described succinctly. Lifestyle modification, medical therapies, and where appropriate, invasive modalities are discussed. Controversies in areas such as cholesterol management and glycemic control are summarized. Part of the Oxford American Cardiology Library, this handbook provides a practical, evidence-based summary of the condition and the most up-to-date research to equip clinicians in managing this common clinical problem.

Cardiovascular pharmacotherapy is a fast-moving and complex discipline within cardiology in general. New studies, trials and indications are appearing on a regular basis. This series, and this particular title within the series, is designed to establish the baseline level of knowledge that a cardiovascular professional needs to know on a day-to-day basis. The information within is designed to allow readers to learn quickly and with certainty the mode of action, the possible adverse effects, and the management of patients prescribed these drugs. The emphasis is on current practice, but with an eye to the near-future direction of treatment. This book is intended to update clinicians on recent data on the medical management of patients with Acute Coronary Syndromes. Alongside each book in the series, this title has been established to allow rapid publication of new editions to cover developments in the field.

In the last decade there has been a growing interest in the study of the interactions between the heart and the brain, especially in the field of cerebral ischemia. The interactions between cardiovascular and cerebrovascular diseases are of relevance not only for research investigation, but also for clinical implications in the daily clinical practice. i.e. A wealth of information has been gathered particularly on three topics, cardiovascular consequences of cerebral injuries, cardioembolic stroke, and association of carotid and coronary artery disease. The available information, however, is still sparse and fragmentary mainly because of the lack of commun­ ication between neurologists and cardiologists. With the aim of improving communication between several disciplines and technologies, we started to organize since 1987 in Bologna, Italy, an international Symposium on heart­ brain interactions to be held every 3 years. Our intention was to gather prominent clinicians and researchers from outstanding cardiologic and neuro­ logic institutions actively involved in the study of heart-brain interactions. The ambitious goal has been to fit different pieces of information like in a puzzle. This book originates from the contributions presented at the 2nd Sympo­ sium which was held in Bologna on November 30-December 1, 1990. The book is subdivided into three sections: I cardiovascular consequences of cerebral damage, II cardiogenic cerebral ischemia, III cerebrovascular and coronary artery disease.

Chronic total occlusion is the complete blockage of a coronary artery. Opening up such blocked passageways is one of the most difficult challenges for coronary interventionists. The procedures take longer than most interventional procedures and frequently have complications. Articles in this issue review the state of the art in percutaneous treatment of chronic total occlusion.

Coronary Heart Disease: Clinical, Pathological, Imaging, and Molecular Profiles presents a comprehensive picture of ischemic heart disease for practitioners, students, and investigators dealing with the varied facets of this complex subject. Individual chapters introduce the anatomy of the coronary blood vessels and cardiac development, while others consider current imaging modalities utilized for ischemic heart disease, including stress echo, nuclear diagnostic tests, non-invasive coronary artery imaging, and coronary angiography. Imaging chapters provide key clinical information on techniques and indications, and include examples of both normal and abnormal patterns. The principle thrust of the book concerns coronary atherosclerosis, the pathology of which is presented in conjunction with the results of anatomic, non-invasive imaging and angiographic studies. Related chapters cover atherogenesis, presenting new insights into the pathophysiology of the vulnerable plaque, the role of progenitor cells in vascular injury, inflammation and atherogenesis, and the genomics of vascular remodeling. Additional topics covered include angina pectoris, acute coronary syndromes, healed myocardial infarction and congestive heart failure, catheter-based and surgical revascularization, and surgical treatment of myocardial infarction and its sequelae. With contributions from a diverse group of internationally-known physicians with broad experience in the diagnosis and treatment of coronary heart disease, this book will be a valuable resource for practitioners in clinical cardiology, thoracic surgery, pathology, and cardiovascular molecular research, as well as for students in training.

Ischemic Preconditioning: The Concept of Endogenous Cardioprotection consolidates, in one volume, both current knowledge and the most recent advances in ischemic preconditioning. The editors have invited investigators at the forefront of ongoing research to provide their scholarly and candid comments concerning each of these issues. This volume includes a comprehensive review of infarct size reduction with ischemic preconditioning, and the most recent data on the effects of preconditioning on ischemia and reperfusion-induced arrhythmias, myocardial metabolism, contractile function, and the coronary vasculature. The role of altered energy metabolism, stress-induced proteins, ATP-sensitive potassium channels, and adenosine -- the major hypotheses that have been proposed to explain the cardioprotective effects of ischemic preconditioning -- are critically reviewed by investigators who have been instrumental in developing these concepts. In addition, the editors raise the intriguing possibility that ischemic preconditioning may be more than simply a laboratory curiosity. Using a multidisciplinary approach, this volume challenges the readers to contribute their own expertise to address the unanswered questions concerning this endogenous, cardioprotective phenomenon.

Because the increasing complexities of diagnos­ testing and training, for example) are of neces­ ing and treating coronary artery disease are at sity discussed in more than one chapter with times overwhelming for many physicians, the appropriate cross referencing. Special attention purpose of this book is to bring together in one has been directed at making the references as comprehensive yet reasonably concise text a current as possible. Since the aim of the book is to do more than just update the concepts, the scholarly but clinically oriented analysis of the reader is also informed of the pertinent contro­ major aspects of coronary artery disease. The book is mainly intended for internists versies in the field. The word controversy is used in its most liberal form, so as to include areas of and clinical cardiologists as well as for those in training for these respective disciplines, but it disagreement or of uncertainty as well as should also be of interest to primary care physi­ changes in traditional views. Each of the con­ cians responsible for the management of pa­ tributors has been asked to identify specifically tients with coronary artery disease. Each of the the most important of the controversies in his contributors-whether cardiologist, radiologist, particular area of interest and to address himself or surgeon-has been selected for his special to these issues in the course of the chapter.

My Christian Heart guides you to the peace you seek for both your body and your soul by giving you the information you need to live a healthy and spiritually fulfilling life. This is a handbook to maintaining heart health while taking into context both the physical and spiritual needs of the reader. All of the important science behind heart health (healthy diets, foods, exercise, cholesterol levels, etc.) is communicated in a medically accurate yet spiritual manor.

All of the importance science behind heart health is communicated in a medically accurate yet easy-to-read manor. The third edition of The Heart of the Matter stresses the importance of prevention and up-to-date steps one can take to prevent heart disease, high blood pressure and stroke. This book summarizes the latest on fats, cholesterol, and lipids and the roles they play in heart disease.

This study on'Exercise testing and training in coronary heart disease'is a remarkable compilation of numerous research studies, primarily from labora­ tories in Europe and the United States over the last decade or more. The topic reflects a growing awareness of and concern about the rapidly expanding understanding of the pathophysiology of coronary atherosclerotic heart disease. Since muscular exercise increases aerobic metabolism of myocardial and working skeletal muscles, greater flow of oxygenated blood is required by each; yet underlying vascular disease restricts these responses. This implicit paradox is here considered forthrightly. Examination of these relationships in symptomatic patients requires care and caution, because of the potential and occasionally real risks entailed. Accordingly, indirect assessment, particularly by noninvasive techniques, becomes increasingly important to detecting and monitoring - for the safety of the patients studied - the evidence of myocardial ischemia and impairment of left ventricular function under stress. Adequate assessment requires well-designed experimental studies to quantify true relationships and to measure the limits of functional capacity and the mechanisms of its impairment. Further­ more, alterations can be induced by therapy, whether this be pharmacological, medical or surgical, or achieved by physical reconditioning through exercise training. Not only is the cardiovascular system impaired by discrete and diffuse vascular lesions at central sites, but the degree of impairment is dynamic rather than static.

Coronary flow reserve is a functional measure of stenosis severity re­ flecting the integrated effects of its geometry including percent stenosis, absolute lumen area, length and shape. Its clinical application has been primarily qualitative in non-invasive, perfusion imaging. Measurement of coronary flow reserve during routine coronary arte­ riography has been an elusive goal. Transit time and indicator dilution techniques for assessing coronary flow reserve at cardiac catheteriza­ tion are associated with marked variability compared to microspheres or flow meters, thereby making their use questionable in comparison to the precision of good quantitative arteriography. Coronary flow reserve measured by special Doppler catheters as an adjunct to coronary arte­ riography shows in man the value of this integrated functional measure of stenosis severity and the limitations of percent diameter narrowing as a measure of its physiologic significance. However, Doppler catheters require additional instrumentation that is not yet an integral part of coronary arteriography and provide measures of absolute coronary flow reserve only. Relative maximum flow or relative flow reserve has been demon­ strated to be an important independent, complimentary descriptor of stenosis severity independent of fluctuating hemodynamic conditions. The method developed for DSA by Nico Pijls, described in this book is the first approach for assessing relative coronary flow reserve as a part of routine coronary arteriography by DSA. The theory and basic con­ cepts are well developed, experimental validation thorough and clinical applications timely.

Occult atherosclerotic diseases impose great challenges in the cardiovascular practice. Although their pathology is not much different from that of the overt group of diseases, the clinical approach to their diagnoses remains a puzzle. This has mainly emerged as a result of the problems faced in trying to pick up the vulnerable subjects from among the general public. More definitive candidates to be evaluated are those belonging to one of the high risk groups. There are no statistical figures available on the incidence of occult atherosclerotic disease in the'non risky'general public and this is definitely an area that needs further investigation. Atherosclerotic disease whether they are in the cerebral, coronary, renal or lower limb arteries are theoretically interrelated because the basic patho­ logical changes are usually similar. However there still remain some differ­ ences which are mainly due to variation in the flow pattern in the arteries. Thus it will be important clinically and from the management point of view to investigate for the presence of occult disease in other arteries if an atherosclerotic disease in a certain artery has been discovered. This approach is of a great significance especially from the preventive point of view in order to avoid catastrophic events which may have resulted from pathology in the other region.

This handy reference puts essential information at your fingertips! Pocket Reference for the 12-Lead ECG in Acute Coronary Syndromes, 3rd Edition helps you recognize ST segment elevation myocardial infarction (STEMI) by introducing the 5-step approach to 12-lead analysis, making it faster and easier to learn 12-lead interpretation. Clear and concise, this book provides a simple, step-by-step approach along with tables, illustrations, and practice 12-lead ECGs to help you determine the likelihood of the presence of STEMI versus imposters or other causes of ST elevation. Written by two well-known educators, Tim Phalen, a paramedic, and Barbara J. Aehlert, a nurse, this pocket reference is available separately or as a package with its corresponding textbook, The 12-Lead ECG in Acute Coronary Syndromes Text, 3rd Edition. - A clear, succinct, pocket-sized approach makes it easy to identify possible ST segment elevation myocardial infarction, determine the likelihood of the top STEMI imposters, and confidently categorize the ECG. - Streamlined explanation of STEMI recognition includes an emphasis on STEMI imposters (non-infarct causes of ST elevation). - Full-color illustrations clearly depict concepts and skills. - Updated approach to ECG interpretation helps you determine STEMI versus other causes of ST elevation. - NEW 5-step approach simplifies how to determine non-infarct causes of ST elevation, whether STEMI or STEMI imposter(s). - NEW content in Suspecting STEMI chapter includes identifying the J-Point, determining ST elevation, Lead'Views,'suspecting STEMI, and additional STEMI ECG changes. - NEW content in STEMI Imposters chapter includes the top 5 STEMI imposters, ruling out the top STEMI imposters, and a 5-step analysis. - NEW content in STEMI Imposters chapter includes the coronary artery anatomy, right ventricular infarction, posterior infarction, and obtaining additional leads. - NEW Practice ECGs chapter is devoted to practicing the 5-step approach. - NEW Practice ECGs chapter and 23 new 12-lead practice ECGs help you develop skills in 12-lead ECG recognition. - NEW Key Point! boxes call attention to essential information.

This book attempts to focus on the most important clinical aspects of ischaemic heart disease. Clearly, in no way is it supposed to be a comprehensive review of the subject, but it does attempt to address the most important topics for everyday practising clinicians. The question of epidemiology is topical both in the lay and medical press and is, therefore, covered in some detail. It is the editor's opinion that proper understanding of the clinical manifestations of the disease and, therefore, subsequent investigation and treatment are based on a detailed understanding of the pathology and pathophysiology, and as a result these subjects have also been covered in detail. In the last decade there have been considerable advances in our understanding of the mechanisms of angina and also the haemodynamic and metabolic consequences of both angina and myocardial infarction. Again, if appropriate investigations and treatment are to be undertaken, they can only be done with the proper knowledge of the disease being investigated. Finally, the investigation and management of the various mani­ festations of ischaemic heart disease have been addressed. In the last ten years there has been an explosion in the drugs available for the treatment of ischaemic heart disease and how they should be used has become much more sophisticated. The place of coronary artery surgery has now been rationalized and angioplasty provides an important adjunct to treatment.

a comprehensive and real picture of the complexities of ischemic heart disease, both to the person who deals in day to day practice with its problems, as well as to the This book presents a comprehensive picture of is­ chemic heart disease to those who, either as practition­ student and resident who tries to develop firm concepts ers or students, deal with the varied facets of this com­ regarding the varied states observed in this common plex subject. It has meaning to the fields of clinical condition. cardiology, radiology, thoracic surgery, and pathology. After an introductory chapter on the anatomy of the coronary blood vessels, there follows a chapter on coro­ nary arteriography. The latter considers techniques, in­ dications, examples of normal and abnormal patterns, and complications of this procedure. Specific chapters deal with variations in the sites of origin and distribution of coronary arteries, both as seen angiographically and anatomically. Congenital anomalies of the coronary arteries which may engender states of ischemic heart disease are presented. The principal thrust of the work concerns the main arena of ischemic heart disease, namely, coronary ath­ erosclerosis. The pathology of coronary atherosclerosis is presented in conjunction with the results of anatomic and angiographic studies. Major chapters discuss the subjects of angina pecto­ ris, acute myocardial infarction, healed myocardial in­ farction, surgical'revascularization'with indications and the postoperative states, and the surgical treatment of myocardial infarction and its sequelae.

Ventricular fibrillation is a cause of cardiac arrest and sudden cardiac death. The ventricular muscle twitches randomly, rather than contracting in a coordinated fashion (from the apex of the heart to the outflow of the ventricles), and so the ventricles fail to pump blood into the arteries and into systemic circulation. Ventricular fibrillation is a sudden lethal arrhythmia responsible for many deaths mostly brought on by ischaemic heart disease. Acute coronary syndrome (ACS) is a set of signs and symptoms related to the heart. ACS is compatible with a diagnosis of acute myocardial ischemia. This book presents current research from across the globe in the study of ventricular fibrillation and acute coronary syndrome, including clopidogrel response in acute coronary syndrome; primary ventricular fibrillation in'tako-tsubo'syndrome; and ECG predictors of fibrillatory events

Acute Coronary Syndromes-a Companion to Braunwald's Heart Disease-covers the state-of-the-art scientific and clinical information you need to rapidly evaluate and manage acute coronary syndromes. Dr. Pierre Theroux and his team of expert contributors present advances in diagnostic and imaging techniques such as biomarkers, nuclear cardiology, echocardiography, and multislice CT; secondary prevention; and new antiplatelet, anti-ischemic, and gene therapies.Tap into the most definitive knowledge available from one of the leading experts in the field and a stellar cast of contributors. Understand the special considerations for the care of acute coronary syndromes in the emergency department and the coronary care unit. Effectively handle the treatment of special populations and chronic patients thanks to coverage of these challengesSee techniques and procedures in greater detail and clarity through the all-new full-color design. Approach treatment with a global perspective from the new section on Population-Based Perspective that discusses the INTERHEART study, insights from the REACH registry, lessons learned from European registries, and ACS in North America. Gain a comprehensive understanding of ACS through coverage of pathophysiology, molecular mechanisms, the role of the immune system, and brand-new chapters on cell necrosis and cell regeneration and pharmacogenetics in the section on Disease-Based Perspectives. Integrate the latest testing and treatment techniques into your practice thanks to new chapters on biomarkers in acute ischemic heart disease; the role of noninvasive testing in prognostic risk stratification; the culprit lesions and patient at risk; non-responsiveness to antiplatelet therapy; bleeding in the acute coronary syndromes; and the refractory patient.

Myocardial ischemia results from a reduction in coronary blood flow to the working myocardium, which leads to a corresponding decrease in oxygen delivery to the heart. This book reviews the pathophysiology of myocardial ischemia as well as advancements that are being made to enable diagnosis of this disease in the early stages. The authors of this book also discuss current evidence about cardiac biomarkers in patients on hemodialysis (HD), with emphasis on two emerging biomarkers, cTn and BNPs. Furthermore, potential roles for these markers to be incorporated into future diagnostic and therapeutic strategies for myocardial ischemia in HD patients is analyzed. Additionally, this book focuses on the post-MI biochemical, cellular and tissue-level changes that ultimately result in hypertrophy, dilatation, and heart failure and examines the ways in which those changes affect susceptibility to ventricular arrhythmias. Finally, this book provides an overview of the clinical application status and limitations of current treatment of myocardial ischemia, future technologies under development, and results of preclinical studies using animal models. Current therapeutic regiments also address the long-term effects of MI, including management of cardiac remodeling and recurrent ischemia. Medical therapies such as angiotensin-converting enzyme inhibitors, beta-adrenergic blockers and other agents continue to show promise in this regard.

In order to provide the latest and most sophisticated treatment the cardiology clinician must have current knowledge of a vast amount of translational research in the pathophysiology of these disorders as well as be aware of recent advances and issues in pharmacogenic and interventional therapies. Topics in Arrhythmias and Ischemic Heart Disease provides expert reviews and assessment of the most recent clinical research and on current trends in evaluation, diagnosis, and clinical management. Reviews include assessment of emerging data and indications of likely key advances with signifiacnt impact on clinical research in the near future. This volume is a must-have for every cardiologist needing to be fully current on recent advances in ischemic heart disease and arrhythmic disorders. About the Series Developed by expert faculty at the Cornell Division of Cardiology, the Emerging Concepts in Cardiology series edited by Craig T. Basson and Bruce B. Lerman, provides'state of the art reviews'of each topic from a clinical perspective, with expert perspectives in current clinical research and emerging basic and traditional research issues all in a concise, attractive and well-illustrated texts.

Dans le monde actuel, les situations stressantes sont innombrables. Le stress se situe non seulement dans les évènements traumatiques et les catastrophes naturelles mais aussi dans les tensions de la vie quotidienne et de l'environnement. Prenant leur origine dans le cerveau, les réactions aux stress libèrent une cascade de neuromédiateurs stimulant des systèmes neuro-hormonaux actifs sur l'appareil cardio-circulatoire. Cet ouvrage fait le point sur les différentes sources des stress, leurs principaux effets neurologiques, endocriniens et cardiovasculaires, les pathologies qui en découlent et les diverses possibilités thérapeutiques, cardiologiques et psychiatriques. Les mécanismes des différentes pathologies sont étudiés : ischémie myocardique, syndrome coronarien, cardiomyopathie, arythmie, HTA, insuffisance cardiaque, mort subite, dépression. Chacune est illustrée d'un ou plusieurs cas cliniques et de nombreux tracés. Dans une langue claire et concise, ce livre s'adresse particulièrement aux cardiologues, praticiens ou en formation, aux psychiatres et psychothérapeutes mais aussi aux médecins généralistes qui y trouveront une référence pour leur pratique quotidienne.Les conséquences cardiaques des traumatismes psychiques. • Le point sur les effets neurologiques, endocriniens et cardiovasculaires du stress. • Les pathologies qui en découlent et les possibilités thérapeutiques cardiaques et psychiatriques pour y faire face. • Chaque pathologie est illustrée d'un ou plusieurs cas cliniques et de nombreux tracés.

Acute coronary syndromes encompasses the spectrum of clinical disorders caused by acute ischemic heart disease -- unstable angina, ST-elevation myocardial infarction, non-ST-elevation myocardial infarction -- which account for 2 million hospitalizations and 30% of all deaths in the United States each year.ACS Essentials, Third Edition provides the latest clinical guidelines and trials for the management of acute coronary syndromes. Step-by-step guide to unstable angina, important clinical trials, common management pitfalls, drug summaries, and other cardiovascular risk reduction measures are emphasized.

This innovative book focuses on HDL and its relationships to triglyceride-rich particles. As new therapies for HDL raising become available, a comprehensive understanding the role of HDL in Coronary Heart Disease is of great importance. This book is an excellent resource for educating physicians and scientists about dyslipidemia and HDL metabolism, including many exogenous substances which interact with and influence HDL. Readers will benefit from the unique visual exposition and the insights of international experts.

Coronary artery disease is the most commonly encountered problem in adult cardiology in the world. Echocardiography is the most commonly used imaging modality encountered in cardiology practice in the world. Even though there are many Acute Coronary Syndrome (ACS) reference books and echocardiography reference books, there is no single practical book so far in the literature with focus on the combined topics. The authors believe that this will be the first book to provide information on how echocardiography can be used in, prevention, diagnosis and treatment of ACS.

Acute Coronary Syndrome covers the spectrum of clinical conditions ranging from unstable angina to non-ST elevation myocardial infarction and ST elevation myocardial infarction. These life-threatening disorders are a major cause of emergency medical care, hospitalization and mortality. Management of Acute Coronary Syndromes is designed to provide busy clinicians with a comprehensive guide to the investigation, diagnosis and treatment of these syndromes. It encompasses the latest technologies, including the use of biomarkers and non-invasive imaging procedures. For each condition, the reader is taken through all of the therapeutic options available; in each case the indications and contraindications are evaluated in the light of the latest clinical trials. Potential complications are dealt with in a similar fashion, permitting the reader to anticipate and manage problems as they arise. The authors also present evidence-based recommendations for long-term care of at-risk patients, encompassing pharmacologic therapies and lifestyle management. The book concludes with a comprehensive collection of appendices that include treatment algorithms, risk scores and a summary of the latest management guidelines. Management of Acute Coronary Syndromes is the most up to date and comprehensive evidence-based guide to managing acute coronary syndromes, in a compact and usable format. It will be of interest to busy specialist physicians in cardiovascular medicine, cardiac and vascular surgery, and critical care, as well as primary care physicians and hospitalists who care for patients with these syndromes.

Acute coronary syndrome (ACS) continues to challenge our health care system in the complexity of presentation and the ever increasing number of patients exhibiting signs and symptoms of an acute coronary syndrome. Written by leading experts, Short Stay Management of Chest Pain provides scientific and clinical insights on the management of patients who arrive at the hospital with a presentation consistent with a potential acute coronary syndrome. Focusing on the cardiology aspects of chest pain, Short Stay Management of Chest Pain is a valuable tool for acute care physicians, nurses, and hospital administrators devoted to caring for this population. Short Stay Management of Chest Pain details the remarkable improvements in diagnostic accuracy and improved patient outcomes for patients presenting with suspected acute coronary syndromes.

Chronic total occlusions (CTO) are common, and found in approximately one third of patients with significant coronary artery disease who undergo angiography. Over the past 20 years, CTO lesions have represented the most difficult anatomy for treatment — with lower success rates and higher complication rates. Chronic Total Occlusions provides interventionalists insight into the world of CTOs with introductory chapters that describe the pathology and indications of CTOs along with a review of clinical trials. Imaging modalities including CT angiography, magnetic navigation wire, and IVUS guided recanalization of CTO are also introduced, together with information on new wires technology and devices for CTOs. With numerous illustrations of these devices, technologies, and strategies to improve the CTO success rate, this clinical guide, headed up by Ron Waksman, will prove to be the ideal companion for interventional cardiologists and cardiac surgeons who are required to perform angioplasty and coronary stenting.

Le malattie cardiovascolari rappresentano attualmente la causa principale di mortalità e, oltre a modificare sensibilmente la qualità della vita, comportano un notevole impegno economico per la società. Poiché la maggior parte degli eventi coronarici si verifica per la complicanza di una placca aterosclerotica parietale non stenosante, il suo riconoscimento può assumere rilevante significato clinico ed essere di interesse nella scelta di un trattamento medico o interventistico. Attraverso l'utilizzo di apparecchiature sempre più sensibili e veloci, oggi la TC coronarica ci consente, finalmente, di visualizzare la lesione responsabile delle sindromi coronariche acute e di caratterizzarla. La conoscenza delle apparecchiature, la valutazione dei loro limiti e l'adeguata preparazione del paziente, rappresentano passaggi importanti per l'ottenimento di immagini adeguate dal punto di vista diagnostico. L'opera nasce dalla volontà di fornire al cardiologo o al medico non esperto di imaging le basi per comprendere principi tecnici e modalità di acquisizione e di ricostruzione delle immagini. Allo stesso tempo anche il radiologo che non abbia esperienze specifiche di imaging cardiaco potrà acquisire conoscenze di base di anatomia e fisiopatologia delle coronarie.

Coronary artery disease is the most common cause of morbidity in the developed and developing world. In the acute situation, in contrast to the stable presentation, there is a need for urgency with clear benefits from intervention. However it is imperative that risks are assessed and addressed as part of the long term strategy. Preventing acute coronary syndromes is more important than dealing with them. This concise, practical pocketbook opens with the background and mechanisms leading to the acute event and how an understanding of the pathophysiology can direct the overall management and not just the acute presentation. The books intention is to highlight the practical aspects of management and establish straightforward management plans. It therefore looks at the syndromes via a team approach to address all of the issues and optimise care.

Coronary artery disease or CAD is the end result of the process of accumulation of atheromatous plaques within the walls of the arteries supplying the myocardium. Atherosclerosis is a chronic systemic disease process, affecting all the vascular beds in body and many factors responsible for its evolution have been identified. A rising incidence of this disease among people of Indian origin and an emerging role of genetic factors leading to atherosclerosis necessitates modifications in ourstrategies to handle it. The importance of the risk factors in causation of the disease need to be emphasized even more and masses need to be educated about the role of lifestyle modifications in its management. Further, early detection of preclinical or sub-clinical disease would add another dimension to the overall preventive strategy for this condition. This book is designed to update the readers on the evergrowing list of risk factors for CAD and the increasing significance of lifestyle modifications in prevention of the disease. Besides these, the therapeutic approach towards this chronic disease and methods of early detection has also been discussed. Typical supportive case scenarios are also included to exemplify and highlight the various points discussed. Thus, it provides an excellent opportunity to widen one's perspective in this area.

Now you have a dependable guide to the practical application of hemodynamics. This concise handbook will help both practicing and prospective clinicians better understand and interpret the hemodynamic data used to make specific diagnoses and monitor ongoing therapy. Written from the perspective of a clinician, this convenient paperback opens with an overview of the basics of hemodynamics, then devotes chapters to specific disease states. Topics include: • coronary artery disease • cardiomyopathies • valve disease • arrhythmias • pericardial disease Numerous pressure tracings throughout the book reinforce the text by demonstrating what you will see in daily practice. To extract as much useful information as possible from the hemodynamic data obtained from your patients, be sure to consult Cardiovascular Hemodynamics for the Clinician.