Classification EF Description I. Heart failure with reduced ejection fraction (HFrEF) ≤40 Alo referred to as systolic HF Efficacious therapies well demonstrated to date. II. Heart failure with preserved ejection…
1. Severe resting LV dysfunction (LVEF <35 %) not readily explained by noncoronary causes 2. Resting perfusion abnormalities ≥10 % of the myocardium in patients without prior history or evidence…
Non-biological Biological Drug development process Pharmacokinetics Mainly done in young male animals of well selected genetic background Body composition Weight Reductionist approach Absorption Clinical phase 1 and 2 trials mainly…
Preferred strategy Patient characteristics Early Invasive Recurrent angina or ischemia at rest or with low-level activities despite intensive medical therapy Elevated cardiac biomarkers (TnT or TnI) New ST-segment depression Signs…
Eisenmenger syndrome Cyanosis from any cause Marfan syndrome with aortopathy Severe/symptomatic mitral or aortic stenosis Pulmonary arterial hypertension from any cause Symptomatic heart failure from any cause Adapted from Thorne…
Fig. 19.1 Pathophysiologic mechanisms of stress on the development of atherosclerosis. Stress activates the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system and depresses the parasympathetic nervous system. This results in…
Direct effects Indirect effects Arterial vasodilatation Lowers cholesterol Improves vascular tone Decreases insulin resistance Inhibits smooth muscle proliferation Inhibits platelet aggregation Inhibits endothelial dysfunction Improves fibrinolysis and activates coagulation Facilitates…
BP classification SBP (mmHg) DBP (mmHg) Normal <120 and <80 Prehypertension 120–139 or 80–89 Stage 1 hypertension 140–159 or 90–99 Stage 2 hypertension >160 or >100 Source: National Heart, Lung,…
Fig. 10.1 The initial approach to the patient with unexplained syncope Evaluation of Palpitations A 12-lead electrocardiogram is the initial evaluation for all patients with palpitations. This should be evaluated…
Degree of stenosis (%) ICA PSV (cm/s) Plaque estimate (%) ICA/CCA PSV ratio Diagnostic accuracy (%) Normal <125 None <2.0 <50 <125 <50 <2.0 90 50–69 125–230 ≥50 2.0–4.0 40…
