Etiology and Pathophysiology The variety of disease states that may result in a restrictive cardiomyopathic process are summarized in Box 31.1 . Myocardial fibrosis, myocardial infiltration by specific proteins, endomyocardial scarring, and cardiac muscle hypertrophy all may contribute to diastolic…
Heart failure (HF) is a complex clinical syndrome that can result from any structural or functional cardiac disorder that impairs the ability of the ventricle to fill with (HF with preserved ejection fraction; HFpEF) or eject (HF with reduced ejection…
Definitions and Epidemiology The term acute decompensated heart failure (ADHF) encompasses an array of disease processes related to inefficient cardiac function with compromised hemodynamics and/or volume status. Although ADHF has historically been treated on an inpatient basis, there are increasing…
Over the last few decades, heart failure (HF) has emerged as a true epidemic, with an estimated global prevalence of 38 million patients. HF affects 6.5 million American adults, with nearly 1 million new cases annually. HF can be due…
Basic Principles of Coronary Blood Flow Myocardial cell contraction and relaxation are aerobic processes that require oxygen. Determinants of myocardial oxygen demands include preload, afterload, heart rate, contractility, and basal metabolic rate. Other than basal metabolic rate, these are factors…
Unfortunately, presentation with cardiac arrest or sudden cardiac death is a common manifestation of congenital coronary anomalies. This clinical relevance underpins the necessity of understanding the anatomy and presentation of congenital coronary anomalies and their treatment options. The two primary…
Cardiogenic shock (CS) is characterized by hypotension and end-organ hypoperfusion as a result of low cardiac output. CS remains the most common cause of death after presentation with a myocardial infarction (MI). This clinical state occurs in up to 10%…
Cardiovascular disease is the leading cause of death of both sexes in the United States and all industrialized nations, and is increasingly becoming an important cause of death in developing countries. According to the Centers for Disease Control and Prevention,…
Percutaneous coronary intervention (PCI) has undergone a dramatic transformation since its introduction in the 1970s. In the early 1990s, coronary stenting revolutionized PCI, improving procedural results and dramatically reducing the need for emergency coronary artery bypass graft surgery (CABG). The…
The diagnosis of acute coronary syndrome (ACS) is based on findings ranging from clinical presentation on ECG and/or biochemical findings to pathological characteristics. Patients with ACS include those whose clinical presentations cover the following range of diagnoses: unstable angina, non–ST-elevation…