كتاب Mayo Clinic Cardiology - Concise Textbook
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 كتاب Mayo Clinic Cardiology - Concise Textbook

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Mayo Clinic Cardiology - Concise Textbook
FOURTH EDITION
Editors-in-Chief
Joseph G. Murphy, MD
Margaret A. Lloyd, MD
Associate Editors
Peter A. Brady, MB, ChB, MD
Lyle J. Olson, MD
Raymond C. Shields, MD  

كتاب Mayo Clinic Cardiology - Concise Textbook  M_c_c_10
و المحتوى كما يلي :


Contributors xv
Section I Fundamentals of Cardiovascular Disease 1
Chapter 1 Cardiovascular Examination 3
Clarence Shub, MD
Chapter 2 Applied Anatomy of the Heart and
Great Vessels 20
Joseph G. Murphy, MD, and R. Scott Wright, MD
Chapter 3 Evidence-Based Medicine and Statistics in
Cardiology 44
Charanjit S. Rihal, MD
Chapter 4 Noncardiac Surgery in Patients With
Heart Disease 49
J. Wells Askew III, MD, and Clarence Shub, MD
Chapter 5 Essential Molecular Biology of Cardiovascular
Diseases 58
Cindy W. Tom, MD, and
Robert D. Simari, MD
Section II Noninvasive Imaging 69
Chapter 6 Restrictions on Drivers and Aircraft Pilots With
Cardiac Disease 71
Stephen L. Kopecky, MD
Chapter 7 Principles of Echocardiography 77
Teresa S. M. Tsang, MD
Chapter 8 Stress Echocardiography 100
Patricia A. Pellikka, MD
Chapter 9 Transesophageal Echocardiography 106
Sarinya Puwanant, MD, Lawrence J. Sinak, MD,
and Krishnaswamy Chandrasekaran, MD
Chapter 10 Nuclear Imaging 120
J. Wells Askew III, MD, and Todd D. Miller, MD
Chapter 11 Positron Emission Tomography 130
Panithaya Chareonthaitawee, MD
Chapter 12 Cardiovascular Computed Tomography and
Magnetic Resonance Imaging 139
Thomas C. Gerber, MD, PhD, and
Eric M. Walser, MD
Chapter 13 Cardiac Radiography 159
Jerome F. Breen, MD, Mark J. Callahan, MD,
and Margaret A. Lloyd, MD
Chapter 14 Atlas of Congenital Heart Defects 177
Sabrina D. Phillips, MD, and Frank Cetta Jr, MD
Chapter 15 Cardiopulmonary Exercise Testing in Clinical
Medicine 185
Thomas G. Allison, PhD, MPH
Chapter 16 Stress Test Selection 197
Thomas G. Allison, PhD, MPH
Section III Electrophysiology 203
Chapter 17 Electrocardiographic Diagnoses: Criteria and
Definitions of Abnormalities 205
Stephen C. Hammill, MD
Chapter 18 Cardiac Cellular Electrophysiology 239
Hon-Chi Lee, MD, PhD
Chapter 19 Indications for Invasive and Noninvasive
Electrophysiologic Testing 250
Barry A. Boilson, MD, and
Peter A. Brady, MB, ChB, MD
Chapter 20 Heritable Cardiomyopathies and Channelopathies:
Clinical Presentations, Genetics, and Implications
of Genetic Testing 257
J. Martijn Bos, MD, PhD, and
Michael J. Ackerman, MD, PhD
Chapter 21 Pediatric Arrhythmias 266
Bryan C. Cannon, MD
Chapter 22 Atrial Fibrillation and Flutter 270
Peter A. Brady, MB, ChB, MD
Contentsxii Contents
Chapter 23 Supraventricular Tachycardia 281
Joseph J. Gard, MD, Ammar Habib, MD,
and Samuel J. Asirvatham, MD
Chapter 24 Ventricular Tachycardia and Ectopy 289
Thomas M. Munger, MD
Chapter 25 Arrhythmias in Congenital Heart Disease 302
Christopher J. McLeod MB, ChB, PhD, and
Peter A. Brady, MB, ChB, MD
Chapter 26 Evaluation and Management of Pregnancy Associated
Arrhythmias 307
Peter A. Brady, MB, ChB, MD
Chapter 27 Syncope: Diagnosis and Treatment 313
Win-Kuang Shen, MD
Chapter 28 Pacemakers 324
Yong-Mei Cha, MD, and David L. Hayes, MD
Chapter 29 Cardiac Resynchronization Therapy 334
Grace Lin, MD, and David L. Hayes, MD
Chapter 30 Implantable Cardioverter-Defibrillator
Troubleshooting 339
Barry A. Boilson, MD, and Margaret A. Lloyd, MD
Chapter 31 Implantable Cardioverter-Defibrillator Trials and
Prevention of Sudden Cardiac Death 349
Margaret A. Lloyd, MD, and
Bernard J. Gersh, MB, ChB, DPhil
Chapter 32 Heart Disease in Athletes 357
Stephen C. Hammill, MD
Chapter 33 Autonomic Function Testing 359
K. L. Venkatachalam, MD
Chapter 34 Antiarrhythmic Drugs 363
Peter A. Brady, MB, ChB, MD
Chapter 35 Intracardiac Electrophysiology Tracings 372
Malini Madhavan, MBBS,
Christopher J. McLeod MB, ChB, PhD,
Douglas L. Packer, MD, and
Samuel J. Asirvatham, MD
Section IV Valvular Heart Disease 383
Chapter 36 Valvular Stenosis 385
Rick A. Nishimura, MD
Chapter 37 Valvular Regurgitation 393
Rick A. Nishimura, MD
Chapter 38 Rheumatic Heart Disease 403
Andrew G. Moore, MD
Chapter 39 Carcinoid and Drug-Related Heart Disease 409
Heidi M. Connolly, MD, and
Patricia A. Pellikka, MD
Chapter 40 Prosthetic Heart Valves 416
Martha A. Grogan, MD, and
Fletcher A. Miller Jr, MD
Chapter 41 Surgery for Cardiac Valve Disease 425
Rakesh M. Suri, MD, DPhil, and
Thomas A. Orszulak, MD
Chapter 42 Pathogenesis of Valvular Heart Disease 435
Nalini M. Rajamannan, MD, and
Joseph G. Murphy, MD
Chapter 43 Epidemiology of Valvular Heart Diseases 442
Vuyisile T. Nkomo, MD, MPH
Section V Aorta and Peripheral Vascular Disease 445
Chapter 44 Peripheral Vascular Disease 447
Peter C. Spittell, MD
Chapter 45 Cerebrovascular Disease and Carotid
Artery Stenting 455
Peter C. Spittell, MD, and David R. Holmes Jr, MD
Chapter 46 The Aorta 460
Peter C. Spittell, MD
Chapter 47 Renal Artery Disease 470
Verghese Mathew, MD
Chapter 48 Pathophysiology of Arterial Thrombosis 475
Robert D. McBane, MD, and
Waldemar E. Wysokinski, MD, PhD
Chapter 49 Treatment and Prevention of Arterial
Thrombosis 484
Robert D. McBane, MD, and
Waldemar E. Wysokinski, MD, PhD
Chapter 50 Venous and Lymphatic Disorders 500
Raymond C. Shields, MD
Chapter 51 Vasculitis 506
Paul W. Wennberg, MD
Chapter 52 Marfan Syndrome 514
Naser M. Ammash, MD, and Heidi M. Connolly, MD
Section VI Coronary Artery Disease Risk Factors 523
Chapter 53 Coronary Artery Disease Epidemiology 525
Thomas G. Allison, PhD, MPH
Chapter 54 Metabolic Syndrome 531
Thomas G. Allison, PhD, MPHContents xiii
Chapter 55 Pathogenesis of Atherosclerosis 537
Joseph L. Blackshear, MD, and Birgit Kantor, MD
Chapter 56 Dyslipidemia 551
Joseph G. Murphy, MD, Thomas
G. Allison, PhD, MPH, and R. Scott Wright, MD
Chapter 57 Lipid-Lowering Clinical Trials and Medications 558
Joseph G. Murphy, MD, R. Scott Wright, MD,
and Thomas G. Allison, PhD, MPH
Chapter 58 Novel Biomarkers of Coronary Artery
Disease Risk 571
Iftikhar J. Kullo, MD, FACC, FAHA
Chapter 59 Diabetes and Coronary Artery Disease 574
Robert L. Frye, MD, and David R. Holmes Jr, MD
Chapter 60 Hypertension 578
Adrian J. B. Brady, BSc, MD, R. Scott Wright, MD,
and Joseph G. Murphy, MD
Chapter 61 Stroke and Cardiovascular Disease 591
Joseph G. Murphy, MD, and
Margaret A. Lloyd, MD
Chapter 62 Heart Disease in Women 595
Patricia J. M. Best, MD, and
Sharonne N. Hayes, MD
Chapter 63 Heart Disease in the Elderly 603
Imran S. Syed, MD, Joseph G. Murphy, MD, and
R. Scott Wright, MD
Section VII Myocardial Infarction 607
Chapter 64 Cardiac Biomarkers 609
Brian P. Shapiro, MD, Luciano Babuin, MD, PhD,
and Allan S. Jaffe, MD
Chapter 65 Acute Coronary Syndromes 615
R. Scott Wright, MD, Stephen L. Kopecky, MD,
and Joseph G. Murphy, MD
Chapter 66 Chronic Stable Angina 627
Kalkidan G. Bishu, MD, and
Frank V. Brozovich, MD, PhD
Chapter 67 Right Ventricular Infarction 637
Joseph G. Murphy, MD, and R. Scott Wright, MD
Chapter 68 Adjunctive Therapy in Acute Myocardial
Infarction 641
R. Scott Wright, MD, Imran S. Syed, MD, and
Joseph G. Murphy, MD
Chapter 69 Arrhythmia Complications of Acute Myocardial
Infarction 652
Joseph G. Murphy, MD, and Margaret A. Lloyd, MD
Chapter 70 Mechanical Complications of Acute Myocardial
Infarction 657
Joseph G. Murphy, MD, and Margaret A. Lloyd, MD
Chapter 71 Cardiogenic Shock 665
Joseph G. Murphy, MD
Chapter 72 Reperfusion Strategies for ST-Elevation
Myocardial Infarction 672
Joseph G. Murphy, MD
Chapter 73 Cardiac Emergencies 682
Joseph G. Murphy, MD, Barry A. Boilson, MD,
and Margaret A. Lloyd, MD
Chapter 74 Risk Stratification After Myocardial Infarction 690
Randal J. Thomas, MD, MS
Chapter 75 Cardiac Rehabilitation 695
Thomas G. Allison, PhD, MPH
Chapter 76 Coronary Artery Bypass Surgery 701
Thoralf M. Sundt III, MD
Section VIII Diseases of the Heart, Pericardium, and
Pulmonary Circulation 707
Chapter 77 Pericardial Diseases 709
Rowlens M. Melduni, MD
Chapter 78 Pulmonary Embolism 725
Vivek Iyer, MD
Chapter 79 Pulmonary Hypertension 735
Rachel J. Le, MD, and
Garvan C. Kane, MD, PhD
Chapter 80 Pregnancy and the Heart 752
Heidi M. Connolly, MD
Chapter 81 Adult Congenital Heart Disease 761
Naser M. Ammash, MD, and
Carole A. Warnes, MD
Chapter 82 HIV Infection and the Heart 773
Joseph G. Murphy, MD, and
Zelalem Temesgen, MD
Chapter 83 Infective Endocarditis 777
Nandan S. Anavekar, MB, BCh, M. Rizwan Sohail,
MD, and Joseph G. Murphy, MD
Chapter 84 Systemic Disease and the Heart 797
Grace Lin, MD, Marian T. McEvoy, MD,
and Joseph G. Murphy, MD
Chapter 85 Cardiac Tumors 807
Joseph G. Murphy, MD, and R. Scott Wright, MDxiv Contents
Chapter 86 Sleep Apnea and Cardiac Disease 812
Tomas Kara, MD, PhD, Tomas Konecny, MD,
and Virend Somers, MD, PhD
Chapter 87 Cardiovascular Trauma 820
Joseph G. Murphy, MD, and R. Scott Wright, MD
Chapter 88 Acute Brain Injury and the Heart 824
Nandan S. Anavekar, MB, BCh,
Sarinya Puwanant, MD, and
Krishnaswamy Chandrasekaran, MD
Chapter 89 Noncardiac Anesthesia in Patients With
Cardiovascular Disease 830
Laurence C. Torsher, MD
Section IX Cardiomyopathy and Heart Failure 837
Chapter 90 Reflex and Humoral Control of the Circulation 839
Alfredo L. Clavell, MD
Chapter 91 Systolic Heart Function 843
Wayne L. Miller, MD, PhD, and Lyle J. Olson, MD
Chapter 92 Heart Failure With Preserved Ejection Fraction 850
Barry A. Borlaug, MD
Chapter 93 Heart Failure: Diagnosis and Evaluation 858
Richard J. Rodeheffer, MD, and
Margaret M. Redfi eld, MD
Chapter 94 Right Ventricular Failure and Cor Pulmonale 864
Robert P. Frantz, MD, and Joseph G. Murphy, MD
Chapter 95 Pharmacologic Therapy of Systolic Ventricular
Dysfunction and Heart Failure 869
Richard J. Rodeheffer, MD, and
Margaret M. Redfi eld, MD
Chapter 96 Mechanical Ventricular Assist Devices 874
John A. Schirger, MD, Soon J. Park, MD, and
Sudhir S. Kushwaha, MD
Chapter 97 Myocarditis 877
Leslie T. Cooper Jr, MD, and Lori A. Blauwet, MD
Chapter 98 Dilated Cardiomyopathy 888
Horng H. Chen, MD, BCH, and
Sanjay Dandamudi, MD
Chapter 99 Restrictive Cardiomyopathy 892
Sudhir S. Kushwaha, MD
Chapter 100 Hypertrophic Cardiomyopathy 898
Steve R. Ommen, MD
Chapter 101 Cardiac Transplantation 908
Barry A. Boilson, MD, Richard C. Daly, MD,
and Sudhir S. Kushwaha, MD
Section X Invasive/Interventional Cardiology 919
Chapter 102 Diagnostic Cardiac Angiography 921
André C. Lapeyre III, MD
Chapter 103 Coronary Artery Physiology and Intracoronary
Imaging 953
Abhiram Prasad, MD
Chapter 104 Principles of Myocardial Revascularization in
Interventional Cardiology 966
Joseph G. Murphy, MD, Gregory W. Barsness, MD,
and Rajiv Gulati, MD
Chapter 105 Percutaneous Treatment of Structural
Heart Disease 971
Margaret A. Lloyd, MD, Joseph G. Murphy, MD,
and Charanjit S. Rihal, MD
Chapter 106 Catheter Closure of Intracardiac Shunts 977
Guy S. Reeder, MD
Chapter 107 Invasive Hemodynamics 984
Rick A. Nishimura, MD
Chapter 108 Atlas of Hemodynamic Tracings 995
Rick A. Nishimura, MD, and
Joseph G. Murphy, MD
Section XI Appendix 1023
Chapter 109 Preparing for Cardiology Examinations 1025
Joseph G. Murphy, MD, and
Margaret A. Lloyd, MD
Chapter 110 Principles of Coronary Stenting 1035
Joseph G. Murphy, MD, Gregory
W. Barsness, MD, and Rajiv Gulati, MD
Chapter 111 Endomyocardial Biopsy 1041
Joseph G. Murphy, MD, Robert P. Frantz, MD,
and Leslie T. Cooper Jr, MD
Credit Lines 1047
Index 1059
1059
Index
Abdominal aorta
aneurysms of, 451, 464f, 550
applied anatomy, 35–36, 35f
atherosclerosis prevalence, 537, 549f
Doppler recording, 91f
grade 4 ulcerocalcific disease, 469f
Marfan syndrome, 519
MRA/CTA evaluation, 156–157
penetrating aortic ulcer, 467, 469f
postoperative CV care, 520
type III aortic dissection, 465f
Abdominal aortic aneurysm (AAA)
atherosclerotic AAA, 36
complications of, 461
CTA findings, 150
elective surgical/endovascular treatment,
461–463
iliac artery aneurysm association, 451
imaging studies, 460, 461f, 464f
inferior vena cava and, 21
lack of symptoms, 460–461
medical management, 461
MRA findings, 147f
repair of, and perioperative hypertension, 55
Abdominojugular (hepatojugular) reflux
sign, 5
Abnormal automaticity, 246
Abnormal chordae tendineae, 393
Absolute risk reduction (in measures of
effect), 45
ACAS (asymptomatic carotid atherosclerosis)
study, 457
Accelerated idioventricular rhythm, 248t, 653
Accelerated junctional tachycardia
(nonparoxysmal), 248t
Accelerated junctional tachycardias, 246
Accessory-pathway mediated tachycardia
(APMT), 266–267
treatment options, 286–287
ACCF/AHA (American College of
Cardiology Foundation/American
Heart Association)
CAD assessment guidelines, 53, 53b
perioperative guidelines algorithm, 49, 50
stress test recommendations, 52b
ACCORD study, 576, 577
Acquired AV node dysfunction, 302
Acquired sinus node dysfunction, 302
Acromegaly, 4t, 798
Action potentials, regional variations
atria, 245
AV node, 245–246
sinus node, 245
ventricles, 246
ACTIVE A clinical trial, 487t
ACTIVE W clinical trial, 487t
Acute arterial occlusion, 450
Acute brain injury
autonomic nervous system anatomy, 823f
cardiac complications
of encephalomyelitis, 827
of head trauma, 826
cardiac innervation
parasympathetic, 822
sympathetic, 822, 824
CV complications, cerebrovascular
accident
cardiac biomarkers, 825
electrocardiographic abnormalities,
824–825, 824f
neurogenic left ventricular
dysfunction, 825
subarachnoid hemorrhage, 825–826,
825f, 826f–827f
manifestations in seizures
electroconvulsive therapy, 827
epileptic seizures, 826–827
Acute coronary syndromes (ACS). See also
unstable angina
atrial fibrillation, 271
CAD likelihood, significance, 616t
clinical assessment, initial, 617–618
clopidogrel use, 487
with aspirin, 489
clopidogrel with aspirin, 489
coronary artery calcification, 141
CURE trial, 487
endothelial dysfunction, plaque
formation, 914
GP IIb/IIIa inhibitor use, 1039
initial clinical assessment, 617–618
lipid-lowering therapy, 546
low-molecular-weight heparin, 494b
MI classification, 616
MI postoperative surveillance, 56
NSTEMI syndromes, 492
nuclear imaging, 129
plaque rupture, apparent
thromboembolism, 617f
PROVE-IT trial, 546–547
PURSUIT trial, 492
stress SPECT testing, 129
UA/NSTEMI management principles,
619–626
unfractionated heparin, 493
Page numbers followed by “f“ denote figures; those followed by “t“ denote tables; those followed by “b“ denote boxes.1060 Index
Acute coronary syndromes (ACS) (cont.)
unstable coronary syndromes,
pathophysiology, 616–617
venous thromboembolism, 500
Acute heart failure
aortic regurgitation, 16
cardiac injury, 822
dyspnea presence, 48, 873
evaluation of, 863
giant cell myocarditis, 861
ivabradine BEAUTIFUL trial, 633
systolic ventricular dysfunction
treatment, 873
Acute inferior-posterior-lateral myocardial
infarction, 227f
Acute mitral regurgitation, 396, 662,
663f, 664f
Acute mitral valve regurgitation, 437
Acute myocardial infarction. See also acute
myocardial infarction, adjunctive
therapy; acute myocardial infarction,
arrhythmia complications
atherosclerotic plaque distribution, 40
AV block, second-degree, Mobitz
type I, 214f
driving restrictions and, 72t
echocardiographic evaluation, 93, 93b
EP testing contraindication, 251b
pericarditis in, 716–717
perioperative, 55
SHOCK Trial data, 46
surgical risk factors, 50, 51b
temporary pacing for, 325
Acute myocardial infarction, adjunctive
therapy
aldosterone antagonists, 648t
diabetes mellitus management, 647, 649
ED/prehospital setting, 642f
aspirin, 641–642, 643f, 648t
beta-blockers, 643f, 644, 648t
heparin, 643–644, 648t
morphine, 642–643, 648t
nitroglycerin, 644, 648t
oxygen, 642, 648t
P2Y
12 antiplatelet therapy, 644–645
renin-angiotensin-aldosterone antagonist
therapy, 645, 646f, 647
effect on mortality, 643f
lifestyle risk factor management, 649, 651
Mayo Clinic risk score, 642t
statins/lipid-lowering therapies, 647, 648t
thirty-day mortality risk, 643f
TIMI risk score, 642t
Acute myocardial infarction, arrhythmia
complications
asystole, electromagnetic dissociation, 653
electrical storm, 653
other ECG findings, 654
post-MI conduction disturbances
AV block, mechanisms, significance, 655
bundle branch block, 655
first-degree heart block, 654
intraventricular block, 655
second-degree AV block, 654–655
third-degree heart block, 655
reperfusion arrhythmias, 653
supraventricular arrhythmias, 652
temporary pacing, pre-infarct period, 653t
T-wave alternans, 653
ventricular arrhythmias, 653
Acute myocardial infarction, mechanical
complications
acute mitral regurgitation, 662–663
cardiogenic shock, 657–658
hemodynamic classification, 657
hemodynamic monitoring, 658
LV mural thrombus, 663–664, 664f
papillary muscle rupture, 663f, 664f
pericardial effusion and pericarditis, 663
posteromedial mitral papillary muscle
rupture, 664f
postinfarction syndrome (Dressler
syndrome), 663
RV infarction, 5, 637–640, 652,
657–662
Acute pericarditis
causes, 710–712
diagnostic evaluation, 712
differential diagnosis, 235, 628
ECG evaluation, 205
with PR-segment depression, 228f
ST-segment, T-wave abnormalities,
206, 227, 464
transient constrictive phase, 713
treatment, 712–713
Acute rejection (cardiac transplantation), 912
Acute rheumatic fever
clinical features, 404, 804–805
epidemiology, 403
Jones criteria, 404b
pathogenesis, 403–404
WHO criteria, 404b
Acute ST-segment elevation myocardial
infarction, 53
ACUTE study, of cardioversion, 108
Addison disease, 166, 799
Adenosine, 100
adverse effects, 123
contraindications, 100
indications for use, 126t
mechanism of action, 122–123
pharmacologic stress test, 100, 122, 144
during pregnancy, 308
Adenosine-sensitive ventricular tachycardia,
297–298, 298–300
ADONIS clinical trial, 368, 369f
ADP-receptor antagonists, 486–489. See also
thienopyridines
AFCAPS/TexCAPS trial, 564
African Americans
CAD rates, 526, 574
diabetes mellitus rate, 574, 575t
high blood pressure rates, 580
stroke rate, 455
AIM-HIGH study, 536, 561, 577
Aircraft pilots with cardiac disease. See
drivers and aircraft pilots with cardiac
disease, restrictions on
Aldosterone antagonists, 648t, 871. See also
spironolactone
Alpha-adrenergic blockers, 585
Alpha level, in studies, 45, 46
Amantadine, 316b
Ambrisentan, 749
American College of Cardiology Foundation
Quality Strategic Directions
Committee Appropriateness Criteria
Working Group, 77
American College of Emergency
Physicians, 77
American Heart Association/American
College of Cardiology
absence of statin recommendation, 435
anorexigen management guidelines, 413
cardiac CT, MRI statements, 140
family history, genetic markers
guidelines, 573
invasive EP testing criteria, 250
novel plasma biomarkers guidelines, 572
pacemaker implantation guidelines, 324
VO
2 max recommendations, 196
wide complex tachycardia, monomorphic
VT, polymorphic VT
management, 289
American Indian/Alaska natives
diabetes mellitus rates, 575t
American Society of Echocardiography, 77
American Society of Nuclear Cardiology, 77
Amiloride, 585, 586
Amiodarone, 267, 276, 276t, 294, 310,
367–368
Andersen-Tawil syndrome, 244, 265
Anderson-Fabry disease, 145
Aneurysms
abdominal aortic aneurysm, 21, 55, 147f,
150, 451, 460–463
atherosclerotic abdominal aortic
aneurysm, 36
atherosclerotic aneurysms, 550
predisposing factors, 450–451
Angina pectoris
CMV approval/disapproval and, 74t
driving restrictions and, 72t
unstable/severe, Canadian
class III or IV, 51b
Angiography. See also computed tomography
angiography
ARVC/ACM diagnosis, 261t
coronary angiography
acute coronary syndromes, 129
catheter-based, 141, 147, 152
coronary CT angiography, 139, 141–143,
150f, 448
invasive, 133
magnetic resonance angiogram,
149f, 385, 448, 449f
multivessel CAD image, 125f
preoperative, perioperative, 53–54,
53b, 103
revascularization, 200f
peripheral vascular disease diagnosis, 448,
450–452
popliteal artery entrapment, 452
radionuclide angiography, 127, 198, 400
stenosis of right common iliac artery, 450f
syncope evaluation, 317
ventricular tachycardia diagnosis, 291
Angiosarcoma, 715, 807, 808b, 809, 811
Angiotensin-converting enzyme (ACE)
inhibitors, 56
for acute MI, 645–646
for heart failure in women, 601
for HFpEF, 856
for hypertension, 583
for peripheral arterial disease, 449
for sudden death prophylaxis, 294
syncope evaluation, 315Index 1061
for systolic ventricular dysfunction,
869–870
Angiotensin receptor blockers (ARBs)
for acute myocardial infarction, 647
for ARVC, 250
for diastolic ventricular dysfunction, 605
for hypertension, 583
for Marfan syndrome, 518, 521
for syncope, 315
for systolic ventricular dysfunction, 870
VALIANT trial, 647
Ankylosing spondylitis, 4t
Anomalous pulmonary venous connection,
21–22
Anterior myocardial infarction, 325
Antiarrhythmic drugs (AADs), 363–371.
See also antiarrhythmic drugs
(AADs), specific agents
adjuvant therapy for DCCV facilitation, 275
classifications, 363
clinical trials, 367–371, 369f
effects on reentrant circuits, 363
for IART, 304
in-hospital vs outpatient initiation, 371
suppressive therapy, 276
syncope and, 316
Antiarrhythmic drugs (AADs), specific agents
adenosine (unclassified), 370
class I agents
disopyramide (class IA), 276t, 309, 365
flecainide (class IC), 267, 276t,
309–310, 366
lidocaine (class IB), 365–366
mexiletine (class IB), 297, 366
monitoring of agents, 364
phenytoin (class IB), 366
proarrhythmic effects, 364
procainamide (class IA), 365
propafenone (class IC), 366–367
quinidine (class IA), 309, 364–365
use-dependent action phenomenon, 363
class III agents
amiodarone, 267, 276, 294, 310,
367–368
dofetilide, 276f, 369–370
dronedarone, 276, 368
ibutilide, 275, 370
sotalol, 243, 260, 267, 274t, 276t, 293f,
304, 368–369
Anticoagulation therapy
atrial arrhythmias, 304
AV junction ablation complications, 280
cardioversion and, 108, 275
driving restrictions, 74t
in heart failure, 872–873
indications for ECG use, 78t
invasive EP testing risks, 254
oral anticoagulation approach, 56, 275, 278
for postoperative AF, 277
in pregnancy, 310
stroke risk prevention, 593
Antidepressant medications, 316b
Antidromic reciprocating tachycardia, 290b
Antihistamines, 248t, 262, 682, 922
Antiphospholipid syndrome, 501, 504, 592t
Antiplatelet agents
ADP-receptor antagonists: thienopyridines,
486–489, 486b, 487t
clopidogrel, 486–489, 487t
prasugrel, 489
ticagrelor, 489
ticlopidine, 486
COX inhibitors: aspirin, 484–486, 485b
GpIIb-IIIa inhibitors, 489–492
Antiproliferative agents, 537, 747, 911,
1035, 1036. See also azathioprine;
mycophenolate
Antithrombin III deficiency, 502
Aorta, applied anatomy, 35f
abdominal aorta, 35–36
aortic arch, 34–35
ascending aorta, 34–35
congenital heart disease
aortic arch congenital abnormalities, 36
aortopulmonary window, 36
coarctation of the aorta, 36
ductus arteriosus, 36
descending thoracic aorta, 35
Aortic aneurysms
abdominal aortic aneurysm, 21, 55, 147f,
150, 451, 460–463, 461f, 464f
atherosclerotic abdominal aortic
aneurysm, 36
MRA/CTA evaluation, 152
sudden death from, 290b
Aortic arch congenital abnormalities, 36
Aortic atheroembolism, 460
Aortic atheromatous disease, 593
Aortic dissection, 461–463
acute aortic regurgitation from, 33, 437
acute arterial occlusion from, 450
aortic arch and, 35
AR murmur from, 16
ascending aorta disease and, 399
cardiac arrest from, 311
classification, clinical features, 463
coarctation of the aorta and, 36
CTA of type III, 154f
diagnostic imaging, 93, 106, 107t, 464,
465f, 466
etiology of, 463
hypertrophic obstructive cardiomyopathy
and, 6
laboratory tests, 463–464
pharmacologic therapy, 467, 468b
pleural effusion complication, 95f
syncope and, 315b
systolic murmur from, 15
TEE evaluation, 106, 107t
Aortic incompetence, 7, 8b, 658, 801, 822,
1026, 1027, 1031
Aortic intramural hematoma, 468–469
Aortic root angiography, 400, 929–930, 993
Aortic root dilatation, 4t, 8b, 33–34, 67t, 400,
437, 516f
Aortic rupture, incomplete, 469
Aortic stenosis, 6, 12, 25, 34f, 54, 435.
See also severe aortic stenosis;
supravalvular aortic stenosis; valvular
aortic stenosis; valvular stenosis
aortic sclerosis comparison, 12
aortic valve replacement
recommendation, 388t
CMV approval/disapproval and, 75t
commercial driving risks, 75t
in congenital heart disease, 65–66
congenital valvular aortic stenosis, 8b
continuous murmurs in, 18
controversial management issues, 388–389
definition, causes, 385
echocardiographic evaluation, 89e, 90, 90f
fourth heart sounds in, 11–12
in hypertrophic cardiomyopathy, 6, 257
LV pressure overload from, 25
natural history, treatment, 388
noninvasive imaging evaluation, 90, 90f
palpable A- wave from, 3
pulsus parvus in, 6
right atrial enlargement finding, 164f
severe aortic stenosis, 6, 10, 12, 54, 88f, 90,
386–388
severity determination, 387t
subvalvular aortic stenosis, 385–386,
902, 932f
sudden death from, 290b, 358
surgery, indications for, 427
third heart sounds in, 11
transmitted murmurs in, 6
in valvular heart disease, 54
Aortic ulcer, penetrating, 467–468
Aortic valve
applied anatomy, 32–33, 33f
indications for surgery, 425, 426f–427f,
428
valvular heart disease, pathogenesis,
435–437
Aortic valve regurgitation, 16
causes, 398–399
ascending aorta diseases, 399
intrinsic valvular disease, 398–399
clinical syndrome of, 399–400
CMV approval/disapproval and, 75t
echocardiographic evaluation, 91, 91f
evaluation of, 400
natural history, treatment, 400–402
pathophysiology, 399
surgery, indications for, 425, 427
Aortic valve sclerosis, 435
Aortic valvuloplasty, 437, 605, 758, 971
Aortoiliac disease, 448, 450
Apixaban, 493
ARBITER-6 study, 567–568
Argatroban, 493, 504, 835
Arrhythmias, 54–55. See also acute
myocardial infarction, arrhythmia
complications; pediatric arrhythmias;
pregnancy-associated arrhythmias;
tachyarrhythmias; ventricular
arrhythmias
acquired LQTS and, 262t
AV bundle and, 41–42
AV interactions, ECG diagnosis, 206, 212
AV node and, 41
Brugada syndrome and, 264
clinical risk factor assessments, 51
conduction disturbances and, 54–55
in congenital heart disease, 302–306
anomalies, complexes, 305–306
associations, 302–304, 303t
decompensated CHF, 51b
driving ability evaluation, 73, 75t
EP testing evaluation, 250
exercise testing evaluation, 197
fetal arrhythmias, 309, 312
HCM and, 257–258
involving DADs, 248
mechanisms, 247f1062 Index
Arrhythmias (cont.)
obstructive sleep apnea and, 816
post-cardiac transplantation, 912–913
ryanodine receptors and, 243
stress echocardiography evaluation, 100
supernormal excitability and, 246
underlying cause treatment, 71
in women, 601–602
Arrhythmogenesis mechanisms
abnormal rhythm conduction
reentry, 248
abnormal rhythm generation
abnormal automaticity, 246
delayed afterdepolarizations, 248
early afterdepolarizations, 247–248
triggered activity, 246–247
Arrhythmogenic right ventricular dysplasia
(ARVD), 289
SCD in athletes, 357, 358
sudden death from, 290b
VT in, 295–296
Arrhythmogenic right ventricular myopathy
(ARVC)
clinical presentation, 260, 868
EMB diagnosis, 1044
genetic basic/genotype-phenotype
correlations of, 261–262
revised task force criteria, 261t
SCD/indications for ICD, 260
Arrhythmogenic RV dysplasia, 891
Arterial pulse
carotid pulse abnormalities, 6–7
femoral pulse abnormalities, 7
Arterial thrombosis
clopidogrel use for, 64
heparin-induced thrombocytopenia
and, 452
Arterial thrombosis, pathophysiology of,
475–483
anticoagulant system, 477–478
coagulation factor activation, 475,
476f, 477
contact activation (intrinsic) pathway, 480
endothelium, 475
fibrinogen, 481fi
brinolytic system, 478
new paradigm of, 482–483
old paradigm of, 481–482
platelets, 478–480
thrombus propagation, 477
tissue factor (extrinsic) pathway, 480
von Willebrand factor, 480–481
Arterial thrombosis, treatment and prevention,
484–499
fibrinolytic agents, 497–498
heparinoids
fondaparinux, 495–496, 496f
heparin-induced thrombocytopenia,
494–495
low-molecular-weight heparin, 493–494
unfractionated heparin, 493
platelet inhibitors
ADP-receptor antagonists:
thienopyridines, 486–489, 486b, 487t
COX inhibitors: aspirin, 484–486, 485b
GpIIb-IIIa inhibitors, 489–492
phosphodiesterase inhibitors, 489
thrombin inhibitors
apixaban, 493
argatroban, 493
bivalirudin, 492, 492b
dabigatran etexilate, 493
lepirudin, 492, 492b
rivaroxaban, 493
ximelagatran, 493
warfarin, 496–497, 496b, 497f
Artifactual tachycardia, 290b
ASCOT-LLA trial, 563f, 564
Aspergillus infective endocarditis, 784f
Aspirin
adjunctive
for MI, 641–642, 643f
for STEMI, 679
for erythromelalgia, 454
for peripheral arterial disease, 449
for sudden death prophylaxis, 294
ASSENT-3 clinical trial, 490
ASTEROID trial, 567
ASTRAL trial, 473–474
ASTRONOMER clinical trial, 437
Asystole and electromechanical
dissociation, 653
Atenolol, 309, 311, 468b, 518, 589, 624t,
683, 757
ATHENA clinical trial, 368
Atherosclerosis
abdominal aorta, fatty streaks, 549f
ACAS study, 457
aortic arch aneurysms, 35
aortic atherosclerosis, 16, 460
aortic valve disease association, 435
arterial remodeling, 543
aspirin treatment, 486
cardiac risk factors, 50, 66, 480, 503, 529,
538–541
carotid artery disease association,
455–456
carotid pulse pressure association, 6, 7
cigarettes smoking implications, 541
claudication from, 448t
coronary artery calcification process, 140
coronary artery cross sections, 538f
diabetes mellitus implications, 539–541
diffuse atherosclerosis, 7
early processes, 541, 542f, 543, 545f
endothelium reaction, 541
foam cells in, 542f
histologic typology, contents, 544
hypertension implications, 539
LDL-C implications, 539, 541, 542f
obstructive sleep apnea and, 815–816
peripheral arterial disease association, 447
plaque stabilization, regression,
546–548, 550
platelet activation physiology, 548f
risk factors, 552
role of Lp(a) lipoprotein, 551
smooth muscle cell proliferation, 538f
statin trials, comparative, 548t
stenotic plaque, 544f, 545f, 547f
sudden death from, 290b
sudden death risks, 290b
in Takayasu arteritis, 509f, 510
TEE evaluation, 117f
thoracic aortic aneurysms from, 460
thrombosis, 545–546
vaso vasorum, angiogenesis,
neovascularization, 543–544, 543f
vulnerability, plaque rupture, 544–545,
545f, 546f, 547f
Atherosclerotic abdominal aortic
aneurysm, 36
Atherosclerotic aneurysms, 550
Athletes and heart disease, 357–358
athletes vs. nonathletes, 357
causes of sudden death, 257, 260, 262
CPX testing, 185, 195t, 197, 202
determination of athletic eligibility,
357–358
diastolic dysfunction evaluation, 86f
endurance athletes, 187, 188
screening for SCD risks, 358f
Atorvastatin, 436, 440f, 546, 547f, 548, 559,
564–569, 647, 776
A to Z statin trial, 548t, 567, 647
Atria, applied anatomy, 22–24
atrial septal defect, 24
atrial septum, 22–23
comparison of, 23–24
left atrium, 23
right atrium, 22
Atrial arrhythmias
cardiac action potentials and, 245
cardioversion of, 275
congenital tachycardia and, 303
lipomatous hypertrophy of the atrial
septum in, 41
from Mustard/Senning procedures, 306
sudden death from, 290b
Atrial ectopic tachycardia (AET), 267
Atrial fibrillation, 248t
cardiac associations, 271b
classification of, 272
clinical importance, 270
clinical presentation, 271–272, 304
epidemiology of, 270
EP testing risk, 255b
first episode, evaluation and management,
272–273
heart failure, 873
IART comparison, 304
modulating factors, 271f
noncardiac associations, 271b
nonpharmacologic management, 279–280
obstructive sleep apnea and, 817
pathophysiology of, 270
post-MI, 652
progression of, 273f
rate control agents and control, 275
rhythm vs. rate control, 273, 275
in women, 601
Atrial flutter, 248t, 268, 272t
classification of, 272
clinical importance, 270
common associations
congestive heart failure, 270–271
hypertension, 270
hypertrophic cardiomyopathy, 271
myocardial infarction, ischemia, 271
preexcitation syndromes, 271
thyrotoxicosis, 271
epidemiology of, 270
first episode, evaluation and management,
272–273
isthmus-dependent, 303–304
nonpharmacologic management, 279–280
pathophysiology of, 270Index 1063
postoperative atrial flutter, 275, 276–277
preexcited atrial flutter, 276, 277f
rate control agents and control, 275
recurrence after successful DCCV, 275
rhythm vs. rate control, 273, 275
risk factors for stroke, 277–278
anticoagulants, 278
thromboembolic complication prevention,
277–278
Atrial myxoma, 507b
Atrial rhythms
ECG diagnoses, 205–206
ECG score sheet diagnosis, 207, 208f–210f,
209–210
Atrial septal aneurysm, 8, 96, 145f, 977,
979f, 981f
Atrial septal defect, 167f, 170f, 177f. See also
primum atrial septal defect; secundum
atrial septa defect
abnormal jugular venous pulse waves, 6b
advanced carcinoid syndrome, 438
amyl nitrate/vasopressors, effects, 16t
anomalous venous connection, 22
in arrhythmias, 305
clinical clues, general examination, 4t
congenital absence of the pericardium, 710
cryptogenic stroke, 593
cryptogenic stroke and, 593
described, 305
driving restrictions, 66
Ebstein anomaly of the tricuspid valve, 303
ECG diagnosis, 207
ejection clicks, 8b
familial atrial septa defects, 66
left-to-right shunts, 738b
percutaneous atrial septal occlusion
devices, 978f, 978t
right ventricular infarction, 639
septal occluder device treatment, 176
sinus venosus atrial septal defect, 22, 98f,
119f, 763
S
2 splitting, 9f
TEE evaluation, 97, 98f, 107t
Atrial septostomy, 749
Atrial switch (dextrotransposition of the great
arteries), 178f, 179f
Atrial tachyarrhythmias, postoperative, 54
Atrial tachycardia, 248t
treatment options, 287–288
Atrioventricular block
acquired AV block, 302, 324
arrhythmia association, 262t
atrial flutter with, 268
atrial tachycardia with, 206
in children, 268–269
congenital AV block, 302, 303t
EP testing evaluation, 253b
first degree, 72t, 231, 267
high-grade, 51b, 126, 126t, 253,
281, 373
infrahisian, 373, 375f
localizing the site of, 373
Mobitz type I, 72t
Mobitz type II, 72t, 212, 251
second-degree, 251, 268–269, 324
suprahisian, 372, 374f
third-degree, 212, 251, 269, 325
Atrioventricular conduction system
disease, 315b
Atrioventricular node reentrant tachycardia
(AVNRT), 267, 281–282, 284f
coronary sinus EGMs and, 377–379
treatment options, 286
Atrioventricular valves, applied anatomy
chordae tendineae, 28
papillary muscles, 28
valve annulus, 28
valve leaflets, 28
Atropine, 100–101, 212, 246, 299, 317, 360,
834, 922
Attenuation correction in PET, 130
Austin Flint murmur, 17
Automatic tachyarrhythmias, 246
Autonomic function testing, 359–362
biochemical tests
plasma norepinephrine levels, 362
cardiology-related anatomy, physiology,
359
pharmacologic tests
atropine, 360
carotid sinus massage, 360
isoproterenol, 360
norepinephrine, 360
quantitative sudomotor axon reflex
test, 361
sudomotor, 360–361
thermoregulatory sweat test, 360–361,
360f–361f
physiologic tests
carotid sinus massage, 360
head-up tilt test, 359–360
AV conduction abnormalities
ECG diagnoses, 206
ECG score sheet diagnosis, 212–213
AVERT trial, 565–566
AV fistula formation, EP testing risk, 255b
AVID ICD for SCD prevention trial
(1997), 351t
AV junctional rhythms
ECG diagnoses, 206
ECG score sheet diagnosis, 210
AV nodal blocking agents. See also
adenosine; beta-blockers; digoxin;
diltiazem; verapamil
for arrhythmias during pregnancy, 308–309
AV reciprocating tachycardia (AVRT), 286
Azathioprine, 508, 883, 908, 911–912,
915, 1041
Bacterial endocarditis, 507b
BARI 2D trial, 576
BARI trial, 970
Basal cell carcinoma, 507b
Beals syndrome (congenital contractural
arachnodactyly), 517
Becker muscular dystrophy, 64, 797
Behçet syndrome, 507t, 510, 786, 801
BENESTENT trial, 964
Benign coronary artery anomalies, 923
Beta-adrenergic blockers
for atrial tachycardia, 287
for heart failure, 871
for hypertension, 583–584
interactions, side-effects, 569t
for tachycardia, 286
Beta-blockers. See also bisoprolol; esmolol;
metoprolol; metoprolol succinate;
propranolol
for acute myocardial infarction,
643f, 644, 649
adverse effects, 55, 309
for APMT, 267
for ARVC, 258
assessment for need, 49, 56
for atrial fibrillation, atrial flutter, 275
for atrial tachyarrhythmias, 54
for CPVT, 264–265
driving guidelines, 74t
for erythromelalgia, 454
for familial channelopathy syndromes, 297
for HCM, 258, 904–905
for hypertension, 56
intravenous administration, 56
for long QTS syndrome, 262, 263
for Marfan syndrome, 517
for perioperative ischemia, 55
during pregnancy, 309
for PVCs, 301
for sudden death prophylaxis, 294
syncope evaluation, 315
for systolic ventricular dysfunction, heart
failure, 871, 872t
BHAT ICD for SCD prevention trial
(1982), 352t
Bicuspid aortic valve
aortic arch anomalies, 152
aortic regurgitation, 91
aortic stenosis, 385, 386b
benign coronary artery anomalies, 923
coarctation of the aorta, 153f
congenital absence of the pericardium, 710
congenital bicuspid aortic valve, 8b, 33, 34,
36, 517, 761, 763
driving restrictions, 75t
in pregnancy, 755
systolic ejection clicks, 8, 400
TEE evaluation, 111f
thoracic aortic aneurysms from, 460
Bisoprolol, 309t, 584, 871, 872t, 883
Bivalirudin, 452, 458, 492, 492b, 494, 620, 835
Blood pressure. See also hypertension
African Americans, 580
atherosclerosis risk factors, 552
cardiac emergencies, 688
carotid sinus stimulation for lowering,
586–587
carotid sinus stimulation treatment,
586–587
discrepancies between arms, arms
and legs, 5b
examination reading, 3
JNC 7 blood pressure staging, 578, 579t
measurement, 579–580
Mexican Americans, 580
National High Blood Pressure Education
Program, 588
role of cardiovascular reflexes, 839
self-measurement (HBPM), 580
stroke risk, 580f, 591
supravalvular aortic stenosis
discrepancy, 5b
whites, 580
BNP. See brain natriuretic peptide
Board examination. See cardiovascular
examination
Body weight. See also cardiopulmonary
exercise testing1064 Index
Body weight (cont.)
FDA prasugrel warning and, 489
influence on VO
2, 186–187
low-molecular-weight heparin and, 494
Bosentan, 748f, 749, 867
Bradyarrhythmias
acute brain injury, 822
CAD risk factor, 546
cardiac rehabilitation criteria, 695
causes of, 246
CPX interpretation, 188
diagnosis/management, 251b
EP testing indications, 251b
Guillain-Barré syndrome, 798
limit influence of, 54
obstructive sleep apnea, 812, 816
QT prolongation, 316b
RV infarction complication, 639
sudden death risk, 872
Bradycardias
acquired bradycardia, 302
acquired LQTS association, 262t
cardiac syncope, 315
congenital bradycardia, 302
driving restrictions, 72t
ECG diagnosis, 205
management of, 303
medication-induced, 123
pacemaker bradycardia, 231f
preoperative management issues, 55
SCD risk factor, 290b
sinus bradycardia, 207, 231, 238, 268
sudden death from, 290b
torsades de pointes risk factor, 276
in utero, 42
Bradycardia-tachycardia syndrome, 268
Brain natriuretic peptide (BNP)
acute heart failure, 873
chronic stable angina, 629f
congestive heart failure, 1034
ECG evaluation, 78t
evaluation for, 47t
increased levels, causes, 841b
pulmonary hypertension algorithm, 750f
right ventricular pressure overload, 746
ventricular dysfunction prognosis, 861t
Breathing Not Properly Multinational Study,
47–48
British Pacing and Electrophysiology Group
Generic Code, 325
Broad-QRS tachycardia, 254
Brugada syndrome
asymptomatic, 297
clinical presentation, 264
driving restrictions, 75t
genetic basis/genotype-phenotype
correlations, 263t, 264
polymorphic VT rhythms in, 289
SCD from, 290b
SCD in athletes, 357, 358
sudden death from, 290b
syncope evaluation, 315
Buerger disease (thromboangiitis obliterans),
451–452, 451f, 451t
Bundle branch reentry ventricular tachycardia,
294–295, 296f
CABG Patch Trial, ICD for SCD prevention
(1997), 353t, 355
CADILLAC clinical trial, 490
Calcific aortic valve disease
cardiovascular risk factors, 436b
genetic component, 435
mechanism of development, 436f
osteoblast regulatory pathways, 437b
prospective clinical trials, 436–437
risk factors/CAD comparison, 443
statin studies, 439t
statin treatment, 435–436
Calcineurin inhibitors, 910–911, 915–916.
See also cyclosporine; tacrolimus
Calcium channel, L-type, 243, 263t, 264, 600
Calcium channel blockers, 54, 56. See also
diltiazem; nifedipine; verapamil
for atrial fibrillation, atrial flutter, 275
for atrial tachyarrhythmias, 54
for atrial tachycardia, 287
for HCM, 904–905
for hypertension, 584–585
for Marfan syndrome, 518
for pulmonary hypertension, 747
for PVCs, 301
syncope evaluation, 315
for systolic ventricular dysfunction, heart
failure, 871
for tachycardia, 286
T-type, 244
CAMIAT clinical trial, 353t, 367
Candesartan, 647, 856, 870
CAPRIE clinical trial, 487t
Carcinoid heart disease, 409–415
adenomas, 393
advanced tricuspid valve disease, 411f
anesthetic management, 412–413
carcinoid tumors
cardiac involvement, 409–410
diagnosis, 409
systemic, regional therapy for, 409
carcinoid valvular disease, pathology, 411
diagnosis, 409, 410
echocardiographic features, 410–411
mitral leaflet abnormalities from, 393
pulmonary stenosis, incompetence in, 32
pulmonary valve involvement, 412f
schematic illustration, 410f
surgical management of, 411–412
tricuspid regurgitation in, 92
tricuspid stenosis in, 29
tricuspid valve, gross pathologic
specimen, 412f
valve prosthesis choices, 412
valvular incompetence in, 29
Carcinoid syndrome, 4t, 17, 409–413,
438, 441
Cardiac allograft vasculopathy (CAV),
911, 913–916, 918
Cardiac arrest, and hypoxic-ischemic brain
injury, 592
Cardiac chambers, applied anatomy
atria, 21–25
ventricles, 25–28
Cardiac channelopathy-susceptibility genes,
263t. See also long QT syndrome
Cardiac conduction system, applied
anatomy, 42f
atrioventricular bundle, 41–43
atrioventricular node, 41
bundle branches, 43
innervation, 43
internodal tracts, 41
sinus node, 40
Cardiac emergencies
acute coronary syndromes, 685–687
AF/AFL, rapid ventricular response,
683–684
aortic dissection, 687
beta-blocker toxicity, overdose, 688
blood pressure management, 688
calcium channel blocker toxicity, overdose,
688–689
digoxin toxicity, overdose, 688
hyperkalemia, 688
hypertensive emergencies, 687
multifocal atrial tachycardia, 685
pacemaker-mediated tachycardia, 685
paroxysmal SV tachycardia, 684
pericardial tamponade, 688
polymorphic ventricular tachycardia,
682–683
pulmonary edema, 687
pulmonary thromboembolism, 688
reciprocating tachycardia, Wolff-Parkinson
syndrome, 684–685
right ventricular ischemia,
infarction, 687
Cardiac magnetic resonance imaging (MRI).
See also magnetic resonance imaging
clinical uses
cardiac stenosis, 884
coronal artery calcium scanning,
140–141
myocarditis evaluation, 879, 881
ventricular structure, function
assessment, 743
description, 143
exercise cardiac MRI, 144
inappropriate use, 79b
proposed myocarditis criteria, 881b
risk factors, 881–882
usefulness of, 143–144
Cardiac PET radiopharmaceuticals
nitrogen-13 ammonia, 131–132, 132f, 133f,
134f, 136f, 137f
PET metabolic tracers, 132–133
PET perfusion tracers, 131
rubidium 82, 131f, 132, 133f, 134f
Cardiac radiography, 159–176. See also
cardiac radiography, pulmonary
vasculature
aortic disease, 170, 172, 172f, 173f
cardiac masses, 170, 171f
implanted cardiovascular devices
septal occluder devices, 176, 176f
transcatheter aortic valve implants,
175f, 176
valves, 162f, 174f, 175–176, 175f
ventricular assist devices, 175f, 176f
pericardial disease
normal pericardium, 168
pericardial calcification, 169, 170f
pericardial defects, 169–170, 171f
pericardial effusion, 169
pulmonary vasculature
decreased pulmonary blood flow,
166, 168f
increased pulmonary blood flow,
166, 167fIndex 1065
increased resistance to pulmonary blood
flow, 166–167
normal pulmonary blood flow, 165–166
pulmonary arterial hypertension,
167–168, 169f, 170f
pulmonary venous hypertension,
167, 168f
silhouette and chamber size, 160f–162f
generalized cardiac enlargement,
160–161, 163f
heart size, 160
lateral projection, 159–160
left atrial enlargement, 161–162, 163f
left ventricular enlargement, 163, 164f
posteroanterior projection, 159
right atrial enlargement, 164–165, 165f
right ventricular enlargement, 165
Cardiac radiography, pulmonary vasculature
normal pulmonary blood flow, 165–166
pulmonary arterial hypertension, 167–168,
169f, 170f
pulmonary venous hypertension, 167, 168f
Cardiac rehabilitation (CR)
definition, 695–696
historical perspective, 696
post-CPX mortality data, 194f
post-MI, 691
VO
2 max long-term survival prediction, 192
WHO definition, 695–696
Cardiac resynchronization therapy (CRT),
325, 355
benefits from, 851t, 873
cardiomyopathy and heart failure,
872–873
clinical trials, 334, 335t–336t
defined, 334
ECG use indication, 78t
goal of, 325
implantation technique, 337
indications for, 334
left anterior oblique cross-sectional
view, 337f
posteroanterior chest radiographs, 338f
responders/prediction of response, 337–338
systolic dysfunction approach, 870t
Cardiac sarcoidosis, 801f, 881, 884, 884f,
890, 894, 894f
Cardiac sarcomas
angiosarcoma, 715, 807, 808b, 809, 811
Kaposi sarcoma, 773, 775, 811
Cardiac tamponade, 5, 6b
aortic dissection association, 717
causes, 20–21
hemodynamics of, 713–714
invasive EP testing risks, 255b
jugular vein clues, 6b
M-mode, 2D features, 94
pericardial effusion and, 169, 713–716
pericardial tamponade, 688
sudden death from, 290b
“Swinging Heart“ in, 94f
syncope and, 315b
treatment of, 715
Cardiac transplantation, 53b
allograft rejection management,
1043–1044, 1045b
antibody-mediated rejection, 914f
bedside right heart catheterization, 997
CAD CPX assessment, 197
cardiogenic shock, orthopedic
transplantation, 670
cell-mediated rejection, 913f
Chagas cardiomyopathy, 886
complications, early (post-transplant)
acute rejection, 912
arrhythmia, 912–913
hyperacute rejection, 912
primary graft failure, 912
complications, late (post-transplant)
cardiac allograft vasculopathy, 911,
913–916, 918
chronic kidney disease, 915–916
infection, 916
lymphoproliferative disease, 917f
malignancy, 916–917
contraindications, 909b
current demographics and outcomes, 918
DCM patient consideration, 877, 889, 891
donor and recipient matching, 908–910
driving restrictions, 72t, 73t
ECG evaluation, 881
endomyocardial biopsy evaluation, 882
heart failure, 861, 862t, 863
immunosuppression methods, 910–912
indications for, 908, 909b
ISHLT data, 912, 915, 916, 918
LVAD and, 874–875
myocarditis treatment, 883
operative details, 910
biatrial anastomosis, 910f–911f
bicaval anastomosis, 910f–911f
pulmonary hypertension eligibility, 751
restrictive cardiomyopathy from, 893b
TEE application, 108t, 110, 835
Cardiac troponin, 259, 259t, 609–610,
610t, 612f
Cardiac tumors
carcinoid heart disease, 811, 811f
cardiac myxomas, 807
cardiac sarcomas
angiosarcoma, 715, 807, 808b, 809, 811
Kaposi sarcoma, 773, 775, 811
cardioembolic stroke and, 592t
familial cardiac tumors, 807–808
lipomatous hypertrophy of the atrial
septum, 808–809
mesothelioma of the AV node, 809
metastatic cardiac tumors
AIDS, 811
melanoma, 810f
neoplastic pericarditis, 811, 811t
papillary fibroelastoma, 809
presentation of, 807
TEE assessment, 106, 110, 116
Cardiac valve disease surgery, 425–434
aortic regurgitation, indications, 425, 427
aortic valve stenosis, indications, 427
minimally invasive robotic surgery,
432–434, 433f
mitral regurgitation, indications, 427, 429f
mitral stenosis, indications, 428, 432f
reoperation, 434
suture reconstruction, 433f
thoracoscopic approach, 432
triangular resection, 433f, 434f
tricuspid valve, 429
valve choice, 429–431
Cardiac valves, applied anatomy
aortic valve, 32–33
atrioventricular valves, 28
fibrous cardiac skeleton, 33–34
mitral valve, 29–31
pulmonary valve, 32
semilunar valves, 31–32
tricuspid valve, 28–29
Cardiogenic shock, 46, 657–658
accompanying inflammatory state, 670
acute aortic regurgitation, 401
acute myocardial infarction, 106, 657–658
beta blocker therapy, 644
bundle branch block, 655
causes, 106, 665
circulatory assist devices, 669–670
coronary angiography and
revascularization, 668–669
coronary angiography risks, 922
diagnosis of, 666
failed treatment in, 670
hypertension in, 1028
implantable cardioverter defibrillator, 355b
incidence/mortality, 665
predictors of, 665–666
inotropic/vasopressor agents, 669
Killip classification, 619t
management
acute pulmonary edema, 667
angiography, 667
cardiogenic shock, 667–668
general issues, 670
hypovolemia, 667
intra-aortic balloon pump, 667
invasive monitoring, 667
myocardial infarction, 604
noncardiogenic shock vs., 997
refractory cardiogenic shock, 909b
reperfusion strategy for STEMI, 679–680
RV infarction and, 666–667
SHOCK clinical trial, 669–670
Cardiomyopathies. See also dilated
cardiomyopathy; hypertrophic
cardiomyopathy; restrictive
cardiomyopathy
cardiomyopathy-associated PVCs, 301t
cardiomyopathy mutants, 67
diabetic cardiomyopathy, 575
hypertrophic cardiomyopathy, 93
hypertrophic obstructive cardiomyopathy
and, 6
idiopathic dilated cardiomyopathy, 145
infiltrative cardiomyopathy, 613, 722
inflammatory cardiomyopathy, 891
ischemic cardiomyopathy, 355b, 891
metabolic cardiomyopathy, 891
stress-induced cardiomyopathy, 891
tachycardia-induced cardiomyopathy, 272
valvular cardiomyopathy, 891
Cardiomyopathy-associated premature
ventricular contractions, 301t
Cardiopulmonary exercise testing (CPX),
185–196
CCI codes in CPX laboratories, 185
conventional ECG vs., 187–188
cycle ergometer exercise tests vs., 188
dyspnea on exertion: case study, 194–195,
194b, 194f, 195f
historical background, 185
interpretation, 188–1891066 Index
Cardiopulmonary exercise testing (cont.)
prognosis based on VO2 max, 192, 194
ranges for VO2 max, 195–196
sample CPX tests: case studies, 189–192,
189b, 189f, 189t, 190f, 191b, 191f,
191t, 192f, 192t
test instrumentation, 186f
uses, 188
VO
2 to cardiac output, relationship,
185–187, 186f
Cardiovascular examination
abnormalities on palpation of precordium,
3, 5
angiographic images, important, 1027
aortograms/ventriculograms, clinical clues,
1026
arterial pulse, 6–7
blood pressure, 3
Board overview, 1025
cardiac murmurs, 12, 13f, 14–18, 15t,
16b, 16t
cardiovascular disease, physical signs
acute mitral regurgitation, 1030
acute pericarditis, 1029
acute pulmonary hypertension, 1030
aortic regurgitation, 1031
aortic stenosis, 1031
atrial septal defect, 1032
cardiac tamponade, 1029
chronic pulmonary hypertension, 1030
Eisenmenger syndrome (right-to-left
shunt), 1032
hypertrophic cardiomyopathy, 1032
infective endocarditis, 1029–1030
left ventricular failure, 1028
mitral regurgitation (chronic), 1030
mitral stenosis, 1030
mitral valve prolapse, 1030
murmurs (named murmurs), 1032–1033
patent ductus arteriosus, 1032
pulmonary regurgitation, 1032
pulmonary stenosis, 1031–1032
right ventricular failure, 1028–1029
tetralogy of Fallot, 1032
tricuspid regurgitation, 1031
tricuspid stenosis, 1031
ventricular septal defect, 1032
clinical clues to abnormalities, 4t
ECG tracing diagnosis, clinical clues
arrhythmias, 1026
chest pain, 1026
healthy patients, 1026
metabolic ECGs, 1025–1026
postoperative patients, 1026
echocardiographic images, important, 1027
electrophysiologic/pacemaker tracings,
important, 1027
general appearance, 3
heart sounds, 7–12
jugular veins, 5
physical signs, important
apex beat palpation, 1027
arterial pulses, 1027
auscultation, 1027
JVP, 1027
topics on typical examinations
arrhythmias, 1034
arteritis, 1033
congestive heart failure, 1034
coronary artery anomalies, 1033
coronary artery disease, 1033
hypertrophic cardiomyopathy,
1033–1034
MI, mechanical complications, 1033
MR/CT imaging, 1033
pulmonary hypertension, 1034
stress testing, 1033
valvular heart disease, 1033
Cardiovascular reflexes
blood pressure regulation, 839
inferior infarctions, 654
lesions, influences of, 359
Cardiovascular Risk Stratification
Pyramid, 571f
Cardiovascular trauma
aorta and great vessels, 823
blunt cardiac injury, 820
cardiac lesions, 165, 405, 408, 754, 755b,
761, 821b
damage to intracardiac structures, 822–823
diagnosis of injury, 821–822
electrical injury to the heart, 823
fatal hemopericardium, 821f
medical cardiac injury, 821
motor vehicle accidents, 821f, 823, 823f
myocardial contusion, 611t, 658, 820,
821–822, 821b
penetrating cardiac injury, 820
pericardial injury, 820
traumatic lesions, 821b
treatment of injury, 822
Cardioversion. See also direct-current
cardioversion
abnormalities diagnosed with TEE,
108, 108t
ACUTE study of, 108
anticoagulation and, 275
for AVRT, 286
CARDS trial, 564
CARE-HF clinical trial (for CRT), 336t, 338
CARE trial, 565, 566
CARGO study, 912
Carotid artery disease, 454–459
ACAS study, 457
angiographic evaluation, 456
asymptomatic AAA, 461
CAD risk factor, 552
carotid endarterectomy treatment, 456
carotid sinus massage contraindication, 316
causes of stroke, 455–456
cephalic arteries, spontaneous
dissection, 459
cerebral embolism, 459
extracranial carotid artery disease, 456
noninvasive imaging evaluation, 456
stroke risks, 455
Veterans Administration study, 456–457
Carotid artery stenting
adjunctive therapy, 458
clinical trials, 458–459
procedural goals, 457–458
Carotid atherosclerosis, 6–7, 447,
455–456, 457
Carotid endarterectomy treatment
benefits of, 456
carotid artery stenting, 457–459
computed tomographic angiogram, 472f
limitations of, 457
with medical therapy, 456–457
risk stratification, 50b, 831t
risk factors, 457
Carotid pulse
abnormalities, 6–7, 6b
jugular vein pulse comparison, 6t
Carotid sinus massage, 376f
description, 360
noninvasive EP testing algorithm,
255f, 256
pacemaker-mediated-tachycardia, 685
paroxysmal supraventricular
tachycardia, 684
RVOT VT treatment choice, 300
in syncope, 316, 359
Carotid sinus stimulation, for lowering blood
pressure, 586–587
CASCADE, ICD for SCD prevention trial
(1993), 351t
CASH, ICD for SCD prevention trial
(1993), 351t
CASS trials, 968
CAST, ICD for SCD prevention trial
(1991), 352t
Catecholaminergic polymorphic ventricular
tachycardia (CPVT), 290b
clinical presentation, 264–265
genetic basis/genotype-phenotype
correlations, 265
Catheter ablation
accessory pathway-related
tachycardias, 287
acquired tachycardia, 303–304
atrial flutter, atrial fibrillation,
270, 272, 280
congenital tachycardia, 303
direct current method, 292
for IART, 304
pediatric patients
atrial ectopic tachycardia, 267
junctional ectopic tachycardia, 268
supraventricular tachycardia, 267
ventricular tachycardia, 291
Catheter-based artery embolization, 409
CCP trial, 692t
Cellular electrophysiology, 239–249
action potentials, regional variations
atria, 245
AV node, 245–246
sinus node, 245
ventricles, 246
arrhythmogenesis mechanisms
abnormal rhythm conduction,
248–249
abnormal rhythm generation,
246–248
calcium channel
L-type, 243, 263t, 264
T-type, 244
electrogenic membrane pumps,
exchangers, 244
gap junction channels, 241–242
G protein-gated Kir channel, 243–244
hyperpolarization-activated cyclic
nucleotide gated channel, 244
ion channels
and cardiac action potential, 240–244
structure and function, 239–240
normal rhythm generation, conduction, 246Index 1067
potassium channel, 242, 243, 263,
263t, 296
ryanodine receptors, 240–244
sodium channel, 241, 263, 263t, 264, 297
strong Kir channel, 244
Central sleep apnea (CSA)
acute/chronic effects, 817
CVD association, 817–818
treatment, 818–819
Cerebral embolism, 459, 592
Cerebral hemorrhage, 455, 687, 798. See also
intracerebral hemorrhage
Cerebral thromboembolism, 592
Cerebrovascular disease
CAD risk factor, 566
cardiac transplant contraindications, 909b
carotid artery stenting and, 455–459
cryptogenic stroke, 593
evaluation for, 50, 52b, 315
hypercholesterolemia,
hyperhomocysteinemia, 67t
hypertension risks, 449
ischemic heart disease surgery risks, 833b
risk index, 51b
Chagas disease, 62, 145, 774, 879t, 883, 890,
1042b
Chamber size/wall thickness assessments
left atrial size, 82, 82f, 83f
LV size, 79f, 82
LV thickness, 82, 82e
right ventricular size, right atrial size, right
ventricular wall thickness, 82–83
Channelopathies, 248t
CHARISMA trial, 449, 487t
Chest pain
acute coronary syndromes, 615
acute myocardial infarction and, 93
acute myocardial ischemia, 617
acute pericarditis, 711
amyloidosis, 1043
angina pectoris, 627
aortic dissection, 467f
aortic valve disease, 425
ASTEROID trial, 567
atherosclerosis, 539
CAD evaluation, 197, 616t
Chagas cardiomyopathy, 887t
cocaine use, 804
congenital absence of the pericardium, 709
coronary calcification, 141
dobutamine contraindication, 123
ECG evaluation, 78b, 93, 93b, 226f, 617
failed thrombosis, 659
heart failure, 861, 862t
hypersensitivity myocarditis, 886t
hypertrophic cardiomyopathy, 257
infective endocarditis, 782
Marfan syndrome, 519
mitral valve prolapse, 397–398
morphine sulfate (IV) treatment, 642
MRA/CTA imaging, 152
myocardial perfusion imaging, 129
myocardial reperfusion, 675, 677
myocarditis, 879
noncardiac causes, 963b
normal coronary arteries and, 962–963
PCI-related delay and STEMI, 673
pericardial cyst, 710
postoperative patients, 1026
in pregnancy, 758
pulmonary embolism, 727, 728f
pulmonary hypertension, 735
pulmonary stenosis, 764
pulmonary toxicity, 367
reperfusion arrhythmias, 653
sex differences and bias, 595, 597, 600
syncope, 315
TEE evaluation, 110f
CHF-STAT clinical trial (1995), 352t, 368
Children. See also pediatric arrhythmias
accessory-pathway mediated tachycardia,
266–267
atrial ectopic tachycardia, 267
atrial flutter, 268, 272t
atrioventricular node reentrant
tachycardia, 267
junctional ectopic tachycardia, 267–268
long QT syndrome, 269
normal resting heart rates, 268t
second-degree AV block, 268–269
sinus node dysfunction, 268
third-degree AV block, 269
ventricular arrhythmias, 268
Chloroquine, 316b
Cholesterol. See also dyslipidemia;
high density lipoprotein;
hypercholesterolemia; lipid-lowering
clinical trials and medications; low
density lipoprotein cholesterol;
National Cholesterol Education
Program; statins
ASTRONOMER trial, 437
as CAD risk factor, 529, 529f, 538, 540,
552, 559, 572, 616t
cholesterol emboli, 456b, 507b, 922t
daily intake guidelines, 558
NCEP LDL-C level recommendation, 528
reverse cholesterol transport, 541, 550
transient ischemic attack, 456b
Chronic coronary artery disease
stress SPECT evaluation
diagnostic assessment


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