TAILIEUCHUNG - Ebook Diagnostic imaging cardiovascular (2nd edition): Part 2

(BQ) Part 2 book "Diagnostic imaging cardiovascular" presents the following contents: Coronary artery disease, heart failure, electrophysiology, pulmonary vasculature, arterial, venous, extracranial cerebral arteries, renal vasculature, peripheral vasculature. | Diagnostic Imaging Cardiovascular Left Cardiac CT was performed in an elderly woman presenting with anterior ST elevations and increased troponin who refused cardiac cath and was hemodynamically stable. Curved MPR image of the left anterior descending artery shows no evidence of coronary artery disease. Right Two-chamber image during systole same patient shows severe hypokinesis of the LV apex with preserved contractility of the basal to mid LV segments consistent with stress cardiomyopathy. Section 8 - Coronary Artery Disease Approach to Coronary Heart Disease Introduction Coronary artery disease is a leading cause of morbidity and mortality in Western countries. The underlying pathology is the development of atherosclerotic plaque in the intima of the coronary arteries. While in most cases coronary atherosclerotic plaque will remain clinically silent it can clinically manifest in a number of forms such as stable coronary artery disease acute coronary syndrome heart failure and sudden cardiac death. Clinical Manifestations of Coronary Artery Disease Stable Coronary Artery Disease In stable coronary artery disease atherosclerotic plaque deposits in the coronary arteries lead to significant narrowing of the coronary lumen with subsequent obstruction of the coronary blood stream. This results in deficit in oxygen supply of the downstream myocardium during situations of increased demand typically physical exercise . There is no close correlation between the anatomic degree of luminal obstruction and the extent of downstream ischemia at exercise which depends on numerous factors. These include the severity and length of the lesion the amount of dependent myocardium the resistance of the microvasculature and the amount of collateral flow from other coronary territories. Revascularization serves to treat symptoms and improve prognosis and is usually recommended when the amount of ischemic myocardium exceeds 10 of the left ventricular mass. Acute Coronary Syndromes Acute

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