Practical Cardiovascular Medicine 2nd Edition by Elias B Hanna ISBN 1119832705 9781119832706

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ISBN 10: 1119832705
ISBN 13: 9781119832706
Author: Elias B Hanna

Providing a complete but succinct overview of the information cardiologists and cardiology trainees need to have at their fingertips, Practical Cardiovascular Medicine, Second Edition is an everyday primary guide to the specialty. 

• Provides cardiologists with a thorough and up-to-date review of cardiology, from pathophysiology to practical, evidence-based management 
• Ably synthesizes pathophysiology fundamentals and evidence-based approaches to prepare a physician for a subspecialty career in cardiology 
• Clinical chapters cover coronary artery disease, heart failure, arrhythmias, valvular disorders, pericardial disorders, congenital heart disease, and peripheral arterial disease 
• Practical chapters address ECG, coronary angiography, catheterization techniques, echocardiography, hemodynamics, and electrophysiological testing 
• Includes over 730 figures, key notes boxes, references for further study, and coverage of clinical trials 
• Review questions help clarify topics and can be used for Board preparation – over 650 questions in all

The Second Edition has been comprehensively updated with the newest data and with both the American and European guidelines. More specifically, 20 clinical chapters have been rewritten and extensively revised. Procedural chapters have been enhanced with additional concepts and illustrations, particularly the hemodynamic and catheterization chapters. Clinical questions have been revamped, new questions have been added, including a new, 259-question section at the end of the book.  

Practical Cardiovascular Medicine, Second Edition is an ideal reference for the resident, fellow, cardiologist, and any professional treating patients with cardiovascular disease

Practical Cardiovascular Medicine 2nd Edition Table of contents:

Part 1: CORONARY ARTERY DISEASE

1 Non-ST-Segment Elevation Acute Coronary Syndrome

Appendix 1. Complex angiographic disease- Moderate disease progression

Appendix 2. Women and ACS, elderly patients and ACS, CKD

Appendix 3. Bleeding, transfusion, patients on chronic warfarin or NOAC, gastrointestinal bleed

Appendix 4. Antiplatelet and anticoagulant therapy

Appendix 5. Difference between plaque rupture and plaque erosion

Appendix 6. Spontaneous coronary artery dissection

Appendix 7. Harmful effects of NSAIDs and cyclooxygenase-2 inhibitors in CAD

Appendix 8. Additional ideas on the physiology of hs-troponin-Role of hs-troponin in primary prevention

QUESTIONS AND ANSWERS

References

2 ST-Segment Elevation Myocardial Infarction

1. DEFINITION, REPERFUSION, AND GENERAL MANAGEMENT

2. STEMI COMPLICATIONS

Appendix 1. Out-of-hospital cardiac arrest: role of early coronary angiography and therapeutic hypothermia

QUESTIONS AND ANSWERS

References

Other acute therapies

Early discharge

Prognosis

ICD

Shock (+ SHOCK trial and CULPRIT-SHOCK trial, references 69 and 73)

RV shock (+ reference 89 above)

Mechanical complications

Arrhythmias

Aneurysm and pseudo-aneurysm

Post-MI pericarditis

LV thrombus

Prognosis

Cardiac arrest

Note

3 Stable Ischemic Heart Disease and Approach to Chronic Chest Pain

Appendix 1. Notes on various surgical grafts

Appendix 2. Coronary vasospasm (variant angina, Prinzmetal angina)

Appendix 3. Microvascular endothelial dysfunction

Appendix 4. Women with chest pain and normal coronary arteries

Appendix 5. Diagnostic strategy for ischemia with non-obstructed coronary arteries (INOCA)

Appendix 6. Myocardial bridging

Appendix 7. Coronary collaterals, chronic total occlusion

Appendix 8. Hibernation, stunning, ischemic preconditioning

QUESTIONS AND ANSWERS

References

Part 2: HEART FAILURE (CHRONIC AND ACUTE HEART FAILURE, SPECIFIC CARDIOMYOPATHIES, AND PATHOPHYSIOLOGY)

4 Heart Failure

DEFINITION, TYPES, CAUSES, AND DIAGNOSIS OF HEART FAILURE

1. DEFINITION AND TYPES OF HEART FAILURE

I. Heart failure is diagnosed clinically, not by echocardiography

II. After HF is defined clinically, echocardiography is used to differentiate the three major types of HF

2. CAUSES OF HEART FAILURE

I. Systolic HF or HF with reduced EF (HFrEF)

II. HF with preserved EF (HFpEF)

III. Right HF

3. DIAGNOSTIC TESTS

I. Echocardiography

II. BNP

III. ECG

IV. Coronary angiography and other ischemic tests

V. Diastolic stress testing

VI. Endomyocardial biopsy

VII. Cardiac MRI

CHRONIC TREATMENT OF HEART FAILURE

1. TREATMENT OF SYSTOLIC HEART FAILURE

I. Treat the underlying etiology: target BP and CAD

II. Value of revascularization in ischemic cardiomyopathy: STICH trial

III. Role of viability testing and ischemic testing

IV. Drugs that affect survival in EF<40%

V. Specifics of drugs that affect survival

VI. Drugs that improve symptoms and morbidity

VII. Devices

VIII. Other therapeutic measures

IX. Prognosis

2. TREATMENT OF HFPEF

ACUTE HEART FAILURE AND ACUTELY DECOMPENSATED HEART FAILURE

I. Triggers of acute decompensation

II. Profiles of acute HF: congestion without low cardiac output, congestion with low cardiac output

III. Treatment of acute HF: diagnosis and treatment of triggers

IV. Treatment of acute HF: diuretics, cardiorenal syndrome, aggressive decongestion, ultrafiltration

V. Treatment of acute HF: vasodilators

VI. Treatment of acute HF: IV inotropic agents

VII. In-hospital and pre-discharge use of ACE-I/ARB, angiotensin-neprilysin inhibition, and β-blockers

VIII. Treatment of acute HF: O2, non-invasive ventilatory support (CPAP, BiPAP), intubation

IX. Summary: keys to the treatment of acute HF (Table 4.2)

X. Discharge

XI. Inability of severe HF to tolerate vasodilatation or hemodialysis

XII. Outpatient monitoring of HF and prevention of hospitalization

Appendix 1. Management of isolated or predominant RV failure

QUESTIONS AND ANSWERS

References

Diuretics

5 Additional Heart Failure Topics

1. SPECIFIC CARDIOMYOPATHIES

2. ADVANCED HEART FAILURE: HEART TRANSPLANT AND VENTRICULAR ASSIST DEVICES (VADs)

3. PATHOPHYSIOLOGY OF HEART FAILURE AND HEMODYNAMIC ASPECTS

QUESTIONS AND ANSWERS

References

Part 3: VALVULAR DISORDERS

6 Valvular Disorders

1. MITRAL REGURGITATION

2. MITRAL STENOSIS

3. AORTIC INSUFFICIENCY

4. AORTIC STENOSIS

5. TRICUSPID REGURGITATION AND STENOSIS

6. PULMONIC STENOSIS AND REGURGITATION

7. MIXED VALVULAR DISEASE; RADIATION HEART DISEASE

8. PROSTHETIC VALVES

9. AUSCULTATION AND SUMMARY IDEAS

QUESTIONS AND ANSWERS

References

Part 4: HYPERTROPHIC CARDIOMYOPATHY

7 Hypertrophic Cardiomyopathy

QUESTIONS AND ANSWERS

References

Part 5: ARRHYTHMIAS AND ELECTROPHYSIOLOGY

8 Approach to Narrow and Wide QRS Complex Tachyarrhythmias

Further reading

9 Ventricular Arrhythmias

QUESTIONS AND ANSWERS

References

10 Atrial Fibrillation

I. Predisposing factors (see Table 10.1)

II. Types of AF

III. General therapy of AF

IV. Management of a patient who presents with acute, symptomatic AF

V. Peri-cardioversion anticoagulation management

VI. Antiarrhythmic management after the acute presentation

VII. Decisions about long-term anticoagulation, role of clopidogrel, role of triple therapy

VIII. Special situation: atrial fibrillation and heart failure. Optimal heart rate in heart failure

IX. Special situation: atrial fibrillation with borderline blood pressure or non-AF-related hypotension

X. AF burden as a correlate and a driver of HF progression

Appendix 1. Optimal heart rate and AF rate for optimal cardiac output

Appendix 2. Antiarrhythmic drug therapy

Appendix 3. Catheter ablation of atrial fibrillation, surgical ablation, AV nodal ablation

Appendix 4. INR follow-up in patients receiving warfarin-Non-vitamin K oral anticoagulants

Appendix 5. Bridging anticoagulation in patients undergoing procedures

Appendix 6. Management of elevated INR values

Appendix 7. Left atrial appendage surgical and percutaneous closure

Appendix 8. A common situation: AF and symptomatic pauses or bradycardia

Appendix 9. DC cardioversion in patients with a slow ventricular response

Appendix 10. AF occurring post-cardiac surgery and AF related to acute transient triggers

Appendix 11. Brief asymptomatic runs of AF on device interrogation and association with stroke. Role of rhythm monitoring after cryptogenic stroke

QUESTIONS AND ANSWERS

References

11 Atrial Flutter and Atrial Tachycardia

I. Atrial flutter

II. Focal atrial tachycardia

III. Multifocal atrial tachycardia (MAT) (or chaotic atrial tachycardia)

IV. Ectopic atrial rhythm

QUESTIONS AND ANSWERS

References

Further reading

12 Atrioventricular Nodal Reentrant Tachycardia, Atrioventricular Reciprocating Tachycardia, Wolff–Parkinson–White Syndrome, and Junctional Rhythms

QUESTIONS AND ANSWERS

Further reading

13 Bradyarrhythmias

QUESTIONS AND ANSWERS

References

14 Permanent Pacemaker and Implantable Cardioverter Defibrillator

Appendix. Cases of PM troubleshooting

QUESTIONS AND ANSWERS

References

Note

15 Basic Electrophysiologic Study

I. General concepts; intracardiac electrograms

II. AV conduction abnormalities

III. Sinus node assessment

IV. Ventricular vs. supraventricular tachycardia

V. Dual AV nodal pathways

VI. AVNRT

VII. Accessory pathway, orthodromic AVRT, antidromic AVRT

VIII. Atrial flutter

IX. Inducible VT

X. Mapping for ablation

XI. EP electro-anatomical mapping

Further reading

16 Action Potential Features and Propagation

I. Action potential (see Figures 16.1, 16.2)

II. Action potential propagation and mechanisms of arrhythmias

III. General mechanism of action of antiarrhythmic agents

IV. Modulated receptor hypothesis and use dependence

V. Concept of concealed conduction

VI. Specific examples of drugs (see also Chapter 10)

VII. Amiodarone toxicity

VIII. Effect on pacing thresholds and defibrillation thresholds

Further reading

Part 6: PERICARDIAL DISORDERS

17 Pericardial Disorders

1. ACUTE PERICARDITIS

2. TAMPONADE

3. PERICARDIAL EFFUSION

4. CONSTRICTIVE PERICARDITIS

QUESTIONS AND ANSWERS

References

Further reading

Part 7: CONGENITAL HEART DISEASE

Chapter 18: Congenital Heart Disease

1. ACYANOTIC CONGENITAL HEART DISEASE

2. CYANOTIC CONGENITAL HEART DISEASE

3. MORE COMPLEX CYANOTIC CONGENITAL HEART DISEASE AND SHUNT PROCEDURES

QUESTIONS AND ANSWERS

References

Part 8: PERIPHERAL ARTERIAL DISEASE

19 Peripheral Arterial Disease

1. LOWER EXTREMITY PERIPHERAL ARTERIAL DISEASE

I. Clinical tips

II. Clinical classification of PAD – Critical limb ischemia, acute limb ischemia, atheroembolization

III. Diagnosis of PAD

IV. Medical therapy of PAD

V. Revascularization for PAD

VI. Notes on the technical aspects of surgical and percutaneous therapies

VII. Management of acute limb ischemia

VIII. Management of lower extremity ulcers (Table 19.6)

2. CAROTID DISEASE

I. Assessment of carotid stenosis

II. Medical therapy of carotid stenosis

III. Revascularization of asymptomatic carotid stenosis

IV. Revascularization of symptomatic carotid stenosis

V. Main risks of CEA and carotid stenting

VI. CEA versus carotid stenting

VII. Carotid disease in a patient undergoing CABG

VIII. Subtotal and total carotid occlusions

3. RENAL ARTERY STENOSIS

I. Forms of renal artery stenosis

II. Screening and indications to revascularize renal artery stenosis

III. Notes

QUESTIONS AND ANSWERS

References

20 Aortic Diseases

I. Aortic dissection

II. Thoracic aortic aneurysm

III. Abdominal aortic aneurysm

References

Part 9: OTHER CARDIOVASCULAR DISEASE STATES

21 Pulmonary Embolism and Deep Vein Thrombosis

1. PULMONARY EMBOLISM

I. Presentation of pulmonary embolism (PE) and risk factors

II. Probability of PE

III. Initial workup

IV. Specific PE workup

V. Submassive or intermediate-high risk PE, pulmonary hypertension, and thrombolysis

VI. PE and chronic pulmonary hypertension

VII. Acute treatment of PE

VIII. Duration of anticoagulation

IX. Thrombophilias

X. PE prognosis and long-term follow-up

2. DEEP VEIN THROMBOSIS

I. Types

II. Diagnosis

III. Treatment

3. IMMUNE HEPARIN-INDUCED THROMBOCYTOPENIA

I. Incidence

II. Diagnosis

III. Treatment

QUESTIONS AND ANSWERS

References

22 Shock and Fluid Responsiveness

1. SHOCK

I. Shock definition and mechanisms

II. Goals of shock treatment

III. Immediate management of any shock

IV. Sepsis and septic shock

V. Cardiogenic shock

2. FLUID RESPONSIVENESS

Appendix. Hemodynamic equations, transfusion, and miscellaneous concepts

QUESTIONS AND ANSWERS

References

Note

23 Hypertension

1. HYPERTENSION

I. Definition

II. ACC and ESC targets of therapy and rationale

III. Treatment of hypertension: timing, first-line drugs, compelling indications for specific drugs

IV. Resistant hypertension

V. Secondary hypertension

VI. Peripheral vs. central aortic pressure: therapeutic implications

VII. First-line antihypertensive drugs

VIII. Second-line antihypertensive drugs

IX. Orthostatic hypotension and extremely labile HTN

2. ACUTE SEVERE HYPERTENSION: HYPERTENSIVE EMERGENCIES AND URGENCIES

I. Definitions

II. Treatment of hypertensive emergencies

III. Treatment of hypertensive urgencies

IV. Specific situations (see Table 23.5)

QUESTIONS AND ANSWERS

References

24 Dyslipidemia

I. Indications for therapy

II. Notes on LDL, HDL, and triglycerides

III. Drugs: LDL-lowering drugs

IV. Drugs: TG/HDL-treating drugs and lifestyle modification

V. Metabolic syndrome

VI. Diabetes and cardioprotective diabetic drugs

VII. Elevated hs-CRP (high-sensitivity C-reactive protein test) ≥2 mg/l

VIII. Chronic kidney disease (CKD)

IX. Causes of dyslipidemia to consider

X. Side effects of specific drugs: muscle and liver intolerance with statins, fibrates, and niacin

XI. Aspirin is ineffective in primary prevention

QUESTIONS AND ANSWERS

References

25 Pulmonary Hypertension

I. Definition

II. Categories of PH

III. Two tips in the evaluation of PH

IV. Hypoxemia in patients with PH

V. Diagnosis: echocardiography; right and left heart catheterization

VI. Treatment

QUESTIONS AND ANSWERS

References

26 Syncope

I. Neurally mediated syncope (reflex syncope)

II. Orthostatic hypotension and postural orthostatic tachycardia syndrome

III. Cardiac syncope

IV. Other causes of syncope

V. Syncope mimic: seizure (see Table 26.1)

VI. Clinical clues (see Table 26.2)

VII. Diagnostic evaluation of syncope ( Figure 26.1 )

VIII. Tilt table testing (see Table 26.4)10, 40

IX. Indications for hospitalization

X. Treatment of vasovagal syncope, orthostatic hypotension, and POTS

QUESTIONS AND ANSWERS

References

27 Chest Pain, Dyspnea, Palpitations

1. CHEST PAIN

I. Causes (see Table 27.1)

II. Features

III. Management of chronic chest pain

IV. Management of acute chest pain

2. ACUTE DYSPNEA

I. Causes (see Table 27.2)

II. Notes

III. Management

3. PALPITATIONS

I. Causes

II. Diagnosis

References

28 Infective Endocarditis and Cardiac Rhythm Device Infections

1. INFECTIVE ENDOCARDITIS

I. Clinical diagnosis

II. Echocardiography: timing and indications

III. Organisms

IV. Morphology

V. Anatomical complications

VI. Indications for valvular surgery and special situations

2. CARDIAC RHYTHM DEVICE INFECTIONS

I. Organisms and mechanisms of infection

II. Diagnosis

III. Diagnosis in patients with bacteremia but no local or TEE signs of infection

IV. Management

References

29 Preoperative Cardiac Evaluation

I. Steps in preoperative evaluation

II. Surgical risk: surgery’s risk and patient’s risk

III. CARP and DECREASE V trials

IV. Only the highest-risk coronary patients require revascularization preoperatively

V. Preoperative percutaneous revascularization

VI. Surgery that needs to be performed soon after stent placement

VII. Preoperative β-blocker therapy

VIII. Other interventions that improve outcomes

IX. Severe valvular disease

X. Perioperative hypertension

XI. Preoperative management of patients with pacemakers or ICDs

QUESTIONS AND ANSWERS

References

30 Miscellaneous Cardiac Topics

1. CARDIAC MASSES

I. Differential diagnosis of a cardiac mass

II. Cardiac tumors; focus on atrial myxoma

2. PREGNANCY AND HEART DISEASE

I. High-risk cardiac conditions during which pregnancy is better avoided 9

II. Cardiac conditions that are usually well tolerated during pregnancy, but in which careful cardiac evaluation and clinical and echo follow-up are warranted 9

III. Cardiac indications for cesarean section

IV. Mechanical prosthetic valves in pregnancy: anticoagulation management

V. Peripartum cardiomyopathy (PPCM)

VI. Cardiovascular drugs during pregnancy (see Table 30.2)

VII. Arrhythmias during pregnancy

VIII. MI and pregnancy

IX. Hypertension and pregnancy

3. HIV AND HEART DISEASE

I. Pericardial disease

II. HIV cardiomyopathy

III. Pulmonary hypertension (PH)

IV. CAD

4. COCAINE AND THE HEART

I. Myocardial ischemia

II. Other cardiac complications of cocaine

5. CHEMOTHERAPY AND HEART DISEASE

I. Cardiomyopathy

II. Myocardial ischemia

III. Atrial fibrillation

6. CHEST X-RAY

I. Chest X-ray in heart failure (see Figures 30.2, 30.3)

II. Various forms of cardiomegaly (see Figure 30.4)

III. Left atrial enlargement; aortic dilatation

IV. Lateral chest X-ray

V. Chest X-ray in congenital heart disease

QUESTIONS AND ANSWERS

References

Part 10: CARDIAC TESTS: ELECTROCARDIOGRAPHY, ECHOCARDIOGRAPHY, AND STRESS TESTING

31 Electrocardiography

I. Overview of ECG leads and QRS morphology

II. Stepwise approach to ECG interpretation

III. Rhythm and rate

IV. QRS axis in the limb leads and normal QRS progression in the precordial leads

V. P wave: analyze P wave in leads II and V1 for atrial enlargement, and analyze PR interval (see Figures 31.18, 31.19)

VI. Height of QRS: LVH, RVH

VII. Width of QRS. Conduction abnormalities: bundle brunch blocks

VIII. Conduction abnormalities: fascicular blocks

IX. Low QRS voltage and electrical alternans

X. Assessment of ischemia and infarction: Q waves

XI. Assessment of ischemia: ST-segment depression and T-wave inversion

XII. Assessment of ischemia: differential diagnosis of ST-segment elevation

XIII. Assessment of ischemia: large or tall T wave

XIV. QT analysis and U wave

XV. Electrolyte abnormalities, digitalis effect and digitalis toxicity, hypothermia, PE, poor precordial R-wave progression

XVI. Approach to tachyarrhythmias

XVII. Approach to bradyarrhythmias: AV block

XVIII. Abnormal automatic rhythms that are not tachycardic

XIX. Electrode misplacement

Appendix 1. Supplement on STEMI and Q‐wave MI: phases and localization

Appendix 2. Spread of electrical depolarization in various disease states using vector illustration ( Figures 31.100 – 31.103 )

QUESTIONS AND ANSWERS

References

Further reading

32 Echocardiography

1. GENERAL ECHOCARDIOGRAPHY

I. The five major echocardiographic views and the myocardial wall segments

II. Global echo assessment of cardiac function and structure

III. Doppler and assessment of valvular regurgitation and stenosis

IV. Summary of features characterizing severe valvular regurgitation and stenosis (see Tables 32.1, 32.2)

V. M-mode echocardiography

VI. Pericardial effusion

VII. Echocardiographic determination of LV filling pressure and diastolic function

VIII. Additional echocardiographic hemodynamics

IX. Prosthetic valves

X. Brief note on Doppler physics and echo artifacts

2. TRANSESOPHAGEAL ECHOCARDIOGRAPHY (TEE) VIEWS

Appendix. Note on LV mechanics and myocardial tissue strain

Further reading

33 Stress Testing, Nuclear Imaging, Coronary CT Angiography, Cardiac MRI, Cardiopulmonary Exercise Testing

I. Indications for stress testing

II. Contraindications to all stress testing modalities

III. Stress testing modalities

IV. Diagnostic yields and pitfalls of stress ECG and stress imaging

V. Mechanisms of various stress modalities

VI. Nuclear stress imaging (see Figures 33.3, 33.4, 33.5)

VII. Coronary CT angiography and coronary calcium scoring

VIII.Cardiac MRI: summary of applications and findings

IX.Cardiopulmonary exercise testing (CPET)

References

Part 11: CARDIAC TESTS: INVASIVE CORONARY AND CARDIAC PROCEDURES

34 Angiographic Views: Coronary Arteries and Grafts, Left Ventricle, Aorta, Coronary Anomalies, Peripheral Arteries, Carotid Arteries

I. Right coronary artery

II. Left coronary artery

III. Coronary angiography views. Recognize the angle of a view: LAO vs. RAO, cranial vs. caudal

IV. Coronary angiography views. General ideas: cranial vs. caudal views

V. Coronary angiography views. General ideas: foreshortening and identifying branches

VI. Left coronary views (see Figure 34.8)

VII. Right coronary views

VIII. Improve the angiographic view in case of vessel overlap or foreshortening: effects of changing the angulation, effects of respiration, and vertical vs. horizontal heart

IX. Saphenous venous graft views

X. LIMA-to-LAD or LIMA-to-diagonal views

XI. Left ventriculography

XII. Aortography for assessment of aortic insufficiency

XIII. Coronary anomalies

XIV. Lower extremity angiography

XV. Carotid angiography

QUESTIONS AND ANSWERS

Further reading

35 Cardiac Catheterization Techniques, Tips, and Tricks

I. View for the engagement of the native coronary arteries: RAO vs. LAO

II. Design of the Judkins and Amplatz catheters (see Figures 35.2–35.7)

III. Engagement of the RCA (see Figure 35.8)

IV. How to gauge the level of the RCA origin in relation to the aortic valve level

V. What is the most common cause of failure to engage the RCA? What is the next step?

VI. Tiger or JR4 catheter engages the conus branch. What is the next step?

VII. Left coronary artery engagement: general tips

VIII. Management of a JL catheter that is sub-selectively engaged in the LAD or LCx

IX. Specific maneuvers for the Amplatz left catheter

X. If you feel that no torque is getting transmitted, what is the next step?

XI. Appropriate guide catheters for left coronary interventions

XII. Appropriate guide catheters for RCA interventions (Figure 35.20)

XIII. Selective engagement of SVGs: general tips

XIV. Specific torque maneuvers for engaging the SVGs

XV. Appropriate catheters for engaging SVGs (see Figure 35.24)

XVI. Engagement of the left internal mammary artery graft

XVII. Left ventricular catheterization

XVIII. Engagement of anomalous coronary arteries

XIX. Specific tips for coronary engagement using a radial approach

XX. Damping and ventricularization of the aortic waveform upon coronary engagement, and role of side-hole catheters

XXI. Technique of right heart catheterization

36 Hemodynamics

I. Right heart catheter (see Figure 36.1)

II. Overview of pressure tracings: differences between atrial, ventricular, and arterial tracings (Figures 36.2, 36.3, 36.4)

III. RA pressure abnormalities

IV. Pulmonary capillary wedge pressure (PCWP) abnormalities

V. LVEDP

VI. Cardiac output and vascular resistances

VII. Shunt evaluation

VIII. Valvular disorders: overview of pressure gradients and valve area calculation

IX. Dynamic LVOT obstruction

X. Pericardial disorders: tamponade and constrictive pericarditis (see Figures 36.23, 36.24)

XI. Exercise hemodynamics

XII.Additional hemodynamic caveats in AF

Appendix 1. Advanced hemodynamic calculation: a case of shunt with pulmonary hypertension

QUESTIONS AND ANSWERS: ADDITIONAL HEMODYNAMIC CASES

References

Suggested reading:

37 Intracoronary Imaging

1. INTRAVASCULAR ULTRASOUND (IVUS)

I. Image basics

II. Plaque types

III. Basic IVUS measurements

IV. Interpretation of how a severe stenosis may look mild angiographically, yet severe by IVUS; significance of lesion haziness (see Figure 37.16)

V. Endpoints of stenting

VI. Assessment of lesion significance by IVUS

VII. Assessment of left main by IVUS

2. OPTICAL COHERENCE TOMOGRAPHY (OCT)

References

Further reading

38 Percutaneous Coronary Interventions and Complications, Intra-Aortic Balloon Pump, Ventricular Assist Devices, and Fractional Flow Reserve

I. Major coronary interventional devices

II. Stent thrombosis, restenosis, and neoatherosclerosis

III. Peri-PCI antithrombotic therapy (see Table 38.3)

IV. Complex lesion subsets

V. Sheath management

VI. Post-PCI mortality and coronary complications

VII. Femoral access complications

VIII. Renal, stroke, and atheroembolic complications

IX. Intra-aortic balloon pump (IABP) or intra-aortic balloon counterpulsation

X. Percutaneous LV assist device: Impella and TandemHeart

XI. Extracorporeal membrane oxygenation (ECMO)

XII. Fractional flow reserve (FFR)

QUESTIONS AND ANSWERS

Further reading

Appendix Appendix General review questions

QUESTIONS

I. NSTEMI and STEMI (Answers on pages 901–903)

II. Stable CAD (Answers on pages 903–905)

III. Heart failure and cardiomyopathies (Answers on pages 905–909)

IV. Valvular disorders (Answers on pages 909–913)

V. Arrhythmias (Answers on pages 913–916)

VI. Congenital heart disease (Answers on pages 916–918)

VII. Peripheral arterial disease- Pulmonary embolism-Pulmonary hypertension (Answers on pages 918–919)

VIII. Hypertension and syncope (Answers on pages 919–920)

IX. Pregnancy-Chemotherapy and heart disease- Miscellaneous (Answers on pages 920–921)

X. ECG (Answers on pages 921, 922)

XI. Echocardiography (Answers on pages 923, 924)

XII. Additional hemodynamics (Answers on page 925)

XIII. Percutaneous coronary intervention and shock (Answers on pages 926–929)

XIV. Radiation in the cardiac catheterization laboratory (Answers on pages 929, 930)

ANSWERS

I. NSTEMI and STEMI

II. Stable CAD

III. Heart failure and cardiomyopathies

IV. Valvular disorders

V. Arrhythmias

VI. Congenital heart disease

VII. Peripheral arterial disease- Pulmonary embolism-Pulmonary hypertension

VIII. Hypertension and syncope

IX. Pregnancy-Chemotherapy and heart disease- Miscellaneous

X. ECG

XI. Echocardiography

XII. Additional hemodynamics

XIII. Percutaneous coronary intervention and shock

XIV. Radiation in the cardiac catheterization laboratory

Index

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