Practical cardiovascular medicine

Description

Cover Title Page Copyright Page Contents Preface Abbreviations About the Companion Website PART 1. Coronary Artery Disease Chapter 1. Non-ST-Segment Elevation Acute Coronary Syndrome I. Definition, types of myocardial infarction, and pitfalls II. Clinical features, ECG, cardiac biomarkers, and echocardiography in ACS III. Initial approach to acute chest pain presentations and the use of conventional and high-sensitivity troponins IV. Management of NSTEMI V. General procedural management after coronary angiography: PCI, CABG, or medical therapy only VI. Discharge medications in NSTEMI VII. Prognosis 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 Chapter 2. ST-Segment Elevation Myocardial Infarction 1. Definition, reperfusion, and general management I. Definition II. Timing of reperfusion III. ECG phases of STEMI IV. STEMI diagnostic tips and clinical vignettes V. Specific case of new or presumably new LBBB VI. Reperfusion strategies: fibrinolytics, primary PCI, and combined fibrinolytics?PCI VII. Coronary angiography and PCI later than 24 hours after presentation-role of stress testing VIII. Angiographic findings, PCI, and cellular reperfusion; multivessel disease in STEMI IX. Antithrombotic therapies in STEMI X. Other acute therapies XI. Risk stratification XII. LV remodeling and infarct expansion after MI XIII. Discharge, EF improvement, ICD 2. Stemi Complications I. Cardiogenic shock II. Mechanical complications III. Recurrent infarction and ischemia IV. Tachyarrhythmias V. Bradyarrhythmias, bundle branch blocks, fascicular blocks VI. LV aneurysm and LV pseudoaneurysm VII. Pericardial complications VIII. LV thrombus and thromboembolic complications IX. Early and late mortality after STEMI Appendix 1. Out-of-hospital cardiac arrest: role of early coronary angiography and therapeutic hypothermia Questions and answers Chapter 3. Stable Ischemic Heart Disease and Approach to Chronic Chest Pain I. Causes of angina and pathophysiology of coronary flow II. Diagnostic approach III. Silent myocardial ischemia. Is there a role for screening asymptomatic patients and post-PCI patients? IV. Medical therapy: antiplatelet therapy V. Medical therapy: antianginal therapy and risk factor control VI. Indications for revascularization VII. CABG and CABG vs. medical therapy VIII. PCI and PCI vs medical therapy IX. PCI vs. CABG in multivessel and left main disease X. High-surgical-risk patients XI. Role of complete functional revascularization XII. Hybrid CABG?PCI XIII. Enhanced external counterpulsation XIV. Mortality in CAD 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 PART 2. Heart Failure (Chronic and Acute Heart Failure, Specific Cardiomyopathies, and Pathophysiology) Chapter 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 III. Two additional 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