Note: Page numbers followed by t indicate table; those in italics indicate figure
A
Abciximab, 945–946
Abdominal aorta, 389
Abdominal aortic aneurysm, 398–404
clinical presentation, 398–399
controversies regarding, 405
diagnostic tests, 399
etiology, 398
lower extremity aneurysms and, 415
therapy, 399
Abdominal aortic aneurysm (AAA), 907
Ablation
alcohol septal, for hypertrophic cardiomyopathy, 137
in ventricular tachycardia, 311
cryoballoon, 372
nodal, 370
radiofrequency, 372
surgical, 372
Abnormal automaticity, 306
Abnormal stress test, LHC, 908–909
Acarbose, diabetes, 652
Accelerated idioventricular rhythm, 327, 328
Access and catheter placement, EPS
CS/high right atrium, 740
femoral veins under local anesthesia, 739
His electrogram, 740
left-sided bypass tracts/left ventricular (LV) tachycardia, 739–740
Action to Control Cardiovascular Risk in Diabetes Lipid Trial (ACCORD Lipid) (2010), 611
Activation mapping, EPS, 760
Active malignancy, 169
Acute aortic dissection, 4–5
CT coronary angiography, 723
Acute aortic regurgitation
causes, 214t
temporary cardiac pacing, 851
Acute cardiogenic pulmonary edema
in heart failure, 104
in hypertensive emergency, 507
severe hypertension, 507
Acute chest pain, CT coronary angiography, 721
Acute cholecystitis, 5
Acute coronary syndrome (ACS)
acute myocardial infarction, 2
atrial fibrillation, 372–373
Acute decompensated heart failure (AHFS), 98
Acute heart failure syndromes, 109–112
Acute hemodynamically significant bradycardia/asystole, temporary cardiac pacing, 851
Acute IE, 279
Acute mitral regurgitation (MR), 871t, 872, 872, 883
Acute myocardial infarction (MI)
adjuvant therapy
aldosterone antagonists, 23
angiotensin-converting enzyme inhibitors, 23
antiarrhythmics, 24
anticoagulation for large anterior wall MIs, 25
beta-blockers, 22–23
calcium channel blockers, 23
diabetes control, 23–24
implantable cardioverter-defibrillators, 24
intra-aortic balloon pump, 24
wearable cardioverter-defibrillators, 24–25
associated with cocaine abuse, 25
clinical classification of different types of, 3t
clinical diagnosis, 3
definition of, 2
definitive electrocardiographic diagnosis, 6
diagnostic testing of, 6–12
differential diagnosis, 3–5
considerations for STEMI, 4t
echocardiography, 12
electrocardiogram displays, 13
electrocardiographic subsets of, 7–11
epidemiology of, 2
laboratory examination, 5–6
LHC, 908–909
pathophysiology of, 2
postoperative acute, 25–26
risk stratification, 12–14
simplified reperfusion strategy, 26–27
therapy, 14–25
timing of biomarker, 6
Acute myocarditis, 142
Acute pericarditis, pericardial disease
causes of, 524t–525t
chest pain, 523
clinical presentation, 523–525
defined, 523
differential diagnosis, 527
electrocardiographic changes in, 526
first-line treatment for, 528t
general indication for imaging, 526–527
inflammatory markers and markers of myocardial injury, 526
management, 525–526
medical therapy, 527–528
pericardial rub, 523
pericarditis findings per imaging modality, 527t
prognostic factors, 525
routine testing, 526
testing, 525
transthoracic echocardiogram, 526
Adenosine
dipyridamole, 696
EPS, 747
nuclear cardiac imaging, 684
in stress testing, 63
Adjuvant therapy
aldosterone antagonists, 23
angiotensin-converting enzyme inhibitors, 23
antiarrhythmics, 24
anticoagulation for large anterior wall MIs, 25
beta-blockers, 22–23
calcium channel blockers, 23
diabetes control, 23–24
implantable cardioverter-defibrillators, 24
intra-aortic balloon pump, 24
wearable cardioverter-defibrillators, 24–25
Advanced cardiac life support (ACLS), in sudden cardiac death, 359
Afterdepolarization
delayed, 306–307
early, 306
Afterload reducing agents, 231
Age-predicted maximum heart rate (APMHR), exercise electrocardiographic testing, 667
Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/TexCAPS) (1998)
hyperlipidemia, 609
Alcohol septal ablation (ASA)
complications, 960
for hypertrophic cardiomyopathy, 137
outcome, 960
procedure, 960
septal myectomy, 960
Alcohol use, HTN, 631
Aldosterone antagonists, 23
Aldosterone receptor antagonists for heart failure, 112, 115
Allergy
LHC, 926
Penicillin, 345t
AlloMap test, in cardiac transplantation, 179
ALOX5AP gene, 559
Alteplase (tPA), 19
American College of Cardiology/American Heart Association (ACC/AHA), 882
American Heart Association (AHA)/American Stroke Association (ASA) Guidelines, 422
American Society of Echocardiography (ASE) guidelines, 693
Aminoglycosides, 287
AV node, 317
for sudden cardiac death prevention, 68–69, 329
for ventricular tachycardia, 329
Amlodipine, 183
A-mode echocardiography, 963
Amplatzer device, 440
Amyloidosis, cardiac, 123
familial, 123
primary, 123
senile, 123
Anaphylactic shock, RHC, 871
Anatomically abnormal valve, 254
Anemia, high-output heart failure due to, 103
Aneurysm
aortic, 389–405
CMRI, 731
lower extremity, 415
in peripheral arterial disease, 408
ventricular, 48
Angina, 92
decubitus, 71
nocturnal, 71
Angina-like chest pain, 241
Angioedema, ACE inhibitor side effect, 114
Angiography
catheter-based, 411
computed tomography
in peripheral arterial disease, 411, 417
in renal artery stenosis, 417
in thoracic aortic aneurysm, 403
coronary
in cardiac tumors, 548
following myocardial infarction, 64
in peripheral arterial disease, 411
in stable angina assessment, 74–75, 75t
magnetic resonance
in aortic dissection, 394
in peripheral arterial disease, 411
in pulmonary embolism, 382
in renal artery stenosis, 417
pulmonary, in pulmonary embolism, 382
Angioplasty to Blunt the Rise of Troponin in Acute Coronary Syndromes Randomized for an Immediate or Delayed Intervention (ABOARD) trial, 41
Angiosarcomas, 552
Angio-seal, LHC, 924
Angiotensin-converting enzyme (ACE) inhibitors, 23
following myocardial infarction, 67
in heart failure, 112, 113–114, 127
side effects, 114
in stable angina, 82–83
Angiotensin II receptor blockers (ARB), for heart failure, 112, 114, 127
Anglo-Scandinavian Cardiac Outcomes Trial-Lipid-Lowering Arm (2003), 610
Ankle-brachial index, in peripheral arterial disease, 407, 409t
Anorexigens, 184–185
Antiarrhythmic agents
in hypertrophic cardiomyopathy, 136–137
in sudden cardiac death, 359–360, 361–362, 363
Antiarrhythmics, 24
Antiarrhythmics Versus Implantable Defibrillator (AVID) trail, 323, 328, 361–362
Antibiotics, pregnancy in women with congenital heart disease, 584
Antibiotic therapy, in infective endocarditis, 337t, 334t–335t, 336, 339
Antibody-mediated rejection (AMR), 179–180
Anticardiac antibody titers, 143
Anticoagulants, choice of, 367
Anticoagulant therapy
direct thrombin inhibitors, 37
factor Xa inhibitors, 38
fibrinolytic agents, 38
glycoprotein IIb/IIIa inhibitors, 38
heparin, 36–37
low-molecular-weight heparin, 37
oral anticoagulation, 38–39
protease-activated receptor-1 antagonist, 38
Anticoagulation, 61
ACC/AHA guidelines for selection of anticoagulation regimen in pregnant patients with mechanical prosthetic valves, 593t
carotid artery disease, 422
duration of, 367
ECMO, 902
for large anterior wall MIs, 25
pericardiocentesis, 1000
during pregnancy, 591–594, 593t
Antidromic AV reentry tachycardia, EPS, 756, 756
Antihyperlipidemic agents, carotid artery disease, 422
Antihyperlipidemic therapy
in acute coronary syndromes, 77
low HDLs, 64
Antihypertensive agents, carotid artery disease, 422
Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT)
hyperlipidemia, 610
hypertension, 633
Antihypertensive therapy in renal artery stenosis, 417
Anti-ischemic therapy
beta-blockers, 33
calcium channel blockers, 33
morphine, 33
nitrates, 32–33
oxygen therapy, 32
Antiphospholipid antibodies, 387
Antiplatelet therapy, 33
anticoagulant therapy
direct thrombin inhibitors, 37
factor Xa inhibitors, 38
fibrinolytic agents, 38
glycoprotein IIb/IIIa inhibitors, 38
heparin, 36–37
low-molecular-weight heparin, 37
oral anticoagulation, 38–39
protease-activated receptor-1 antagonist, 38
aspirin, 34
carotid artery disease, 421–422
following myocardial infarction, 65–66
initial conservative strategy, 34
initial invasive strategy, 34
ischemia guided vs. early invasive strategy, 39–40
P2Y12 (adenosine diphosphate) inhibitors, 34–36
PCI
adenosine diphosphate receptor antagonists, 943–945
aspirin, 943
thromboxane A2 inhibitor, 943
in peripheral arterial disease, 411–412
randomized trials, 40–41
thienopyridines, 65
warfarin, 66
Antiplatelets, 61
Antitachycardia devices
bradycardia detection and therapy, 801
bradycardia pacing, 797
device replacement, 799
electromagnetic interference, 802–803
ICD components, 797
implantation
defibrillation testing, 799
device implantation, 798
evaluating DFT, 799
lead placement, 798
reasons to avoid DFT testing, 799
risks and complications, 799
threshold studies, 798–799
indications and contraindications
ACCF/AHA/HRS, 797
Class IIa indications, 797–798
Class IIb, 798
Class III indications/contraindications, 798
Class I indications, 797
magnet function, 801
patients, managing and following, 801–802
subcutaneous ICD, 796
tachycardia detection, 797
atrioventricular sequential devices, 800
defibrillation therapy, 800–801
EGM and tachycardia sensing, 800
event detection, 800
Antithrombins
defects, 386
PCI, 940–941
aortic aneurysm, 731
aortic dissection, 731
aortic stents and stent grafts, 732
aortic trauma, 731
aortitis, 731–732
atherosclerotic disease, 731
intramural hematoma and penetrating aortic ulcer, 731
magnetic resonance imaging of, 456
physiology, 389
TEE, 987
Aortic aneurysm, 389–405
abdominal aortic aneurysm, 398–404
clinical presentation, 398–399
controversies regarding, 405
diagnostic tests, 399
etiology, 398
lower extremity aneurysms and, 415
screening for, 405
therapy, 399
CMRI, 731
controversies, 405
CT coronary angiography, 723
thoracic aortic aneurysm, 401–402
clinical presentation, 401–402
diagnostic tests, 402–403
surgical recommendations, 403
therapy, 403–404
Aortic arch, 389
Aortic disease, cardiovascular CT, 718
Aortic dissection, 389–405
classification schemes, 392t, 391, 392
clinical presentation, 392–393
CMRI, 731
diagnostic tests, 394t, 393, 393
epidemiology, 391
etiology, 389–391
hypertensive emergency and, 506
imaging modalities, 393–394, 394t
intramural hematoma, 390
pathology, 389–391
penetrating atherosclerotic ulcer, 390
during pregnancy, 589
therapy, 395–398
complications, 396–397
long-term management, 398
percutaneous, 397–398
priorities, 395
surgical, 397
Aortic homografts, 265
Aortic intramural hematomas, CT coronary angiography, 723
Aortic regurgitation
acute
heart sounds, 217
murmurs, 217
peripheral examination, 217
auscultation
diastolic murmur, 215–216
heart sounds, 215
second diastolic murmur, 216
cardiac catheterization, 219
cardiac imaging, 219–220
causes of, 214t
chest radiograph, 217
clinical presentation, 215
ECG, 217
echocardiography, 217
Doppler and color flow imaging, 218
stress echocardiography, 219
TEE, 219
two-dimensional and m-mode, 217
echo-Doppler, 218t
etiology, 214
acute AR, 214
chronic AR, 214
laboratory testing, 217
medical therapy, 220–221
natural history, 220
pathophysiology, chronic, 214–215
percutaneous therapy, 221
physical findings in, 216
palpation, 215
peripheral pulse examination, 215
physical signs, 216t
surgical therapy, 221
Aortic stenosis (AS)
aortic valve replacement in patients, 211t
aortopathy, 197–198
asymptomatic patients with severe AS
CABG and moderate AS, 212
high-risk, 212
auscultatory findings in, 201
bicuspid aortic valve, 196
congenitally abnormal aortic valve, 197
diagnosing, 197
diagnostic testing
chest radiography, 201
electrocardiogram, 201
natriuretic peptides, 201
differential diagnosis, 131, 132t
echocardiography
dobutamine stress echocardiography, 204
exercise stress echocardiography, 204
imaging modalities, 204
transesophageal echocardiography, 203
transthoracic Doppler, 203
etiology, 196
hemodynamic calculations
cardiac catheterization, 205
Doppler echocardiography, 204
infective endocarditis, 197
left ventricle outflow tract obstruction, 202t
left ventricular compensatory response, 199
LHC, 920
medical therapy
antibiotic prophylaxis, 206
asymptomatic AS, 206
symptomatic patients, 206–207
vasodilator, 207
parasternal long-axis view, continuity principle, 205
pathophysiology
asymptomatic patients, 199–200
diastolic dysfunction, 198
pressure overload, 198
supply–demand mismatch, 198
symptomatic patients, 200
patient survival in, 199
percutaneous aortic balloon valvuloplasty, 207
physical findings
arterial examination, 200
auscultation, 201
palpation, 201
rheumatic, 198
severely reduced ejection fraction
high transvalvular gradient, 213
low transvalvular gradient, 213
paradoxical AS, 213
pseudosevere AS, 213
severity parameters, 202t
signs and symptoms
angina, 200
heart failure, 200
syncope, 200
stress echocardiography, 705
subaortic, 213
subvalvular, 198
supravalvular, 198
TAVR
BAVs, 210
bioprostheses, 212
Boston Scientific, 208
Edward Sapien, 208
future trials, 210
in high-risk patients, 210
indications, 208
in intermediate-risk patients, 210
mechanical valves, 212
vs. medical therapy in inoperable patients, 209–210
Medtronic CoreValve, 208
prosthetic dysfunction treated with valve-in-valve, 210
surgical mortality rate, 210–212
valve types, 208
unicuspid aortic valve, 198
valvular, 196–198
Aortic stent-grafting, percutaneous, 397–398
Aortic stents and stent grafts, CMRI, 732
Aortic trauma, CMRI, 731
Aortic valve, 271
homograft, 404
Aortitis, CMRI, 731–732
Aortography
in abdominal aortic aneurysm, 399
in aortic dissection, 394
LHC
aortic insufficiency, 921
carotid angiography, 921–923
in thoracic aortic aneurysm, 403
Apical variant of hypertrophic cardiomyopathy, 845
Apical window, 271
Apixaban, for venous thromboembolism, 378
Apolipoproteins, 609
atrial fibrillation, 366–367
atrioventricular conduction disturbances, 344–348
electrical cardioversion, 860
EMB, 880
exercise electrocardiographic testing, 667, 668t, 674
gene expression profiling in, 563, 564t
hypertrophic cardiomyopathy with, 136–137
initial energy selection for commonly encountered, 859t
intraventricular conduction disturbances, 349
junctional rhythms, 348–349
LHC, 925
management, 148
as myocardial infarction complication, 52
postsurgical bradyarrhythmias, 352
during pregnancy
ACC/AHA guidelines for management of atrial fibrillation in pregnancy, 590t
atrial fibrillation and atrial flutter, 589–590
atrioventricular nodal reentrant tachycardia, 590
ventricular tachycardia, 590
pulseless electrical activity, 353t–354t, 352–354, 353t–354t
sinus node dysfunction, 336–343
sudden cardiac death, 355–364
tachyarrhythmias, 306–334
supraventricular, 307–313
ventricular, 318–334
Arrhythmogenic right ventricular cardiomyopathy (ARVC), 329–330, 356, 563, 564t, 842
Arterial blood gas (ABG), 188, 381
Arterial laceration, pericardiocentesis, 1005
Arterial switch operation, 465, 466, 468
Arteriography, renal, 417
Artifacts ascending aorta, 389
Aspiration thrombectomy, 938
antiplatelet and anticoagulant therapies, 34
heart disease in women, 575–576
in myocardial infarction treatment, 54
in PAD, 411
PCI, 943
resistance, 76
Assessment of frailty, 169
Associated cardiac defects, 455
Asymptomatic ischemia, 90
Asymptomatic myocardial infarction (MI) patterns, 90
Atherosclerosis disease, 731
gene expression profiling in, 556–557
in peripheral arterial disease, 407
Atherothrombosis, gene expression profiling in, 557–558
Atherothrombosis Intervention in Metabolic syndrome with low HDL/high triglycerides: Impact on Global Health outcomes (2011), 613
Athlete’s heart
classification of sports, 596
defined, 595
dynamic training, 595
electrophysiologic cardiac adaptations to repetitive exercise
cardiac rate, rhythm, and conduction changes, 600–601
repolarization changes, 602–603
12-lead electrocardiogram, 602
voltage criteria for ventricular hypertrophy and atrial enlargement, 601–602, 601
eligibility and disqualification for athletes with cardiac disease, 604–605
risk of excessive exercise, 603–604
static training, 595–596
structural cardiac adaptations with repetitive exercise, 596
the aorta, 599
the atria, 599
cardiac assessment to differentiate cardiac pathology from exercise-induced cardiac remodeling, 598t
left ventricle, 597–599
right ventricle, 599
theoretical model of chronic exercise-induced cardiac arrhythmogenic remodeling, 604
Athletes heart, vs. hypertrophic cardiomyopathy, 139
A to Z trial, hyperlipidemia, 612
Atrial fibrillation, 233, 274, 366–373, 452, 815
ablation of nonpulmonary vein triggers, 810
acute coronary syndromes, 372–373
acute paroxysms of, 138
anticoagulation
status and cardioversion for, 858t
strategy with cardioversion, 367
beta blockers, 369
bleeding risk, 368
calcium channel blockers, 369
cardiovascular CT, 718
choice of anticoagulant, 367
choice of oral anticoagulant, 369
chronic, 138
classification of, 366
clinical presentation, 366–367
definition of, 366
diagnostic tests, 367
drugs to maintain sinus rhythm, 371
duration of anticoagulation, 367
ECG patterns, 823
in Wolff-Parkinson-White pattern, 828
electrical cardioversion, 370
EPS, 755
exercise electrocardiographic testing, 674
focal impulse and rotor modification, 810
gene variants in, 566
hypertrophic cardiomyopathy with, 136, 138, 373
indications for cardioversion in patients with, 857t
long-term anticoagulation, 367
nodal ablation, 370
nodal blocking agents, 370–371
nonpharmacologic stroke prevention, 369
oral anticoagulants, choices of, 369t
overview, 366
pathophysiology, 366
pharmacologic cardioversion, 370
postoperative cardiac and thoracic surgery, 372
preexcitation syndromes, 373
pregnancy, 373
pulmonary disease, 373
pulmonary vein isolation, 810
rate control, 369–370
risk factors, 366
specific populations, 372–373
thromboembolic risk, 367–369, 368
thyroid function tests, 367
transthoracic echocardiography, 367
treatment, 367–369
12-Lead electrocardiogram, 367
Vaughan Williams class IA agents, 371
Atrial flutter, 308–310
atypical flutter, 813
patients with prior PVI, 814
scar tissue, 814
clinical presentation, 308
counter-clockwise typical, 813
lockwise typical, 813
pathophysiology, 308
SVT, 754–755
therapy
direct current cardioversion, 310
medical, 309–310
typical cavo-tricuspid isthmus-dependent flutter, 813–814
Atrial pacing, 59
stress echocardiography, 693
Atrial premature depolarizations (APDs), 317
Atrial septal defects (ASDs), 434–442
anatomy and embryology, 434–436
atrial septal aneurysm, 435
cardiac catheterization, 437–438
cardiac MRI, 438
catheterization data, 438
chest roentgenogram, 436–437
clinical manifestations, 436
closure, 439t
diagnostic studies
cardiac catheterization, 437–438
cardiac MRI, 438
echocardiography, 437
diagrammatic representation of, 435
dyspnea, 436
echocardiography, 437
Eisenmenger syndrome, 436
electrocardiogram, 436
fatigue, 436
formation of secundum, 434
fossa ovalis, 434
hemodynamically significant, 440
laboratory examination, 436–437
ostium primum, 435
ostium secundum, 435
pathophysiology, 436
percutaneous structural heart disease
complications, 958
outcomes, 958
procedure, 957–958
PFO and
clinical manifestations, 440
contraindications to percutaneous, 441t
diagnostic studies, 440–441
pathophysiology, 440
primary surgical closure, 439
prognosis, 440
pulmonary vascular disease, 436
sinoseptal defects, 435
sinus venosus defects, 435
supraventricular arrhythmias, 436
surgical/transcatheter therapy, 439
transcatheter closure of, 439
primary surgical closure, 439
surgical/transcatheter therapy, 439
transcatheter closure, 439–440
unroofed coronary sinus, 436
Atrial switch operation, 465
in congenitally corrected transposition of the great arteries, 471
as late intervention, 468
prior, 465
Atrial tachycardias, 310–312, 812
automatic, 311
intra-atrial reentry, 312
multifocal, 311–312
triggered, 311
Atrioventricular block, acquired, 340t
Atrioventricular conduction disturbances, 344–348
classification of, 344
clinical presentation, 344, 346
diagnostic tests, 347, 346–348, 346
therapy, 348
Atrioventricular (AV) nodal jump and echo, 751
Atrioventricular-nodal reentrant tachycardia (AVNRT), 312–313, 810–811
Atrioventricular node, 336
Atrioventricular re-entrant tachycardia (AVRT), 313, 815
Atropine, 696
in atrioventricular conduction disturbances, 348
Augmenting aortic diastolic pressure, IABP counterpulsation, 885
Auscultation, 224
Autografts, 265
Automated external defibrillator (AED), 359
Automatic atrial tachycardia, 311
Automaticity, 306
Autonomic neuropathy, 92
Autoregulation, of blood pressure, 499–500
Autosomal dominant familial hyperlipidemia, 557–558
Autosomal recessive familial hyperlipidemia, 558
AV junction ablation, 811–812
Azathioprine (Imuran), in cardiac transplantation, 174t, 175
B
Balke protocol, exercise electrocardiographic testing, 664
Balloon aortic valvuloplasty (BAV)
aortic valve replacement, 952
complications, 952–953
degenerative or calcific AS, 952
outcomes, 953
procedure, 952
Balloon valvuloplasty, 258
Bare-metal stents (BMS)
glycoprotein IIb/IIIa inhibitors
CABG vs. PCI, 653
PCI, 933–934
Bariatric surgery, obesity, 634
Basiliximab (Simulect), 177
Batista procedure, in chronic heart failure, 154
Beck triad, 534
Begin probe insertion, TEE
digital technique, 990
rotary controls on, 990
sedation, 990–991
Behavior modification, obesity, 634
Bentall procedure, 404
Beriberi, in heart failure, 103
Bernoulli equation, 204
transthoracic echocardiography, 977
acute myocardial infarction, 22–23
adjuvant therapy, 22–23
anti-ischemic therapy, 33
in aortic dissection, 396
atrial fibrillation, 369
exercise electrocardiographic testing, 662
following myocardial infarction, 66–67
in heart failure, 113, 113t, 127
in hypertrophic cardiomyopathy, 135
myocardial infarction, 66–67
noncardiac surgical procedures, 496
in ventricular tachycardia, 322
Bicaval anastomosis approach, to cardiac transplantation, 172
Bicuspid aortic valve (BAV), 196, 455
Bicuspid valve, 567
Bicycle ergometry, stress echocardiography, 694
Bidil, for heart failure, 112, 114
Bile acid sequestrants, hyperlipidemia, 619–620
Bioabsorbable vascular scaffolds (BVS), 934, 935t
Bioprosthetic valves, 235, 281, 325
Bioptome, 878
Bioresorbable polymer DES, 934
Bisoprolol, 369
Bivalirudin, 942–943
Blind approach, pericardiocentesis, 1004
Blood culture, in infective endocarditis, 331–332
Blood pressure, autoregulation of, 499
Blood work
in infective endocarditis, 331–332
in pulmonary embolism, 381
in pulmonary hypertension, 186
in renal artery stenosis, 416
Body imaging, 285
Boekholdt-very low levels of atherogenic lipoproteins from statin trials, 615
Bone marrow suppression, 288
Borg scale, exercise electrocardiographic testing, 668
Brachytherapy, PCI, 940
Bradyarrhythmias
evaluation, EPS
baseline evaluation, 747
carotid sinus massage, 749
programmed stimulation, 747–749
myocardial infarction with, 50t, 51
Bradycardia
carotid artery disease, 425
sinus, inappropriate, 336–343
Brain natriuretic peptide (BNP), in pulmonary embolism, 381
Bridge-to-decision, 156
Bridge to permanent pacing, temporary cardiac pacing, 851
Bridge-to-transplant (BTT), 157
Broken heart syndrome, 573
Bruce protocol, exercise electrocardiographic testing
advantages, 662
disadvantages, 662
modified, 662
Brugada criteria, for ventricular tachycardia, 318, 319–320
Brugada syndrome, 5
gene variants in, 564–565
in sudden cardiac death, 357–358
ventricular tachycardia in, 325
B-type natriuretic peptide (BNP) in heart failure diagnosis, 105
Bubble study, 440
Bundle branch reentry (BBR) tachycardia, 745, 746
Bupropion, 64
diabetes, 645
Burst atrial pacing, EPS, 743
Burst pacing in right ventricle, EPS, 742, 744, 745
Bypass grafts
CT coronary angiography, imaging in
graft location, 721
graft patency, 721
LHC, 919
Bypass surgery, cardiovascular CT, 718
C
Caged ball, 266
Calcified plaques, cardiovascular CT, 721
Calcineurin inhibitors, in cardiac transplantation, 173–175, 174t
Calcium blooming artifacts, 721
Calcium channel blockers, 23, 61
acute myocardial infarction, 23
adjuvant therapy, 23
anti-ischemic therapy, 33
atrial fibrillation, 369
following myocardial infarction, 67–68
in hypertrophic cardiomyopathy, 135
noncardiac surgical procedures, 496
in ventricular tachycardia, 322–323
Calf vein thrombosis, 380
Calorie restriction, obesity, 634
Cancer
following cardiac transplantation, 182
malignant cardiac tumors, 553t, 550t, 552–553
Cangrelor, advantages of, 945
Cannon-Intensive Statin Therapy (2006), 615
Cannulation of subclavian vein, 866
Captopril, in hypertensive urgency, 508–509
Carcinoid heart disease, 251, 257
Cardiac allograft vasculopathy, 180–182, 181t
Cardiac amyloidosis, nuclear cardiac imaging, 689
Cardiac arrest, exercise electrocardiographic testing, 674
Cardiac catheterization, 32, 219, 230, 237, 246, 284
in hypertrophic cardiomyopathy, 140, 134, 135t, 140
Cardiac endothelium, 279
Cardiac index, 448
in cardiac catheterization, 108
Cardiac magnetic resonance (CMR) imaging, 107, 462
myocardial viability testing, 711
limitations, 711
technique, 711
test interpretation, 711
Cardiac masses, CMRI, 734
Cardiac morphology/function, CT coronary angiography
mass, 723
myocardial infarction, 722
ventricular dysplasia, 722
Cardiac output in right heart cardiac catheterization, 108
Cardiac pacing
automatic mode switching, 780
basic pacing modes
atrial demand pacing, 782
AV sequential pacing, 782
guidelines for choice of pacemaker generator in, 781t
reducing ventricular pacing, 782
ventricular demand pacing, 780
biventricular pacing, 782
output, 771
sensing circuits, 771
telemetry circuit, 771
timing circuits, 771
clinical trials, 790–791
components of cardiac pacemakers
lead system, 771–772
polarity, 772
pulse generator, 771
conventional pacing trials
Canadian trial of physiologic pacing, 790
DAVID trial, 791
meta-analysis of trials comparing atrial- and ventricular-based pacing, 791
mode selection trial in sinus node dysfunction, 790
pacemaker atrial tachycardia trial, 790
pacemaker selection in elderly trial, 790
PROTECT-PACE, 791
recommendations, 791
SAVE PACe, 791
UK pacing and cardiovascular events trial, 790
indications for, 774–777t
lead-heart interface, 772
lead system
fixation device, 772
lead body, 771
stimulating/sensing electrode(s), 772
terminal pin, 771
pacemakers
classification, 772
components of cardiac, 771–772
timing cycles and intervals, 773–780
physiology
pulse generator output, 772
safety margins, 773
strength-duration relation, 773, 773t, 778
temporal changes in stimulation threshold, 773
polarity
bipolar, 772
unipolar, 772
pulse generator
circuitry, 771
power source (battery), 771
rate-adaptive pacing
primary components of pacemaker system, 780
sensors, basic technical categories of pacemaker, 780, 781t
safety margins
pulse width, 773
voltage, 773
sensor technology
blending, 792
“cross-checking”, 792
multiple sensors for more physiologic pacing, 792
strength-duration relation, 773t
chronaxie, 773
curve, 778
rheobase, 773
temporal changes in stimulation threshold, 773
Cardiac pain perception, 91
Cardiac rehabilitation programs, 69
Cardiac remodeling
defined, 99
in heart failure, 99
Cardiac resynchronization therapy (CRT)
current guidelines and recommendations, 768–769
dyssynchrony (See Dyssynchrony)
factors associated with improved outcomes
apical lead positions are inferior, 767
LBBB, 767
nonischemic cardiomyopathy, 767
patients with wide QRS durations (150 ms), 767
women, 767
future directions, 769–770
heart failure and, 361
implantation procedure, 769
major trials in minimally symptomatic HF
MADIT-CRT, 766–767
RAFT trial, 767
REVERSE, 766
mechanism, 763
programming and follow-up, 769
QLV and RV-LV timing, 767
recommendations, 768t
role of CRT, 765
summary of major clinical trials
block-HF, 766
CARE-HF, 765
companion, 765–766
echo-CRT, 766
MIRACLE-ICD trial, 765
MIRACLE trial, 765
MUSTIC, 765
PATH-CHF, 765
Cardiac sarcoidosis, positron emission tomography, 691
Cardiac stress testing, 32
Cardiac surgical patients, 294
Cardiac tamponade, 55
pericardial disease
clinical presentation, 534
general indication for imaging, 534–536
management, 534
medical therapy, 536
pathophysiology, 533–534
pericardial pressure-volume curves, 533
Cardiac transplantation, 164–183
azathioprine (Imuran), 174t, 175, 176–177
calcineurin inhibitors, 173–175, 174t
IL-2 receptor blockers, 174t, 177
polyclonal anti-lymphocyte antibodies, 174t, 177
cardiac allograft vasculopathy following, 180–182, 181t
comorbidities and implications for listing, 169
ECG patterns, 848
hypertension following, 182
indications for, 165–166
infectious disease following, 180
malignancy following, 182
outcomes for, 183
overview, 164–1655
patient evaluation for, 166–169, 168t
postoperative complications, 172–173
stress echocardiography, 704
surgical issues related to, 172
systemic immunosuppression, 173–175, 173–177, 174t
Cardiac trauma
angiography, 511–513
blunt trauma, 510–513
commotio cordis, 512
computerized tomography, 510
coronary arteries, 512
definition of, 510
device implants, 514
diagnosis, 548
differential diagnosis, 553
electrocardiogram, 510
great vessels, 512
myocardial contusion, 511
myocardium, 511
penetrating trauma, 513
pericardium, 511
physical examination, 547–548
primary, 549–553
secondary, 553
special considerations, 513–514
therapy, 553–554
transthoracic echocardiography, 510
valvular insufficiency, 511–512
in pulmonary embolism, 381
Cardiogenic shock, complicating acute myocardial infarction
causes of, 56t
chest radiography, 58
clinical presentation, 55–56
diagnostic studies, 57–58
early revascularization, 56
electrocardiogram, 57–58
etiology, 56–57
fibrinolysis, 58
hemodynamic effects of medications used to manage, 61t
ineffective tissue perfusion, 55
laboratory studies, 57
management, 58–61
medical therapy, 59–61
prognosis, 56
pulmonary artery catheter, 58
pulsus alternans, 55
symptoms, 55
transvenous pacing, 59
Cardiogenic shock, RHC, 870–871
Cardiomyopathy
arrhythmogenic right ventricular, 106–107, 328–329, 563
diabetic, 102
dilated, 101
familial, 101–102
gene expression profiling in, 561, 562t
idiopathic, 333
in ventricular tachycardia, 329
gene expression profiling in, 561
in heart failure, 102
hypertensive, 102
vs. athletes heart, 139
with atrial fibrillation, 136–137, 136
clinical presentation, 130–131
defined, 130
diagnostic testing, 133–134
differential diagnosis, 131t
gene expression profiling in, 561–563
genetic aspects of, 132–133, 132t
in heart failure, diagnosis of, 122
infective endocarditis and, 126t, 139
management strategies, 134–139, 136
mitral regurgitation and, 134
with obstruction, 134
physical examination, 131–132, 132t
sudden cardiac death in, 131, 133, 138, 356
syncope in, 131
in ventricular tachycardia, 329
ischemic, 102
surgical revascularization for, 152–153
left ventricular noncompaction, 563–564
nuclear cardiac imaging, 676
peripartum, 102–103
restrictive
defined, 120–121
idiopathic, 123
tachyarrhythmia-induced, 102
toxin-mediated, 102
Cardiomyoplasty, dynamic, 154–155
Cardiopulmonary exercise testing, in right heart catheterization, 108–109
Cardiopulmonary resuscitation (CPR), 513
in sudden cardiac death, 358–359
Cardiopulmonary testing in tetralogy of Fallot, 462
CardioSEAL Septal Occlusion System, 440
Cardiotoxic agents, in heart failure, 102
Cardiovascular computed tomography
angiography
in peripheral arterial disease, 411
in pulmonary embolism, 382
in renal artery stenosis, 417
in thoracic aortic aneurysm, 403
in aortic dissection, 393–394
appropriateness criteria, 724
in cardiac tumors, 548
clinical applications, 719–724
contraindications, 718
contrast-enhanced imaging, 716–717
CT physics, 714
current CT hardware
EBCT, 715
MDCT, 715
dose (or tube current) modulation, 716
four-dimensional/cine imaging, 716
image acquisition techniques
acquisition modes, 715
ECG gating, 716
high-pitch spiral acquisition (flash mode), 715–716
prospectively electrocardiogram (ECG)-triggered sequential (axial, “step-and-shoot”) mode, 715
retrospectively ECG-gated spiral (helical) mode, 715
indications, 717–718
maximal-intensity projections, 716
multiplanar reformation, 716
safety, 718–719
segmented reconstruction, 716
technical challenges for cardiac imaging
spatial resolution, 714
temporal resolution, 714
three-dimensional/volume rendering, 716
Cardiovascular diseases (CVD)
chromosomal abnormalities and, 570, 570t
heart disease in women (See Heart disease in women)
Cardiovascular drugs, pregnancy, 591, 592t
Cardiovascular formulae
electrophysiology/ECG, 1010–1011
general hemodynamics, 1007–1008
miscellaneous, 1011–1012
pharmacodynamics, 1011
shunts, 1010
statistics, 1012
valvular disease and left ventricular (LV) function, 1008–1010
Cardiovascular magnetic resonance imaging (CMRI)
aorta, diseases of
aneurysm, 731
aortic dissection, 731
aortic stents and stent grafts, 732
aortic trauma, 731
aortitis, 731–732
atherosclerotic disease, 731
intramural hematoma and penetrating aortic ulcer, 731
cardiac masses, 734
clinical applications
assessment of ventricular function and CAD, 732–733
congenital heart disease, 734
diseases of aorta, 731–732
diseases of pericardium, 733–734
nonischemic cardiomyopathies, 733
pulmonary veins, 735
valvular heart disease, 734
congenital heart disease, 734
contraindications to, 727
contrast agents
gadolinium, 729–730
nephrogenic systemic fibrosis, 729
coronary artery assessment, 735
delayed imaging, 729
future applications
coronary artery assessment, 735
interventional CMR, 735
molecular imaging, 735
gradient echo, 728–729
indications and applications, 726t
interventional CMR, 735
issues specific to CMR, 728
magnetic resonance angiography, 729
molecular imaging, 735
MRI physics, 727–728
myocardial tagging, 729
nonischemic cardiomyopathies
ARVD, 733
dilated, 733
hypertrophic, 733
infiltrative, 733
parallel imaging, 729
patient preparation
attire, 730
body coil, 730
children, 731
claustrophobia, 730
electrocardiogram monitoring, 730
emergencies, 730–731
patient size, 730
pregnancy, 731
screening, 730
perfusion imaging, 729
pericardium, diseases of
congenital absence of pericardium, 734
constriction and, 734
constrictive pericarditis, 734
effusions, 733
inflammatory pericarditis, 734
pericardial cysts, 734
phase-contrast velocity mapping, 729
practical considerations
patient preparation, 730–731
safety, 730
pulse sequences and applications
cine imaging, 729
delayed imaging, 729
gradient echo, 728–729
magnetic resonance angiography, 729
myocardial tagging, 729
parallel imaging, 729
perfusion imaging, 729
phase-contrast velocity mapping, 729
spin-echo, 728
safety
bioeffects of RF energy, 730
magnetic field gradients, 730
magnetic force, 730
spin-echo, 728
T1, T2, and image contrast, 728
valvular heart disease, 734
ventricular function and coronary artery disease
global ventricular function assessment, 732
LV thrombus, 733
myocardial infarction and viability, 732
myocardial ischemia, 732
regional ventricular function assessment, 732
Cardioversion, electrical, 310
Carditis radiation, 123
CARE-HF trial, 361
Carotid artery disease
bradycardia and hypotension, 425
carotid plaque, 419
and coronary artery bypass grafting, 430
detection and quantification of, 420
diagnosis
computed tomography angiography, 420
contrast angiography, 421
Duplex ultrasound, 420
history and physical examination, 419–420
magnetic resonance angiography, 420–421
epidemiology and etiology of stroke, 419
low-dose vasopressor infusion, 425
medical management
anticoagulation, 422
antihyperlipidemic agents, 422
antihypertensive agents, 422
antiplatelet therapy, 421–422
risk factor modification, 421
pathophysiology, 419
patient selection for carotid stenting, 429–430
percutaneous carotid intervention, 425–429
periprocedural cerebrovascular events, 425
risk factors for carotid atherosclerosis, 419
smoking, 419
surgical management, carotid endarterectomy, 423–425
Carotid artery stenting
in asymptomatic patients, 426t
in symptomatic patients, 427t–428t
Carotid endarterectomy (CEA)
ASA/American College of Cardiology Foundation (ACCF)/AHA recommendations for, 425
in asymptomatic patients, 424t
surgical management, 423–425
trials of, 423t
Carotid plaque, 419
Carotid sinus
syncope, 478
Carotid stenting
ASA/ACCF/AHA recommendations for, 429
vs. CEA, 429–430
Carotid syncope, 481
Carvedilol, 369
Catecholamine, 94
Catecholaminergic polymorphic VT, 326, 357
Catheter ablation
anticoagulation, 805
contraindications, 804
equipment
ablation energy/catheters, 806–807
impedance-based mapping, 806
magnetic-based mapping, 805–806
mapping
patient selection/indications, 804
post-procedural management
anticoagulation, management of, 817–819
major complications, 815–817
targets, 810–815
anatomic, 810–812
focal, 812–813
reentrant, 813–815
substrate, 815
vascular access, 804–805
in ventricular tachycardia, 323
C clamp, 924
Cell-mediated rejection, 179
Central nervous system (CNS) imaging, 285
Central tenet, 927
Cessation of smoking, 631
CHA2DS2-VASc risk stratification score, 368, 368t
Chagas disease, 145
antibiotic therapy, 146
clinical presentation, 146
diagnosis of, 145
heart failure, cause of, 104
ventricular tachycardia in, 330
Chemotherapeutic agents, in heart failure, 102
Chest pain, cardiovascular CT, 717
in aortic dissection, 393
in cardiac tumors, 548
in Ebstein anomaly, 473
in heart failure diagnosis, 106
for HFpEF, 122
pericardiocentesis, 1005–1006
in pulmonary embolism, 381
in pulmonary hypertension, 186
in tetralogy of Fallot, 460–462
in thoracic aortic aneurysm, 402–403
in transposition of the great arteries, 467
congenitally corrected, 470
Cholesterol absorption inhibitors, 620–621
Cholesterol and Recurrent Events Trial (1996), 611
Cholesterylester transfer protein (CETP) inhibitor trials, 614, 621
Chromosomal abnormalities, cardiovascular disease and, 570, 570t
Chronic active myocarditis, 142
Chronic compensated MR, 225
Chronic decompensated MR, 225
Chronic heart failure (CHF), treatment, 152–163
dynamic cardiomyoplasty, 154–155
emerging therapies, 155
endoventricular circular patch plastyre, 154
mechanical circulatory support, 155–163
mitral valve surgery, 154
nonsurgical LV chamber reduction, 155
partial LV resection, 154
stem cell transplantation, 155
surgical revascularization, 152–153
Chronic HTN in pregnancy, 588
Chronic persistent myocarditis, 142
Chronic stable angina
LHC, 908–909
PCI, 927–928
Chronotropic incompetence, defined, 337
Chronotropic response index (CRI), exercise electrocardiographic testing, 673
Chugging, ECMO, 902
Churg-Strauss syndrome (CSS), 519
Cigarette smoking, heart disease in women, 573
Cilostazol, in claudication, 413–414
Cinefluoroscopy, 273
Cine imaging, 729
Circulatory support devices in chronic heart failure (CHF), 155
Cirrhosis, 185
Classification of sports, 596
Claudication
in peripheral arterial disease, 413–414
treatment of, 414
Clinical presentation
infective endocarditis, 279–280
ischemic mitral regurgitation, 236
mitral regurgitation, 223
mitral stenosis, 240
mitral valve prolapse, 238
prosthetic valves, 269
rheumatic fever, 297
tricuspid regurgitation, 236
valvular PR, 259
valvular pulmonary stenosis, 258
Clonidine, 183
in hypertensive emergency, 506
Clopidogrel, 421
PCI, 943–944
in stable angina, 76
Coagulase-negative staphylococci, 281
Coagulopathy, 906–907
Coarctation of the aorta (CoA), 454–455, 584–585
Coexisting carditis, 299
Collaborative Atorvastatin Diabetes Study (CARDS) (2004), hyperlipidemia, 610
Color Doppler imaging
Doppler artifact, 984
factors
acoustic shadowing, 984
attenuation, 984
interrogation angle, 983–984
hemodynamic factors
chamber constraint in eccentric jets, 984
driving pressure, 984
flow volume, 984
machine settings
baseline, 983
beam width, 983
compress, 983
depth setting, 983
gain, 983
gate length/sample size, 983
Nyquist limit, 983
reject, 983
scale, 983
transducer frequency, 983
wall filter, 983
tips for the transthoracic Doppler examination, 982t
Color M-mode (CMM)
transthoracic echocardiography, 966–967
diastolic function/dysfunction staging, 967, 967t
uses of, 967
Commotio cordis, 332
Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure trial, 361
Complete heart block, ECG patterns, 835
Complications of acute myocardial infarction
acute severe MR, 45–47
arrhythmic complications, 52
dynamic left ventricular outflow tract obstruction, 52
embolic complications, 52–53
inflammatory complications, 53–54
late pericarditis, 54
LV failure and cardiogenic shock, 50
RV failure, 50–52
ventricular aneurysm, 49
ventricular free wall rupture, 47–48
ventricular pseudoaneurysm, 48–49
ventricular septal rupture, 42–45
Computer-aided analysis, nuclear cardiac imaging, 686
Concomitant coronary artery disease, 230
Concomitant diseases, HTN, 631–632
ALLHAT, 633
emerging evidence, 633
management of hypertension in specific clinical syndromes, 632t
reduction of long-term cardiovascular morbidity and mortality, 632
treatment of elderly, 633
Conduction system, anatomic considerations, 336
Congenital aortic stenosis (AS), 585
Congenital coronary artery anomalies, LHC, 919–920
Congenital heart disease
adult
congenitally corrected transposition of the great arteries, 469–472
Ebstein anomaly, 472–474
Eisenmenger syndrome, 474–476
tetralogy of Fallot, 459–463
transposition of the great arteries, 464–468, 465
cardiovascular CT, 717
CMRI, 734
CT coronary angiography, 723
PAH risk factors, 185
pregnancy in women with
antibiotics, 584
atrial septal defect and patent foramen ovale, 584
coarctation of aorta, 584–585
congenital aortic stenosis, 585
Ebstein anomaly, 585
Eisenmenger syndrome, 585
patent ductus arteriosus, 584
pulmonic stenosis, 585
tetralogy of Fallot, 585
ventricular septal defect, 584
in ventricular tachycardia, 329
Congestive heart failure (CHF), 99, 128, 449
Connective tissue diseases (CTDs)
Ehlers-Danlos syndrome, 521
Loeys-Dietz syndrome, 521
Marfan syndrome, 519–521
PAH risk factors, 185
Connective tissue, gene expression profiling and, in aortic disease, 559–561
Constrictive pericarditis
abnormal respirophasic septal shift, 539
annular tissue velocities, 540
annulus paradoxus, 539–540
cardiac catheterization, 542
cardiac CT, 542
cardiac MRI, 542
causes of, 537t
chest radiograph, 538
clinical presentation, 538
diagnostic algorithm for, 541
differentiate constriction from restriction, 545t
effusive-constrictive pericarditis, 536
general indication for imaging, 538–544
hallmark of, 537
inflammatory markers, 538
management, 538
medical therapy, 544–545
pathophysiology, 536–538
pericardial thickening, 539
pleural effusions, 538
postcardiac surgery, 536
pulsed Doppler recordings, 540
radiation therapy, 536
respiratory ventricular interaction, 544
respirophasic ventricular septum movement, 539
from restrictive cardiomyopathy, 544
right atrium (RA), right ventricle (RV), and left ventricle (LV) pressure waveform in, 543
septal bounce, 539
and signs of inflammation, 544
strain imaging, 541
symptoms of, 538
Contact force catheters, 806–807
Continuity principle, 204
Continuous-wave (CW) Doppler, 253
Contralateral carotid occlusion, 429
Contrast (iodine) allergy, cardiovascular CT, 718
Contrast angiography, carotid artery disease, 421
Contrast dye, LHC
allergy, 908–909
choice of contrast, 908
Contrast echocardiography
stress echocardiography
contraindications, 696
intravenous agitated saline, 696
optison and definity, 696
transthoracic echocardiography, 974–975
Contrast-enhanced magnetic resonance angiography (CEMRA), 420–421
Contrast-induced nephropathy, cardiovascular CT
prophylactic measures, 719
risk factors, 719
CoreValve Evolut PRO, 208
Cornell protocol, exercise electrocardiographic testing, 664
Coronary angiography, 168
following myocardial infarction, 64
heart disease in women, 575
in heart failure, 108
limitations in LHC, 920
in stable angina assessment, 74–75, 75t
Coronary arteries, EMB, 881
Coronary artery anomalies
cardiovascular CT, 717
CT coronary angiography, 722, 722
Coronary artery bypass grafting (CABG), 58
compared to percutaneous coronary intervention, 87
following myocardial infarction, 63
in stable angina treatment, 87
Coronary artery bypass surgery (CABG)
drug-eluting stents vs., 653–654
percutaneous coronary intervention vs., 653
Coronary artery disease (CAD), 2, 692
gene expression profiling in, 556–557
nuclear cardiac imaging
acute coronary syndromes, 688
detection of CAD, 687
diagnosis, 676
identification of prior MI, 676
physiologic assessment of known coronary lesions, 676
therapeutic intervention assessment, 676
during pregnancy, 589
in sudden cardiac death, 355
Coronary artery dissection, LHC, 925
Coronary Artery Revascularization Prophylaxis trial, 494
Coronary artery spasm, LHC, 925
Coronary calcium scoring, 719–720
Coronary flow reserve (CFR), 92
Coronary sinus, 881
Coronary stenosis, quantification of, 920
Covered stents, 937
C-reactive protein (CRP), 63
clinical use, 636
pathophysiology, 636
Creatine kinase myocardial band (CK-MB), 5
Critical carotid stenosis, 429
Crushing substernal chest pain, 3
Cryoablation, 807
Cryoballoon ablation, 372
Cryoballoon catheters, 807
CT coronary angiography, 720–721
acute chest pain, in, 721
stable chest pain, 721
CTT Collaborators (2005), hyperlipidemia, 615
Culture-negative endocarditis, 282
Culture-negative IE, 283
Cutting balloon atherectomy, 937
Cyclosporine, in cardiac transplantation, 175, 175t
Cytomegalovirus (CMV)
following cardiac transplantation, 180
primary, 180
prophylaxis against, 180
secondary, 180
D
Dabigatran, for venous thromboembolism, 378
Daclizumab (Zenapax), 177
Daily CXR films, IABP counterpulsation, 888
Dallas criteria, 149
D-Dimer, in deep venous thrombosis, 377–378
Deaths
exercise electrocardiographic testing, 674
LHC, 924
pericardiocentesis, 1005
Declaration of brain death, 170
Decompensated heart failure (HF), 907
Decreased oxygen supply, 30
Deep venous thrombosis (DVT), 376–380
calf vein, 380
clinical presentation, 376
diagnostic tests, 376–378, 377t
superficial venous, 380
treatment, 378
upper extremity, 380
Defibrillation
automated external, 359
therapy, 800–801
Defibrillator endocarditis, 281, 291, 330, 341
Definite clinical diagnosis, 285
Definite pathologic diagnosis, 285
Delayed after depolarizations (DADs), 306–307
Delayed femoral pulsations, 455
Delayed imaging, 729
Depressed LVEF, 243
Descending thoracic aorta, 389
Destination therapy, 157
Dexfenfluramine, 261
Dextrocardia, ECG patterns, 850
Diabetes
atherosclerosis and, 641–642
control, 23–24
epidemiology, 639–640
heart disease, impact on, 642
macrovascular trials, 646–650
completed randomized, double-blind, placebo-controlled CV outcome trials in T2DM, 649t
dipeptidyl peptidase-4 (DPP-4) inhibitors trials, 649
glucose control and cardiovascular events, 646–647
glycemia and cardiovascular events, 646
glycemic control and cardiovascular outcomes, 647–648, 648t
sodium glucose transport protein subtype 2 (SGLT-2) inhibitors trials, 649–650
microvascular trials, 646
in myocardial infarction, 65
pharmacotherapy
acarbose and miglitol, 652
amylin, 652
GLP-1, 652–653
incretins, 652–653
insulin, 650–651
intermediate-acting insulin, 650–651
long-acting agents, 651
meglitinides, 652
metformin, 651
pumps, insulin, 651
regular insulin, 650
SGLT-2 inhibitors, 653
sulfonylureas, 651–652
thiazolidinediones, 652
platelet function, 642
revascularization in patients
CABG vs. drug-eluting stents (DESs), 653–654
CABG vs. PCI, 653
vs. optimal medical therapy, 654
screening asymptomatic patients, 654
risk factor modification in patients with, 642–646
spectrum of insulin resistance to T2DM, 640–641
Diabetes mellitus, heart disease in women, 573
Diabetic dyslipidemia, 624
rheumatic fever, 300–301
tricuspid regurgitation, 227–231
tricuspid valve disease, 227–231
valvular pulmonary stenosis, 243–246
Diastolic blood pressure, exercise electrocardiographic testing, 669
Diastolic dysfunction
in heart failure, measurement of, 106
LV, in cardiac transplantation, 172
Diastolic function, transthoracic echocardiography, 976–977
Diastolic murmur in thoracic aortic aneurysm, 402
Diastolic pressure gradient, 252
Dicrotic notch, IABP counterpulsation, 885
Diet, 631
Digitalis and beta-blockers, 234
Digitalis toxicity, 369
in ventricular tachycardia, 307, 331
Digoxin
exercise electrocardiographic testing, 662
in hypertrophic cardiomyopathy, 137
Dihydropyridine CCBs, 136
Dilated cardiomyopathy, 102
gene expression profiling in, 561, 562t
idiopathic, 333
in sudden cardiac death, 355–356
in ventricular tachycardia, 329
Diltiazem, 183
Diminished heart sounds, 534
Dipeptidyl peptidase-4 (DPP-4) inhibitors trials, 649
Dipyridamole, 422
adenosine, 696
dipyridamole infusion, 696
hypotension, bradycardia, or bronchospasm, 696
nuclear cardiac imaging, 684
regadenoson, 696
in stress testing, 63
study end points, 696
Direct current cardioversion (DCCV), 370, 372–373
in atrial flutter, 310
Direct thrombin inhibitors (DTIs), 37, 942–943
Dismal without therapy, 146
Distributive shock, 871
Diuretics
in heart failure, 110–111, 112, 115–116, 126–127
in hypertrophic cardiomyopathy, 137
resistance, 116
in heart failure, 111
nuclear cardiac imaging, 684
in stress testing, 63
Dobutamine stress echocardiography imaging
angina/severe side effects, development of, 696
atropine, 695
infusion, 695
myocardial viability testing
limitations, 712
test interpretation, 712
side effects, 695–696
study end points, 695
Donor-recipient matching, 171
Donor workup, in cardiac transplantation, 170–171, 171t
Doppler analysis, 256
Doppler echocardiography, 204, 258
hemodynamic assessment, 964
in hypertrophic cardiomyopathy, 133t, 134
principles, 964
spectral analysis
color flow imaging, 965–966
tissue Doppler imaging, 966, 966
tissue Doppler imaging mitral annular velocity, 124–125
Doppler ultrasound, intracoronary, in stable angina assessment, 76
Dor procedure, 154
Doxazosin, 183
Drain care, pericardiocentesis, 1006
Dressler syndrome, 54
Dronedarone, 372
Drug-eluting stents (DESs)
bioresorbable polymer, 934
coronary artery bypass surgery vs., 653–654
PCI, 934
Drug-induced eosinophilic myocarditis, 147
Drug-induced valve disease
cause, 261
clinical presentation, 261–262
evaluation, 262
follow-up, 262
pathology and pathogenesis, 261
prevalence, 261
treatment, 262
Dual-chamber pacing, for hypertrophic cardiomyopathy, 137–138
Dual-isotope imaging, nuclear cardiac imaging, 683
Duke criteria, for infective endocarditis, 333–335, 334t–335t
Duke nomogram, exercise electrocardiographic testing, 670, 672
Duplex ultrasound
carotid artery disease, 420
in deep venous thrombosis, 377
in peripheral arterial disease, 409–411
in renal artery stenosis, 416
Dye allergy, 907
latex allergy, 908–909
premedication, 908
radiation safety, 909
sedation, 909
treatment, 908
Dynamic cardiomyoplasty, 154–155
Dynamic LVOT obstruction, as myocardial infarction complication, 52
Dynamic LV outflow obstruction, 235
Dysautonomic syndromes, 480
primary autonomic failure, 480
secondary causes, 480
Dyslipidemia
diabetes, 643
economic consequences of CVD, 608
goals for secondary prevention among patients with known vascular disease, 608t
hyperlipidemia (See Hyperlipidemia)
morbidity and mortality, 608
prevention of coronary artery disease, 608–609
Dyspnea, 104
exertional, 128
Dyssynchrony
assessment
electrical and mechanical dyssynchrony, 764
predictor of subsequent response to CRT, 764–765
AV, 764
interventricular, 764
intraventricular, 764
mechanism of LV
activation and contraction, 764
conduction delay, 763–764
mitigation of intraventricular dyssynchrony, 764
transthoracic echocardiography, 975–976
types
AV dyssynchrony, 764
interventricular dyssynchrony, 764
intraventricular dyssynchrony, 764
E
E/A ratio, in diastolic heart failure, 124–125
Early afterdepolarizations (EADs), 306
Early repolarization, ECG patterns, 846
Ebstein anomaly, 472–474
anatomic considerations, 472, 473
clinical presentation, 472–473
diagnostic tests, 473–474
medical management, 474
pregnancy in women with congenital heart disease, 585
therapy, 474
Echocardiographic score, 248
Echocardiography, 124–125, 237, 259, 298, 301
in cardiac transplantation, 178–179
in cardiac tumors, 548
Doppler in hypertrophic cardiomyopathy, 133t, 134
in heart failure diagnosis, 107, 124–125
in hypertrophic cardiomyopathy diagnosis, 134, 135t
isovolumic relaxation time, 107
in mitral regurgitation, 45
M-mode in hypertrophic cardiomyopathy, 133, 133t
in pulmonary embolism, 381–382
in pulmonary hypertension, 186–187
in stable angina assessment, 73
stress testing, 73
in sudden cardiac death, 357
in tetralogy of Fallot, 462
tissue Doppler imaging mitral annular velocity, 124–125
transmitral flow pattern, 124
in transposition of the great arteries, congenitally corrected, 470
two dimensional
in hypertrophic cardiomyopathy, 133, 133t
in pericardial effusion, 393
in ventricular free wall rupture, 47–48
Echo, pericardiocentesis
anesthetic, 1002
bloody pericardial fluid or frank blood, 1004
confirming catheter/needle placement, 1003
echo probe, 1002
marking needle, 1002
pericardial catheter, placing, 1003
pericardium, entering, 1002–1003
prepping patient, 1002
probe trajectory, 1002
Eclampsia in pregnancy, 588
Effusive-constrictive pericarditis, 544
Ehler-Danlos syndrome
associated with aortic aneurysm and dissection, 391
gene variants in, 560
Eisenmenger syndrome, 474–476
clinical presentation, 475
diagnostic tests, 475
medical management, 474
physiology, 474–475
pulmonary hypertension in, 475, 476
Ejection fraction
heart failure with preserved, 120–129
clinical presentation, 121–122
defined, 120–121
diagnostic testing, 124–126
differential diagnosis, 122–124
laboratory testing, 122
prognosis, 128–129
and restrictive cardiomyopathies, 128
left ventricular in systolic heart failure, 98
Electrical cardioversion
atrial fibrillation, 370
in atrial flutter, 310
cardioversion defined, 855
complications of cardioversion, 860
defibrillation, 855
indications and contraindications, 855, 856t
mechanism, 855
patient preparation
anticoagulation, 857
continuous ECG, 857
ECG, 857
medication and anticoagulation status, 856–857
oxygen and airway management, 857
peripheral venous access, 857
procedure
patient preparation, 855–857
technique, 857–860
special situations
preexisting permanent pacemaker or implantable cardioverter-defibrillator, 861
pregnancy, 861
technique
cardioversion patches placement, 857
delivery of shock, 860
electrode placement, 858
energy selection, 859
initial energy selection for commonly encountered arrhythmias, 859t
sedation, 858–859
synchronization, 860
troubleshooting
capacitor does not discharge, 861
cardioversion unsuccessful, 861
monitor does not work, 860
timing artifact falls on T-wave, 861
Electroanatomic mapping systems, 760
Electrocardiogram (ECG), 201, 237, 240
in aortic dissection, 393
in AV reentrant tachycardia, 316
cardiac chamber enlargement
biatrial enlargement, 822
left ventricular hypertrophy, 820
right ventricular hypertrophy, 821
in cardiac tumors, 547
common arrhythmias
atrioventricular nodal reentrant tachycardia, 825
multifocal atrial tachycardia, 829
torsades, 830
typical atrial flutter, 824
ventricular tachycardia, 826
Wolff-Parkinson-White pattern, 827
conduction disease
complete heart block, 835
first-degree atrioventricular block, 834
left anterior fascicular block, 832
left bundle branch block, 831
mobitz type II second-degree AV block, 834
right bundle branch block, 832
second-degree mobitz type I atrioventricular block, 833
congenitally corrected, 470
congenital syndromes
arrhythmogenic right ventricular cardiomyopathy, 842
long QT syndrome, 840
type I brugada pattern, 841
in Ebstein anomaly, 473
in Eisenmenger syndrome, 475
gating, cardiovascular CT
prospective triggering, 716
retrospective gating, 716
in heart failure diagnosis, 106
for HFpEF, 122
in hypertensive crisis, 502
in hypertrophic cardiomyopathy, 133, 133t
in infective endocarditis, 332
in intraventricular conduction disturbances, 349, 350–351
ischemia mimics
apical variant of hypertrophic cardiomyopathy, 845
early repolarization, 846
pericarditis, 843
takotsubo cardiomyopathy, 844
in junctional rhythms, 348–349
metabolic disturbances
digitalis effect, 838
hypercalcemia, 837
hyperkalemia, 836
hypothermia, 839
miscellaneous patterns
cardiac transplant, 848
dextrocardia, 850
limb lead reversal, 849
pericardial effusion, 847
nuclear cardiac imaging, 689
in pulmonary embolism, 381
in pulmonary hypertension, 186
in right ventricular failure, 50, 51
in sinus node dysfunction, 339
in stable angina, 72–73
in sudden cardiac death, 357
in tetralogy of Fallot, 462
in transposition of the great arteries, 467
12-lead, in atrial fibrillation, 367
in Wolf-Parkinson-White syndrome, 316
Electrocardiographic findings, 225
Electrocardiographic guidance via subxiphoid approach, 1004
Electrocardiographic lead placement, transthoracic echocardiography, 963
Electrocardiography, 301
Electroconvulsive therapy, 789
Electrolyte supplementation, in heart failure treatment, 116
Electron beam computed tomography (EBCT)
cardiovascular CT, 715
in stable angina assessment, 74
Electrophysiologic studies (EPS)
access and catheter placement
CS/ high right atrium, 740
femoral veins under local anesthesia, 739
His electrogram, 740
His/ proximal right bundle potential, 740
introducers, 739–740
left-sided bypass tracts/ left ventricular tachycardia, 739–740
supraventricular tachycardia, 740
tricuspid valve, 740
atrial stimulation, 742–743
baseline assessment
AH interval, 740
cycle lengths, 740
HV interval, 740
measure from resulting deflection, 740
normal baseline intervals, 741
programmed ventricular stimulation using double extra stimuli, 742
cardioactive drugs, 746–747
equipment and setting
intracardiac signals using electrode catheters, 739
radiographic equipment, 738
tools, 739
well-trained personnel, 738
indications
bradyarrhythmias, 738
syncope, 738
tachyarrhythmias, 738
induction of ventricular fibrillation, 745–746
interpretation of findings
bradyarrhythmia evaluation, 747–749
evaluation of accessory pathways, 755–757
SVT evaluation, 749–755
ventricular tachycardia evaluation, 757–762
intracardiac signals using electrode catheters
bipolar recording, 739
nondeflectable catheter, 739
quadripolar woven dacron polyester/polyurethane, 739
preprocedure preparation
elective procedure, 739
electrolytes and coagulation panel, 739
programmed stimulation
burst pacing, 740
continuous monitoring, 742
extra stimulus technique, 740–742
hemodynamic response, 740
paced extra stimulus, 741–742
pacing stimuli, 740–742
sensed extra stimulus, 741
techniques and procedures
access and catheter placement, 739–740
baseline assessment, 740
preprocedure preparation, 739
programmed stimulation, 740–742
temporary cardiac pacing, 852
tools
external defibrillators, 739
junction box, 739
stimulator, 739
ventricular stimulation, 744–745, 745
Electrophysiology, cardiovascular formulae, 1010–1011
Elephant trunk procedure, 404
Elevated erythrocyte sedimentation rate, 282
Elevated hepatic enzymes, 166
Elevated serum creatinine, 166
Embolism as myocardial infarction complication, 52–53
Emergency CABG, 925
Emergency coronary bypass surgery, 22
Encephalitis, 299
Encephalopathy, hypertensive, 506
Endless-loop tachycardia (ELT), 787
infective
hypertrophic cardiomyopathy and, 140
prophylaxis, 139
Endocarditis prophylaxis, 268, 304
Endomyocardial biopsy (EMB)
in cardiac transplantation, 177–180, 178t
in cardiac tumors, 548
complications
arrhythmia, 880
cardiac perforation and tamponade, 880
local complications, 881
mortality, 880
pain, 881
thromboembolism, 880
tricuspid valve dysfunction, 880–881
vena cava, coronary sinus, hepatic vein, and coronary arteries, damages to, 881
devices
bioptome, 878
sheath, 877
disease-specific therapy, 878t
guideline and consensus statement recommendations, 878
in heart failure diagnosis, 108, 125
indications and contraindications, 877
myocarditis, 149
patient preparation, 877
relative contraindications for, 879t
technique, 878
left ventricular biopsy, 880
right ventricular biopsy, 879–880
Endomyocardial fibrosis, 123
Endothelin receptor antagonists (ERAs), 191
Endovascular aneurysm repair, 400
Endoventricular circular patch plasty (EVCPP), 154
Enhanced external counterpulsation (EECP), 84
Entrainment of ventricular tachycardia, 761
Epicardial pacing, temporary cardiac pacing, 852
EP testing, in sudden cardiac death, 357
Eptifibatide, 945–946
Esophageal disorders, 5
Esophageal infections, 987
Estimated LAP/left ventricular end-diastolic pressure (LVEDP), 977
Estimated right atrial (RA) pressure, 977
Estrogen/menopause, 573–574
Estrogen replacement therapy, following myocardial infarction, 68
European Carotid Surgery Trialists’ (ECST) Collaborative Group criteria, 421
Evanescent erythematous macular rash, 299
Excimer laser, 938
Exercise
in claudication treatment, 413
electrocardiographic testing (See exercise electrocardiographic testing)
in heart failure management, 117
HTN, 631
intolerance, 451
obesity, 634
restriction, myocarditis, 148
in stable angina management, 88
Exercise electrocardiographic testing
ACC/AHA guidelines for, 657–659t
advantages, 656
Balke protocol, 664
Bruce protocol
advantages, 662
disadvantages, 662
modified, 662
Cornell protocol, 664
data
age-predicted maximum heart rate (APMHR), 667–668
blood pressure monitoring, 669
electrocardiographic data, 664–667, 664t
functional testing, 669
interpretation of, 670–673
rating of perceived exertion (RPE), 668
symptoms, 669
disadvantages, 656
elements of conclusion section of a modern exercise test report, 670t
exercise protocols, 663t
guidelines for interpretation of results of, 671–672t
heart disease in women, 574
limitations of
Bayes’ theorem, 660
positive predictive value (PPV), 661
sensitivity and specificity, 660
Naughton protocol, 664
optimal protocol
duration, 662
exercise method, 662
stage length, 662
workload, 662
patient preparation, 661t
instructions, 661
medications, 661–662
potential complications, 673–674, 673–674t
Ramp protocols, 664
submaximal, 656
termination
absolute indications, 669
postexercise recovery, 670
relative indications, 669
Exercise SE
electrocardiographic testing vs., 702
image interpretation
abnormal response to exercise defined, 698
adjunctive diagnostic criteria, 698
false-negative findings, 699–700, 701t
false-positive findings, 699, 701t
normal response, 698
resting WMAs, 698
myocardial perfusion scintigraphy vs., 702
supine bicycle exercise, 695
target heart rate, 695
treadmill exercise, 695
upright bicycle echocardiography, 695
Exercise stress testing
nuclear cardiac imaging, 683
stress echocardiography, 692, 693
Exoseal, 924
Extracorporeal membrane oxygenation (ECMO)
absolute contraindications, 900
complications
coronary/ cerebral ischemia, 903
infection, 903
limb ischemia and cannulation-related, 903
pulmonary hemorrhage, 903
severe bleeding, 903
thromboembolism, 903
hemodynamics, practical considerations, and monitoring
arterial and venous oxyhemoglobin goals, 901
continuous venous oximetry, 902
flow rate, 901
oxygenation and sweep, 902
patient monitoring, additional, 902–903
supportive measures, 902–903
tissue perfusion, 901–902
ventilator support, 902
indications, 900
insertion, 901
relative contraindications, 901
weaning, 903–904
Extracorporeal shock-wave lithotripsy (ESWL), 788
Extrapyramidal disorder, 299
Extremity
lower
aneurysms, 415
peripheral arterial disease, 407–415
upper
deep venous thrombosis, 380
peripheral arterial disease, 415
F
Fabry disease, 124
Factor V Leiden, 385–386
Factor Xa inhibitors, 38
Familial dilated cardiomyopathy, 101–102
Familial hyperlipidemia, 557–558
autosomal dominant, 557–558
autosomal recessive, 558
Fascicular ventricular tachycardia, 324
Fastidious infectious agent, 283
Fatigue, 538
Femoral arterial approach, 880
Femoral vein
EMB, 879
RHC, 866
FemoStop, 924
Fenfluramine, 261
Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) (2005) trial, 610–611
Fentanyl, 990
Fibrates, hyperlipidemia, 620
Fibrillation, ventricular, 332–333
Fibrinogen, nonlipid cardiovascular risk factors, 637
Fibrinolysis
bleeding complications after, 20–21
choice of agent, 19–20
contraindications, 19
vs. direct PCI, 17–18
fibrinolytic therapy, 19
Fibrinolytic agents, 38
Fibrinolytic therapy, 19
Fibroelastic deficiency, 239
Fibromas, 550
Fibromuscular dysplasia in peripheral arterial disease, 407
Fibrous obliteration, 241
Fick equation, for cardiac output, 44
First-degree atrioventricular (AV) block and mobitz type II second-degree AV block, 834
First-pass radionuclide angiocardiography, nuclear cardiac imaging, 688
FK506, in cardiac transplantation, 175, 176t
Fludeoxyglucose 18 (FDG), myocardial viability testing, 709, 710
Fluoro-2-deoxyglucose (FDG), positron emission tomography, 690
Fluoroscopic guidance, pericardiocentesis, 1004
Fluttering discomfort, 252
Focal ventricular tachycardia, 324
Follow-up echocardiography, pericardiocentesis, 1006
Fondaparinux
in deep venous thrombosis, 378
PCI, 942
in pulmonary embolism, 383
Formulas in RHC, 874–875, 875t
Fulminant myocarditis, 142
G
Gadolinium, 729
Gamma camera, nuclear cardiac imaging, 679
GAS tonsillopharyngitis, 297
Gaucher disease, 124
Gene expression profiling, 179, 557–558
aortic diseases, 559–560
arrhythmias, 565–566
cardiomyopathies, 561–564
coronary artery disease, 557–558
valvular heart disease, 567
General hemodynamics, cardiovascular formulae, 1007–1008
Genetic issues, 555–570
chromosomal abnormalities, cardiovascular disease and, 570, 570t
gene expression profiling, 557–558
aortic diseases, 559–560
arrhythmias, 565–566
cardiomyopathies, 561–564
coronary artery disease, 557–558
valvular heart disease, 567
genome wide association studies, 556
linkage analyses, 556
Genetic predisposition, 300
Genome wide association studies, 556
Gestational HTN in pregnancy, 588
Giant cell arteritis (GCA), 517–518
Giant Cell Myocarditis Study, 150t
Global registry of acute coronary events (GRACE), 29
Global utilization of streptokinase and tissue plasminogen activator for occluded coronary arteries I trial, 882
Glucagon-like peptide-1 (GLP-1), 645
diabetes, 652–653
receptor agonists, diabetes, 650
Glycogen storage disease, in heart failure, 124
Glycoprotein IIb/IIIa inhibitors, 38
Gorlin formula, 205
GP IIb/IIIa inhibitors, 945–946
Gradient echo, 728–729
Grafting
cardiac allograft vasculopathy, 180–182, 181t
percutaneous aortic stent-grafting, 397–398
Gram-negative organisms, 274
Gunshot wounds, 513
H
HAS-BLED bleeding risk score, 368
Heart disease in women
class III interventions, 580t
evidence-based guidelines for prevention in, 578–579, 578–579t
gender differences
in assessment, 574–575
clinical manifestations, 574
in pathophysiology, 572–573
risk factors, 573–574
in therapies, 575–578
pregnancy and, 579–580
cardiovascular evaluation, 581–582
with congenital heart disease, 584–585
drug therapy for hypertension, 589t
findings in normal pregnancy, 582t
hypertensive disorders, 588–591
management principles for pregnant women with valvular heart disease, 583t
medication considerations, 591–594
normal physiologic changes, 580–581
other cardiovascular diseases and, 588–591
risk assessment and general principles of management, 582–584
risk predictors of adverse maternal and fetal outcomes, 584t
valvular heart disease and, 585–588
risk classification of cardiovascular disease in women, 577t
Heart failure, 143
congestive, 99
defined, 98
high-output, from anemia, 103
in hypertrophic cardiomyopathy, 130–131
LHC, 925
management, myocarditis, 148
myocardial innervation imaging, 689
right, defined, 99
right heart cardiac catheterization in, 107–108
signs of, 27
systolic, 98–118
defined, 98
diagnostic testing, 105–109
pathogenesis, 99
signs and symptoms of, 104–105
treatment, 109–116
treatment of chronic, 152–163
dynamic cardiomyoplasty, 154–155
mitral valve surgery, 153–154
partial LV resection, 154
surgical revascularization, 152–153
Heart failure with preserved ejection fraction (HFpEF), 120–129
clinical presentation, 121–122
defined, 120
diagnostic testing, 124–126
differential diagnosis, 120t, 122–124
laboratory testing, 122
pathophysiology, 121
prognosis, 128–129
and restrictive cardiomyopathies, 128
HeartMate XVE, 156
Heart Protection Study (HPS), 609–610
Heart Protection Study 2-Treatment of HDL to Reduce the Incidence of Vascular Events (HPS2-THRIVE), 613–614
Heart rate recovery, exercise electrocardiographic testing, 672
Heart sounds
in atrioventricular conduction disturbances, 344
in hypertrophic cardiomyopathy, 131, 132t
in tetralogy of Fallot, 460
HeartWare HVAD (HVAD), 159–160, 160
Helex device, 440
HELLP syndrome (hemolysis, elevated liver enzymes, low platelets), 588
Hemangiomas, 551
Hematoma, intramural, 390
Hematuria, 299
Hemochromatosis, in heart failure, 102, 123
Hemodynamic (Killip) class, 14t
Hemodynamics, invasive assessment, 125
Hemodynamics, transthoracic echocardiography
continuity equation, 979
dP/dt, 978
intracardiac pressure measurement, 977–978
PISA method, 979–980
pressure half-time (P½), 980–981
transvalvular pressure gradient, 977–978
volumetric method to assess regurgitant volume/regurgitant fraction, 979
Hemolysis, 902
Hemorrhage, 513
Heparin, 36–37
coagulopathy/contraindication to, 884
thrombocytopenia due to, 386–387
Hepatic vein, 881
Hibernating myocardium, 707
Hibernation, 152
High-density lipoprotein (HDL), 64
diabetes, 643
Highly sensitive (Hs) troponin, 31
High-sensitivity cardiac troponin (hs-cTn), 5
His bundle, 336
HMG-CoA reductase inhibitors
bile acid resins, 622
hyperlipidemia, 617–619
Holosystolic murmurs, 225
Holter monitoring in stable angina assessment, 76
Homocysteine, 386
nonlipid cardiovascular risk factors, as, 637
Homografts, 267
Hormone replacement therapy (HRT)
following myocardial infarction, 68
heart disease in women, 576–577
in stable angina, 83–84
Human immunodeficiency virus (HIV), 146, 185
Human leukocyte antigen (HLA)
antigens, in cardiac transplantation evaluation, 178
tissue typing analysis, 168
Hydralazine
for hypertensive emergency, 503t, 506
Hyperacute rejection, 179
Hypercalcemia, 837
Hypercoagulable conditions, 385–387
antiphospholipid antibodies, 387
antithrombin defects, 386
factor V Leiden, 385–386
heparin-induced thrombocytopenia, 386–387
homocysteine, 386
prothrombin gene mutation, 385–386
Hyperhomocysteinemia, 376
Hyperlipidemia
drugs affecting lipoprotein metabolism, 618t
familial, 557–558
gene expression profiling in, 557
heart disease in women, 573
lipid-lowering trials
meta-analyses, 615
primary prevention trials, 609–611
secondary prevention trials, 611–614
low density lipoprotein cholesterol reduction associated with starting dose of statin agents, 621t
management, 64
in peripheral arterial disease, 413
post-myocardial infarction, 64
in stable angina, 77
management of lipids
The new ACC/AHA 2013 cholesterol treatment guidelines, 615–616
therapy of specific lipid disorders, 622–624
types of therapy, 616–622
physiology, 609
Hyperperfusion syndrome, 429
Hypertension (HTN) (See also Nonlipid cardiovascular risk factors)
blood pressure measurements, 628
ambulatory blood pressure monitoring, 629
office visits, 629
classification of blood pressure for adults aged 18 years and older, 630t
clinical presentation
blood pressure measurements, 628
laboratory evaluation, 630
medical history, 628
physical examination, 628
risk stratification, 630–633
diabetes, 643–644
following cardiac transplantation, 182
heart disease in women, 573
history of, in hypertensive crisis, 501
impact on cardiovascular risk and mortality
MRFIT, 627
prehypertension, 628
rate of cardiovascular events, 628
SHEP, 628
systolic and diastolic blood pressures, positive relationship between, 627–628
systolic blood pressure, 628
management in specific clinical syndromes, 632t
in peripheral arterial disease, 413
physical examination
abdomen, 629
extremities, 629
funduscopic, 629
heart, 629
lungs, 629
neck, 629
neurologic assessment, 629
other assessments, 629–630
in pregnancy
chronic, 588
drug therapy for, 589t
eclampsia, 588
gestational, 588
HELLP syndrome, 588
preeclampsia, 588
refractory, 397
in renal artery stenosis, 416
Hypertension optimal treatment trial, 644
Hypertensive and diabetic cardiomyopathy, 102
Hypertensive crisis, 498–509, 501t
clinical presentation, 501–502
diagnostic tests, 502
epidemiology, 498
etiology, 500–501
hypertensive emergency, 499t
defined, 498
hypertensive urgency
defined, 498–499
therapy, 508–509
pathophysiology, 500, 499–500, 499t
prognosis, 509
pseudoemergencies, 499
therapy, 503–509
cardiovascular emergencies, 507–508
hypertensive emergencies, 503–509, 503t
hypertensive urgencies, 508–509
neurologic emergencies, 506–507
Hypertensive emergency, 499t
defined, 499
goals of, 503
Hypertensive encephalopathy, 506
Hypertensive urgency
defined, 499
drug, 508–509
goals of, 508
therapy, 508–509
Hyperthyroidism
cardiovascular CT, 718
in heart failure, 103
Hypertriglyceridemia, 176
diabetes, 643
Hypertrophic cardiomyopathy, 130–141, 140
vs. athlete’s heart, 139
with atrial fibrillation, 136–137, 136
clinical presentation, 130–131
defined, 130
diagnostic testing, 133–134
differential diagnosis, 131t
EPS, 759
gene expression profiling in, 561–563
genetic aspects of, 132–133, 133t
in heart failure, diagnosis of, 122
infective endocarditis and, 139
management strategies, 134–139, 136
mitral regurgitation and, 134
physical examination, 131–132, 132t
stress echocardiography, 706
in sudden cardiac death, 131, 133, 138, 356
syncope in, 131
in ventricular tachycardia, 329
Hypochromic anemia, 301
Hypoperfusion, 55
Hypotension, 534
in aortic dissection, 396
carotid artery disease, 425
due to myocardial infarction, 50, 50t
Hypothermia, 839
Hypothyroidism, 622–623
in heart failure, 103
Hypovolemic shock, RHC, 870
I
Idiopathic aortitis, 519
Iliac artery stents, 884
Iliofemoral peripheral artery disease, 884
IL-2 receptor blockers, in cardiac transplantation, 174t, 177
Imaging artifacts in transthoracic echocardiography
acoustic shadowing, 981
beam width artifact, 981
range ambiguity, 982
refraction, 981
reverberation, 981
side lobe artifacts, 982
Immunosuppressive therapy, myocarditis, 148–149
Impella, 59
Impella device
complications, 899
contraindications
at least moderate aortic insufficiency, 895
at least moderate AS, 894
mechanical AV, 894
severe PAD, 895
CP catheter, 893
hemodynamics of impella function
RECOVER II, 895
reduced LV end-diastolic volume and pressure, 895
important considerations, 898
indications
cardiogenic shock, 893–894
SAR-SHOCK, 894
insertion technique, 895
monitoring and patient concerns
anticoagulation, 896
correct and incorrect impella position by transthoracic echocardiography, 896
echocardiogram, 895
hemolysis, 896
peripheral pulses, 896
target hemodynamics, 895–896
placement, 894
“protected” high-risk PCI
PROTECT I, 894
PROTECT II, 894
removal, 899
Implantable cardioverter-defibrillators (ICDs), 24, 255
EPS, 746
in sudden cardiac death
vs. antiarrhythmic drugs, 362–363
indications for, 362t–363t
primary prevention, 360–361
secondary prevention, 361–362
in ventricular tachycardia, 322, 327
Improved Reduction of Outcomes: Vytorin Efficacy International Trial (IMPROVE-IT) (2015), 613
Inability to breath-hold, 718
Inborn errors of metabolism, 568t, 570
Increased myocardial oxygen demand, 30
Incremental Decrease in End Points through Aggressive Lipid Lowering (2005), 613
Incretins, diabetes, 652–653
Induced tachycardia evaluation in SVT
atrial activation, 750
atrial tachycardia/atrial flutter, 750
cycle length variation, 753
hemodynamic effect, 750
initiation and termination of tachycardia, 753–754
pacing maneuvers during SVT, 753
premature beats during tachycardia, introduction of, 753
significance of, 754
Infarcted myocardium, 707
Infection, 162–163
pericardiocentesis, 1005
Infective endocarditis
CNS infarcts, 291t
controversies, therapy, 294–295
definite clinical diagnosis, 286t
diagnostic imaging techniques
body imaging, 285
cardiac catheterization, 284
central nervous system imaging, 285
IE diagnosis and management, 283–284
duke criteria
definite pathologic diagnosis, 285
possible diagnostic, 285
rejected diagnosis, 285
etiology, 280–282
cardiac abnormalities, 280
defibrillator endocarditis, 281–282
fungal endocarditis, 282
native valve endocarditis, 280–281
PVE, 281
HACEK, 289t
hypertrophic cardiomyopathy and, 139
laboratory examination
blood cultures, 283
blood tests, 282–283
drug toxicity, 283
electrocardiography, 283
histologic evaluation, 283
organisms causing infective endocarditis, 280t
pathologic diagnosis, 285t
pathophysiology, 282
penicillin-susceptible viridans streptococcus, 287t
physical findings, 279–280
poor outcome, 293t
presence of prosthetic material, 289t
prognosis, 292–293
prophylactic regimens, 295t
prosthetic valve endocarditis due to viridans streptococcus, 288t
pve resulting from enterococcus species, 289t
risk for adverse outcome, 293t
signs and symptoms, 279
staphylococci in native valve endocarditis, 287t
surgical procedures, 294t
surgical therapy, 290
theory response, 292
therapy
medical, 285
principles of, 285–286
Inflammation, myocardial infarction and, gene expression profiling in, 559
Inflammatory cardiomyopathy (See Myocarditis)
Informed consent, pericardiocentesis, 1001
Injuries, electrical cardioversion, 860
Inotropic agents, 60
in heart failure, 111
In-stent restenosis, PCI, 940
Insulin, diabetes, 650–651
Intermittent claudication
in peripheral arterial disease, 414
treatment, 413
Internal jugular vein approach, 879
Internal mammary artery, coronary artery bypass grafting using, 87
International criteria for ECG, 600, 600
International Society for Heart and Lung Transplantation (ISHLT), 165, 177, 180–181
Intervention in Myocarditis and Acute Cardiomyopathy (IMAC) study, 150t, 151
Intra-aortic balloon pump (IABP), 24, 59
catheter removing
balloon catheter and sheath, withdrawal of, 892
hemostasis, 892
monitoring during IABP removal, 892
weaning, 891–892
changing IABP catheter
contralateral femoral artery, 892
reasons for, 892
same femoral artery, 892–893
simultaneous change, 892
complications
balloon entrapment, 891
balloon rupture, 891
bleeding, 891
infection, 891
ischemia, 891
other complications, 891
red blood cell and platelet destruction, 891
vascular, 890
contraindications
abdominal/thoracic aneurysm, 884
aortic dissection, 884
descending aortic and peripheral vascular grafts, 884
heparin, coagulopathy/contraindication to, 884
moderate to severe aortic insufficiency, 884
severe peripheral vascular disease, 884
function, hemodynamics of
augmented coronary perfusion, 885
decreased afterload, 884–885
diastole, inflation, 885
systole, deflation, 885
timing of balloon function, 886
indications
acute myocardial infarction (MI) with cardiogenic shock, 882
decompensated severe aortic valve stenosis (AS) or severe MR, 883
end-stage cardiomyopathy/bridge to cardiac transplantation, 883
high-risk PCI, 882–883
low CO after cardiopulmonary bypass, 883
mechanical complications of acute MI, 883
refractory angina or myocardial ischemia awaiting revascularization, 882
refractory ventricular arrhythmias, 882–883
support during noncardiac surgery, 883
insertion technique
access and sheath, 886
balloon insertion, 886–887
balloon sizing, 885
difficulties with access, 887
fluoroscopy guidance, without, 887
initial setup, 887
peripheral vasculature, evaluating, 886
sheathless insertion, 887–888
surgical insertion, 887
tortuous iliofemoral vessels, 887
postinsertion management
care of patient, 888
monitoring, 888
triggering and timing
during arrhythmias, 889
troubleshooting, 889–890
in ventricular septal defect, 44
Intra-aortic balloon pump in cardiogenic shock (IABP-SHOCK) II trial, 882
Intracardiac shunt, 875–876
Intracerebral hemorrhage, 506–507
Intracoronary Stenting With Antithrombotic Regimen Cooling-Off (ISAR-COOL) trial, 40
Intracoronary vasodilators, 946
Intramural hematoma, 390
and penetrating aortic ulcer, 731
Intraoperative setting, 228
Intravascular ultrasound in stable angina assessment, 75
Intravenous iodinated contrast administration, 718
Intravenous platelet P2Y12 receptor antagonists, 16
Intraventricular conduction disturbances, 349
electrocardiogram in, 349, 350–351
etiology, 349
therapy, 351
Intubation, pericardiocentesis, 1001
Invasive Versus Conservative Treatment in Unstable Coronary Syndromes (ICTUS) trial, 41
Investigational devices, 236
Irreversible LV contractile dysfunction, 225
Irrigated tip catheters, 806
Ischemia
assessment of residual, 63–64
limb, in peripheral arterial disease, 408, 408t
methods to induce in stress testing, 73–74
myocardial
hypertensive crisis and, 507–508
in hypertrophic cardiomyopathy, 130–1311
Ischemia, silent, 90–94
abnormal modulation of, 91
coronary artery disease, 90
diagnosis, 91
prognosis, 91–92
therapy, 91
Ischemic cardiomyopathy, 100–103, 152–153
Ischemic evaluation, temporary cardiac pacing, 852
Ischemic mitral regurgitation, etiology, 236–237
Ischemic myocardium, definition, 707
Ischemic ventricular tachycardia, 326–327
Isoproterenol, EPS, 746–747
Isovolumic relaxation time (IVRT), 107
J
Japan EPA Lipid Intervention Study (2007), 611
Jones criteria, 297
Jugular venous distention (JVP) in heart failure, 104
Junctional rhythms, 348–349
Justification for the Use of Statins in Primary Prevention: An Intervention Trial Evaluating Rosuvastatin (2008), 611
K
Kawasaki disease, 519
Killip classification, 100
L
Labetalol
in hypertensive emergency, 503t, 505
in hypertensive urgency, 509
Laboratory abnormalities, LHC, 907
Left atrial appendage occlusion (LAAO)
AF, 959
complications, 959
outcomes, 959–960
procedure, 959
Left bundle branch block (LBBB), 11, 12
Left bundle branch block, ECG patterns, 831
Left coronary artery, LHC, 911–912
catheters, 911
damping, 912
left anterior oblique caudal view, 917
left anterior oblique cranial view, 916
posteroanterior view, 915
right anterior oblique caudal view, 916
right anterior oblique cranial view, 917
ventricularization, 912–913
Left heart catheterization (LHC)
access site
brachial, 910
catheters, 911
radial artery, 909–910
special situations, 910–911
complications
allergy, 926
arrhythmias, 925
bleeding, 925–926
coronary artery dissection, 925
coronary artery spasm, 925
death, 924
emergency CABG, 925
heart failure, 925
infection, 926
myocardial infarction, 924
neuropathy, 926
renal failure, 925
stroke, 924–925
vagal reaction, 925
vascular, 925
contraindications, 905t, 906–907
patient preparation
contrast dye, 908–909
education, 908
equipment, 908
informed consent, 907
medications, 908
precatheterization assessment, 907–908
postcatheterization care
compression/vascular closure devices, 924
sheath removal (femoral), 923
sheath removal (radial), 923–924
technique
aortic stenosis, 920
aortography, 921–923
crossing aortic valve, 920
engaging vessel, 911–914
imaging vessels, 914–920
left ventriculography, 920–921
pharmacologic testing, 923
technique in tetralogy of Fallot, 462–463
Left internal mammary artery (LIMA), 912, 913
Left-sided prosthetic valve thrombosis, 276
Left-to-right shunt, 44
Left ventricle
dysfunction
asymptomatic, 99
following cardiac transplantation, 172
function
assessment following myocardial infarction, 62
in sudden cardiac death, 68–69
mass in heart failure, 107
partial resection, in chronic heart failure, 154
Left Ventricular Assist Devices (LVADs), 155–156
bleeding, 162
bridge-to-decision, 156
bridge-to-transplant, 157
complications, 160
continuous-flow, 158
destination therapy, 157
development of continuous-flow, 156
implantation strategies for, 156
infection, 162–163
investigational devices, 160
miniature ventricular assist device, 162
nutrition, 158
patient evaluation and selection for, 157–158
psychosocial factors, 158
pump thrombosis, 160–162
renal function, 158
right ventricular failure, 163
right ventricular function, 158
stroke, 163
Syncardia total artificial heart device, 160, 161
total artificial heart, 160
transplant candidacy, 158
Left ventricular dysfunction, 908–909
Left ventricular function, 676
Left ventricular hypertrophy, ECG patterns, 820
Left ventricular noncompaction, 563–564
Left ventricular outflow tract (LVOT), hypertrophic cardiomyopathy and, 130
Left ventricular reconstruction
cardiomyoplasty, 154–155
constraint devices, 155
endoventricular circular patch plasty, 154
partial left ventriculotomy, 154
pathophysiology of, 154
Left ventriculography, LHC
settings, 921
set-up, 920–921
sixty-degree left anterior oblique view of the left ventricle, 922
thirty-degree right anterior oblique view of left ventricle, 922
views, 921
Lifestyle modifications
heart disease in women, 578
in myocardial infarction prevention, 70
in stable angina treatment, 88
Limb ischemia
in peripheral arterial disease, 408, 408t
and threatened limb viability, 884
Limb lead reversal, 849
Linkage analyses, 556
Lipid-lowering therapy
in peripheral arterial disease, 413
in stable angina, 77–78
Lipid-lowering trials, 609–615
Lipomas, 550–551
Lipoproteins, 637
high-density, 65
hyperlipidemia, 609
low-density, 64–65
Liraglutide, diabetes, 645
Liver function test abnormalities, 617–619
Loeffler endocarditis, 123
Loeys-Dietz syndrome
associated with aortic aneurysm and dissection, 391
gene variants in, 560–561
Long QT syndrome
ECG patterns, 840
gene variants in, 565–566, 566t
in sudden cardiac death, 356
in ventricular tachycardia, 324–325
Long-standing severe MR, 223
Long-Term Intervention with Pravastatin in Ischemic Disease Study (LIPID) (1998), 612
Lorcaserin, diabetes, 644
Low-density lipoprotein (LDL), 64–65
reduction with statin therapy, diabetes, 643
Low dose fibrinolytic regimens, 276
Lower extremity
aneurysms, 415
peripheral arterial disease, 407–415
Low-molecular-weight heparin (LMWH), 37
in deep venous thrombosis, 377
PCI, 941–942
during pregnancy, 593–594
in pulmonary embolism, 383
Lown-Ganong-Levine syndrome, 314
LV contractility, ECMO, 902
LV end-diastolic volume, 225
M
Machine settings in transthoracic echocardiography
compress setting, 981
depth, 981
dynamic range, 981
focus (or position), 981
persistence, 981
time gain compensation, 981
transmit gain, 981
Magnetic resonance angiography (MRA), 729
in abdominal aortic aneurysm, 399
in aortic dissection, 394
carotid artery disease, 420–421
in peripheral arterial disease, 411
in pulmonary embolism, 382
in renal artery stenosis, 417
in thoracic aortic aneurysm, 403
Magnetic resonance imaging (MRI), 197, 273, 788
in abdominal aortic aneurysm, 399
in aortic dissection, 394
in cardiac tumors, 548
in heart failure, 125
in hypertrophic cardiomyopathy, 134
in stable angina assessment, 74
in tetralogy of Fallot, 462
in thoracic aortic aneurysm, 403
in transposition of the great arteries, 467
Mahaim tachycardia, 314
Malaise, 538
Malar facial flush, 241
Malignancy, following cardiac transplantation, 182
Malignant cardiac tumors, 550t
Malignant effusion, pericardiocentesis, 1001
Mammary artery, internal, coronary artery bypass grafting using, 87
Marfan syndrome
aortic aneurysm and dissection, 520
arrhythmias, 521
associated with aortic aneurysm and dissection, 391
dilated cardiomyopathy, 521
gene variants in, 559–560
mitral valve prolapse, 520–521
Massive pulmonary embolism, 871t, 872, 874
Maternal rubella infection, 449
MAZE procedure, in atrial fibrillation, 138
Mean arterial blood pressure (MAP), 505
Mechanical cardiac syncope, 480
Mechanical complications of acute MI, 883
Mechanical prostheses, 277
Mechanical prosthetic regurgitation, 271
Medications, obesity, 634
MEF2a gene, 559
Meglitinides, diabetes, 652
Mendelian disorders, 555
Menopause, 573–574
Meperidine, 990
Mesotheliomas, 553
Metabolic radiopharmaceuticals, positron emission tomography, 690
Metabolic storage diseases, in heart failure, 123–124
Metabolic stress testing, in heart failure diagnosis, 108–109, 168
Metabolic syndrome
heart disease in women, 573
obesity, 634
Metabolism, inborn errors of, 568t, 570
Metastasis, cardiac, 552, 553t
Metformin, diabetes, 651
Methyldopa, 183
3,4-Methylenedioxymethamphetamine (MDMA), 261
Metoprolol succinate, 369
Microvascular angina (MVA), 92–93
Midazolam, 990
Midsystolic click, 238
Midsystolic ejection murmur, 216
Miglitol, diabetes, 652
Mild gastrointestinal disturbances, hyperlipidemia, 617
Mild muscular jerking, 481
Milrinone, 60
for heart failure, 111
Miniature ventricular assist device, 162
Missile embolization, 513–514
Mitral regurgitation, 45–47
acute
clinical presentation, 45
diagnostic tests, 45–46
as myocardial infarction complication, 45–47
therapy, 46–47
assessment of, 227t
auscultatory findings in, 224
cardiac catheterization
amplitude of v-waves, 230
atrial fibrillation, 233
coronary angiography, 230–231
feasibility of repair, 233
pulmonary hypertension, 233
surgery timing, 232–233
therapy, 231–232
causes of, 226t
diagnostic testing
caveats, 227–228
proximal isovelocity surface area (PISA), 229–230
pulsed-wave Doppler echocardiography, 228
etiology, 225
flow convergence method, PISA, 229
hypertrophic cardiomyopathy and, 135
laboratory examination, 225
medical therapy, 233–234
mitral valve surgery in, 231t
pathophysiology, 225
physical findings
auscultation, 224–225
holosystolic murmurs, 225
inspection and palpation, 223–224
pulmonary venous flow changes, 229
right heart cardiac catheterization in, 46–47
signs and symptoms, 223
stress echocardiography, 705–706
surgical management of, 228t
surgical therapy
dynamic LV outflow obstruction, 235
flexible ring, 236
intraoperative echocardiography, 235
minimally invasive video-assisted, 234–235
mitral valve repair, 234
mitral valve replacement, 234, 235
percutaneous mitral valve repair and replacement, 235–236
postsurgical follow-up care, 235
repair with replacement, 234
resynchronization, 235
valve apparatus, 224
cardiac catheterization
chest radiography, 246
ECG, 246
Gorlin formula, 246
pitfalls, 246
etiology, 242–243
exertional dyspnea, 246
laboratory examination, 243–245
medical therapy, 246
pathophysiology, 242–243
physical findings, 241–242
rheumatic MS, 242
signs and symptoms, 240–241
stress echocardiography, 706
surgical therapy, 247–248
surgical treatment, 249–250
Mitral valve prolapse
auscultatory findings in, 238
balloon valvuloplasty, 249t
clinical presentation, 238
echo score assessment for, 248t
etiology, 239
gene expression profiling in, 567
in infective endocarditis, 328
left ventricular and pulmonary capillary wedge pressure tracings, 245
parasternal short-axis view, 244
percutaneous mitral balloon valvotomy, 247t
in ventricular tachycardia, 329
Mitral valve repair, 234
for heart failure, 153–154
Mitral valve replacement in heart failure, 153–154
Mitral valvular apparatus, 223
M-mode, transthoracic echocardiography, 963–964
Monitoring, pericardiocentesis, 1006
Morganroth hypothesis, 595
Morphine, anti-ischemic therapy, 33
Muffled heart sounds, 538
MUGA scans, nuclear cardiac imaging, 688–689
Multicrystal camera, nuclear cardiac imaging, 679
Multidetector computed tomography (MDCT), 74
Multi-focal atrial tachycardia, 311–312
Multifocal atrial tachycardia, ECG patterns, 829
Multiplane TEE
lower and middle esophagus, 993–995, 994
schematic representation, 992
transgastric views
deep transgastric, 995
upper esophagus (30 cm)-base of the heart, 991–993, 993
Multiple accessory pathways, 755
Multiple lesions, 30
Multiple organ systems, 297
Multiple risk factor intervention trial (MRFIT), 627
Murmur
in aortic dissection, 393
in hypertrophic cardiomyopathy, 132, 132t
in infective endocarditis, 327
in papillary muscle rupture, 42, 43t
in ventricular septal defect, 42, 43t
Muscular dystrophies, 329
Mycophenolate mofetil (MMF) in cardiac transplantation, 174t, 175–176
Mycophenolic acid (MPA), 176
Myeloperoxidase, nonlipid cardiovascular risk factors, as, 637
Mynx, 924
Myocardial blood flow (MBF), 93
Myocardial depression, electrical cardioversion, 860
Myocardial infarction
acute cardiogenic shock, complicating (See Cardiogenic shock, complicating acute myocardial infarction)
in aortic dissection, 396
complications, 42–54
acute MR, 45–47
arrhythmias, 52
dynamic LVOT obstruction, 52
embolisms, 52–53
pericarditis, 53–54
right ventricular failure, 50–52
ventricular aneurysm, 48
ventricular free wall rupture, 47–48
ventricular pseudoaneurysm, 47
ventricular septal defect, 42–52
gene expression profiling in, 557–558
LHC, 924
medical therapy, 64–68
post-infarction
cardiac rehabilitation programs, 69
coronary angiography, 63
lifestyle modifications, 70
risk stratification, 62–64, 63
prevention
angiotensin-converting enzyme (ACE) inhibitors, 67
antiplatelet therapy, 65
beta -blockers, 66–67
calcium channel blockers, 67–68
lifestyle modifications, 70
lipid management, 64–65
smoking cessation, 64
sudden cardiac death, 68–69
risk stratification, 62–64, 63
sudden cardiac death, preventing, 68–69
Myocardial innervation imaging, nuclear cardiac imaging, 689
Myocardial ischemia
hypertensive crisis and, 507–508
in hypertrophic cardiomyopathy, 130–131
Myocardial Ischemia Reduction with Acute Cholesterol-Lowering Trial (2001), 612
Myocardial mechanics, transthoracic echocardiography, 975
Myocardial perforation and chamber entry, pericardiocentesis, 1005
Myocardial performance index (Tei index), 107
Myocardial perfusion scintigraphy
pharmacologic SE, 703
Myocardial stunning, 703
Myocardial tagging, 729
Myocardial viability testing
definitions, 707
evidence for, 712–713
rest, stress and perfusion characteristics of normal, ischemic, and scarred myocardium, 708t
rubidium positron emission tomography, 710
techniques to assess viability
cardiac magnetic resonance imaging, 711
dobutamine stress echocardiography imaging, 712
positron emission tomography imaging, 709–710
single photon emission computed tomography imaging, 711–712
when to (and when not to) assess for viability, 713
Myocarditis, 4
acute, 330
aggressive clinical course, 146
antimyosin scintigraphy, 144
biopsy for staging, 150
causes of, 145t
clinical presentation, 142–143
clinicopathologic classification of, 142
controversies in, 149–151
coronary angiography, 144
Dallas classification, 142
definition of, 142
diagnostic testing, 144
echocardiogram, 144
electrocardiogram, 144
endomyocardial biopsy, 149
etiology, 144–147
gallium scanning, 144
histologic classification of, 142
hypersensitive reaction, 147
immunosuppressive therapy, 151
inflammatory markers of, 143
laboratory evaluation, 143–144
magnetic resonance imaging (MRI), 144
natural history and sequelae of, 147
predictors for morbidity and mortality, 148
prognosis, 147–148
routine EMB confirmation of, 149
systemic autoimmune disorders with, 147
systemic causes of, 147
ventricular tachycardia in, 330
World Health Organization, 142
Myocarditis Treatment Trial, 147, 151
Myxomas, 549
N
Naltrexone, diabetes, 645
Narula method, 743
National Registry of Myocardial Infarction 2, 882
Native valve endocarditis, 280
Natriuretic peptides, in heart failure diagnosis, 105
Naughton protocol, exercise electrocardiographic testing, 664
Nephrotoxicity, 175
Nesiritide, for heart failure, 110
Neurologic emergencies, hypertensive crisis and, 506–507
Neuropathy, 926
New York Heart Association Functional Classification, for heart failure, 100, 100t
Niacin, hyperlipidemia, 620
Nicardipine, for hypertensive emergency, 503t, 505
Nicotinic acid, 620
Nifedipine, for hypertensive urgency, 509
Nimodipine, 507
Nitinol wire frame, 440
Nitrates
anti-ischemic therapy, 32–33
in stable angina, 78–79
Nitrogen 13 ammonia (13NH3), myocardial viability testing, 709
in heart failure, 110
in hypertensive emergency, 505
Nitroprusside, sodium
in heart failure, 110
in hypertensive emergency, 503t, 506
Nodal ablation, atrial fibrillation, 370
Nodal blocking agents, atrial fibrillation, 370–371
Nonbacterial endocarditis, 282
Nonbacterial thrombotic endocarditis (NBTE), 282
Noncalcified plaque, cardiovascular CT, 721
Noncardiac surgery, stress echocardiography, 704
Noncardiac surgical procedures
active cardiac conditions, 491
algorithm for preoperative cardiac evaluation, 492
aspirin, 496
asymptomatic ischemia, 494
background, 490
beta-blockers, 496
“bridging” therapy, 494
calcium channel blockers, 496
cardiac evaluation of patient undergoing, 493
cardiomyopathies and pulmonary hypertension, 496
clinical presentation of, 490–491
comorbid conditions, 490
echocardiography, 492
electrocardiogram, 491
elevated risk, 491
estimated energy requirements, 491t
functional capacity, 490
high-risk findings, 491
implantable cardioverter-defibrillators, 496
management of specific preoperative conditions, 495–496
noninvasive cardiac stress testing, 492–493
objectives of, 490
PCI on dual antiplatelet therapy, 494
perioperative hemodynamic monitoring, 497
perioperative medical therapy, 496
permanent pacemakers, 496
poor functional capacity, 492
postoperative
heart failure and pulmonary edema, 497
MI, 497
monitoring and management of events, 497
preoperative
cardiac evaluation, algorithm for, 492
coronary revascularization, 494
prospective randomized controlled trials, 494
pulmonary artery catheters, 497
Revised Cardiac Risk Index, 491, 492t
risk prediction tools, 491
routine laboratory tests, 491
statins, 496
stepwise approach to preoperative cardiac assessment, 492
supplemental preoperative evaluation, 491–492
timing of elective, 495
Noncompaction, left ventricular, 563–564
Noninvasive stress testing, 32
Nonlipid cardiovascular risk factors
hypertension
clinical presentation, 628–630
elderly, 628
etiology, 627
impact on cardiovascular risk and mortality, 627–628
laboratory evaluation, 630
risk stratification, 630–633
nontraditional risk factors
C-reactive protein, 636
fibrinogen, 637
homocysteine, 637
lipoprotein (a) or Lp(a), 637
myeloperoxidase, 637
nonlipid genetic factors, 638
obesity
link between obesity and cardiovascular disease, 634
therapy, 634
sedentary lifestyle
pathophysiology, 635
risk reduction, 635–636
tobacco, 634–635
pathophysiology, 635
risk reduction and therapy, 635
Nonlipid genetic factors, nonlipid cardiovascular risk factors, as, 638
Nonpharmacologic stroke prevention, atrial fibrillation, 369
Nonpharmacologic therapy for HTN
cessation of smoking and excessive alcohol use, 631
diet, 631
exercise, 631
weight reduction, 631
Non-ST-elevation acute coronary syndrome (NSTE-ACS), 927–928
chest pain in, 27
clinical presentation, 27–29
clinical risk classification systems, 28
delayed invasive strategy, 40
early hospital care, 32–41
fibrinolytic agents, 38
high-risk patients, 32
hospital discharge and postdischarge care, 41
initial evaluation and management, 30–32
oral anticoagulation, 38–39
pathophysiology, 29–30
protease-activated receptor-1 antagonist, 38
Non-ST-elevation myocardial infarction (NSTEMI), 55
Nonsustained ventricular tachycardia (NSVT), 333–334
Norepinephrine, 59
Normal aortic valve, 920
Normal coronary anatomy, 914–915
Normal myocardial perfusion scan, 32
Normal tissue, definition, 707
Normal TV leaflet morphology, 254
Normal valvular structure, 239
Normochromic anemia, 301
Normochromic normocytic anemia, 282
North American Symptomatic Carotid Endarterectomy Trial (NASCET), 420, 421
NOTCH1 gene, 567
Novel risk factors, 574
Nuclear cardiac imaging, 675, 686–687
clinical applications, 687–689
contraindications
dipyridamole, adenosine, or regadenoson, 676, 679
nuclear studies, 676
equipments, 679–680
multicrystal camera, 679
positron emission tomography scanning, 680
single-crystal camera, 679
SPECT, 680
image interpretation, 684–687
artifacts, 686
characterization of defects, 685–686
fixed defects, 685
partially reversible defects, 685–686
quantitative analysis, 686–687
reverse redistribution, 686
reversible defects, 685
reviewing sequence, 685
risk assessment, 686
standard view of normal anatomy, 684–685
imaging protocols, 682–683
mechanics and techniques, 680–682
photon emission computerized tomography, stress testing, 73
positron emission tomography, 689–691
in hypertrophic cardiomyopathy, 130
stress testing, 73
in right heart catheterization, 107
Nutrition, 158
Obesity
heart disease in women, 573
Occult bleeding, 56–57
Open artery hypothesis, 22
Open heart surgery, cardiovascular CT, 718
Ophthalmology consultation, 169
Optical coherence tomography, 75–76
Oral anticoagulants
oral direct thrombin inhibitors, 378
Xa inhibitors, 378
Oral anticoagulation, 38–39
Oral platelet P2Y12 receptor antagonists, 15
Oral prophylaxis, 303
Orbital atherectomy, 938
Orlistat, diabetes, 644
Orthodromic AV reentry tachycardia, 752, 755
Orthopnea, 104
Orthostatic vital signs, 481
Osler triad, 281
Osteoporosis, 173
Outflow tract ventricular tachycardia, 812–813
Overrepresent true cardiac function, 225
Oxygen, 14
therapy, anti-ischemic therapy, 32
Oxygen 15 water, 690
myocardial viability testing, 709
P
PA catheter insertion, 867
Pacemaker-mediated tachycardia (PMT), 787
Pacemakers
acute complications of pacemaker implantation
cardiac/central venous perforation, 784
diaphragmatic stimulation, 784–785
lead dislodgement or damage, 785
local muscular stimulation, 785
pacemaker malfunction, 785
pacemaker pocket hematoma, 784
pneumothorax/hemothorax, 784
base rate behavior
atrial-based timing, 779
hysteresis, 779
ventricular-based timing, 779
chronic complications of pacemaker implantation
intravascular thrombosis/ obstruction, 785
pacemaker system infection, 785
Twiddler syndrome, 785
classification, 772
common issues for patient with
EMI in hospital environment, 788–789
environmental EMI, 789
pacemaker response to EMI, 789
perioperative patient, 787–788
common problems
acute complications of pacemaker implantation, 784–785
chronic complications of pacemaker implantation, 785
components of cardiac, 771–772
EMI in hospital environment
cardiac monitors, 788
cardioversion/defibrillation, 789
dental equipment, 789
diathermy, 789
electrocautery, 789
electroconvulsive therapy, 789
ESWL, 788
MRI, 788
radiation therapy, 788
transcutaneous electric nerve stimulation, 788
environmental EMI
cellular telephones, 789
electronic article surveillance (EAS), 789
high-voltage power lines and electrical substations, 789
industrial electrical equipment, 789
metal detectors, 789
microwave ovens, 789
failure of pacemaker stimulus output
lead failure, 786
oversensing, 786
pseudomalfunction, 786
pulse generator failure, 786
failure to capture
elevated capture threshold, 786
exit block, 786–787
latency, 787
lead malfunction, 786
pseudomalfunction, 787
hypertrophic cardiomyopathy
presumed mechanism of benefit, 791
recommendations, 791
implantation
postoperative issues, 783–784
preoperative issues, 782–783
implantation, indications for, 772
indications for, evolving
hypertrophic cardiomyopathy, 791
long QT syndrome, 792
leadless, 792
long QT syndrome
presumed mechanism of benefit, 792
recommendations, 792
malfunction
ELT, 787
failure of pacemaker stimulus output, 786
failure to capture, 786–787
failure to sense, 787
general evaluation, 786
pacemaker syndrome, 787
PMT, 787
perioperative patient, 787–788
postoperative issues
discharge planning, 784
general recommendations, 783
pacemaker evaluation, 784
postoperative testing, 783
resuming anticoagulation, 783
preoperative issues
history and physical examination, 782–783
medications, 783
patient preparation, 783
tests, 783
response to EMI
pacing inhibition, 789
rapid pacing, 789
reversion to asynchronous pacing, 789
timing cycles and intervals, 778
base rate behavior, 779
timing circuits, 773
upper rate behavior, 779–780
Pacemakers, infective endocarditis, 330, 341
Pace mapping, 760
Pacing
in atrial flutter, 310
in atrioventricular conduction disturbances, 348
indications for, 340t–342t
rapid atrial, in atrial flutter, 310
in sinus node dysfunction, 343
in sudden cardiac death, 361
Pain, 881
Panel reactive antibodies (PRAs), in cardiac transplantation evaluation, 166
Pansystolic murmur, 255
Papillary fibroelastomas, 549–550
Papillary muscle rupture
mechanical complications of, 3
mitral regurgitation caused by, 46
murmur associated with, 42, 43t
Paradoxical AS, 213
Parallel imaging, 729
Parasternal RV lift, 241
Parenteral anticoagulants, 16
PARTNER 1 trial, transcatheter aortic valve replacement, 955
Patent ductus arteriosus (PDA), 451t, 450
aneurysm, 452
antibiotic prophylaxis, 454
birth, 450–451
cardiac catheterization, 453
clinical presentation, 451–452, 455
coarctation of the aorta, 454–455
complications of transcatheter closure, 454
diagnostic testing, 452–453, 455–456
embolized coils, 454
fetal circulation, 450
fibrotic remnant, 450–451
follow-up, 457
laboratory testing, 452
natural history, 449
pathophysiology, 449–451
percutaneous balloon angioplasty, 457
percutaneous coil occlusion, 454
premature birth, female sex, and genetic factors, 449
risk factors, 449
stent implantation, 457
transcatheter techniques, 453–454
Patent foramen ovale (PFO), 434
percutaneous structural heart disease
complications, 957
outcomes, 957
procedures, 956–957
Patient care, pericardiocentesis, 1006
Patient Prosthesis Mismatch (PPM), 276
PCSK-9 familial hyperlipidemia, 557
Pectus excavatum, 238
Penetrating atherosclerotic ulcer, CT coronary angiography, 724
Pentoxifylline, in claudication, 414
Perclose (Abbott), 924
Percutaneous aortic balloon valvuloplasty (PABV), 207
Percutaneous aortic stent-grafting, 397–398
Percutaneous carotid intervention, 425–429
Percutaneous coronary intervention (PCI)
angiographic/procedural/clinical success, 929
compared to coronary artery bypass grafting, 87
complications
abrupt closure, 929
atheroembolism and thromboembolism, 929–930
contrast-induced nephropathy, 930
contrast-mediated reactions, 930
coronary perforation, 930
stent thrombosis (ST), 930
vascular access site complications, 930
considerations for, 928t
diagnostic adjuncts
coronary flow reserve (physiologic), 932
FFR (physiologic), 932–933
instantaneous wave-free ratio (iFR; Volcano Corporation), 933
IVUS (anatomic), 932
optical coherence tomography, 932
pulmonary artery catheter (physiologic), 933
experienced operators/centers, 930–931
indications, 927–928
multivessel, 58
pharmacologic adjunctive therapy, 940–946
post-PCI management
access site care, 946–947
contrast-induced nephropathy, monitoring for, 947
myocardial ischemia, monitoring for, 947
primary, 58
prognosis, 929
restenosis, 940
sheaths, guides, and wires, 931–932
in stable angina, 84–87
standard evaluation, 928t
supportive adjunctive therapy, 946
surgical backup, 931
SVG interventions, 929
therapeutic devices
bioabsorbable vascular scaffolds, 934
bioresorbable polymer DES, 934
BMS, 933–934
coronary stents approved in United States, 935t
covered stents, 937
cutting balloon atherectomy, 937
excimer laser, 938
orbital atherectomy, 938
percutaneous transluminal coronary angioplasty, 933
rotational atherectomy, 937
stent thrombosis, 934–937
thrombectomy, 938–939
Percutaneous endovascular aortic repair (EVAR)
in abdominal aortic aneurysm, 400
in aortic dissection, 397–398
classification of Endoleaks, 400, 401t
Percutaneous mitral balloon valvuloplasty (PMBV)
background, 951
complications, 952
outcomes, 952
procedure, 951
Percutaneous paravalvular leak closure, structural heart disease
background, 961
complications, 961
outcomes, 961
procedure, 961
Percutaneous pulmonic valve intervention (PPVI), 260
candidacy, 260
complications, 260–261
results, 260–261
valve types, 260
Percutaneous structural heart disease procedures
ASA (See Alcohol septal ablation)
ASD closure, 957–958
BAV (See Balloon aortic valvuloplasty)
LAAO (See Left atrial appendage occlusion)
percutaneous paravalvular leak closure, 961
percutaneous transcatheter mitral valve repair, 950
carillon, 949
complications, 950
MitraClip, 949
outcomes, 951
procedure, 949–950
PFO closure, 955–957
PMBV (See Percutaneous mitral balloon valvuloplasty)
transcatheter aortic valve replacement, 953–955
VSD closure, 958–959
Percutaneous therapy, 231
in acute MR, 46
in right ventricular failure, 51
ventricular free wall rupture, 48
in ventricular septal defect, 44
in ventricular tachycardia, 323
Percutaneous transluminal coronary angioplasty, 933
Perfusion imaging, 729
Perfusion (blood flow) tracers, 689–690
Pericardial disease, 523–545
acute pericarditis
causes of, 524t–525t
chest pain, 523
clinical presentation, 523–525
complications, 528–529
defined, 523
differential diagnosis, 527
electrocardiographic changes in, 526
first-line treatment for, 528t
general indication for imaging, 526–527
inflammatory markers and markers of myocardial injury, 526
management, 525–526
medical therapy, 527–528
pericardial rub, 523
pericarditis findings per imaging modality, 527t
prognostic factors, 525
routine testing, 526
testing, 525
transthoracic echocardiogram, 526
cardiac tamponade
clinical presentation, 534
defined, 533
general indication for imaging, 534–536
management, 534
medical therapy, 536
pathophysiology, 533–534
pericardial pressure-volume curves, 533
constrictive pericarditis
abnormal respirophasic septal shift, 539
annular tissue velocities, 540
annulus paradoxus, 539–540
cardiac catheterization, 542
cardiac CT, 542
cardiac MRI, 542
causes of, 537t
chest radiograph, 538
clinical presentation, 538
defined, 536
diagnostic algorithm for, 541
differentiate constriction from restriction, 545t
effusive-constrictive pericarditis, 536
general indication for imaging, 538–544
hallmark of, 537
inflammatory markers, 538
management, 538
medical therapy, 544–545
pathophysiology, 536–538
pericardial thickening, 539
pleural effusions, 538
postcardiac surgery, 536
pulsed Doppler recordings, 540
radiation therapy, 536
respiratory ventricular interaction, 544
respirophasic ventricular septum movement, 539
from restrictive cardiomyopathy, 544
right atrium, right ventricle, and left ventricle pressure waveform in, 543
septal bounce, 539
and signs of inflammation, 544
strain imaging, 541
symptoms of, 538
overview, 523–524
classification of, 530t
clinical presentation, 530
defined, 529
general indication for imaging, 532
management, 530–532
medical therapy, 532
prognosis and follow-up, 532–533
Pericardial diseases
cardiovascular CT, 717
CT coronary angiography
congenital absence of the pericardium, 723
constriction, 723
cyst, 723
neoplasms, 723
Pericardial effusion
ECG patterns, 847
pericardial disease
causes of, 531t
classification of, 530t
clinical presentation, 530
general indication for imaging, 532
management, 530–532
medical therapy, 532
prognosis and follow-up, 532–533
pericardiocentesis
after open heart surgery, 999
idiopathic, 1000
malignant, 1000
Pericardiocentesis
complications, 1005
contraindications, 1000–1001
diagnostic studies, 1005
indications
alleviation of cardiac tamponade, 999
pericardial effusion, 999–1000
patient preparation
informed consent, 1001
intubation, 1001
monitoring, 1001
sedation, 1001
postprocedure care, 1005–1006
surgical management vs., 1001, 1001t
techniques, 1002–1004
Pericarditis, 4
acute pericarditis, defined, 523
constrictive pericarditis
defined, 523
Doppler recordings of mitral and tricuspid inflow in, 535
right heart catheterization, 536
early, 53–54
ECG patterns, 843
electrocardiographic changes of, 54, 54t
late, 54
as myocardial infarction complication, 53–54
Pericardium, diseases of
anatomic considerations, 523–524
CMRI
congenital absence of pericardium, 734
constriction, and, 734
constrictive pericarditis, 734
effusions, 733
inflammatory pericarditis, 734
pericardial cysts, 734
Peripartum cardiomyopathy, 146
during pregnancy, 590
Peripheral arterial disease (PAD), 407–408
lower extremity, 407–415
clinical presentation, 408, 408t
diagnostic tests, 408t, 409–411
etiology, 407
treatment, 411–415
lower extremity aneurysms, 415
overview, 407
renal artery stenosis, 416–418
treatment, 411–415
antiplatelet therapy, 411–412
revascularization, 414–415
risk factor modification, 413
upper extremity, 415
Peripheral arteries, cardiovascular CT, 724
Peripheral cyanosis, 241
Peripheral pulses, 482
Pharmacodynamics, cardiovascular formulae, 1011
Pharmacoinvasive strategy, 21–22
Pharmacologic cardioversion, atrial fibrillation, 370
Pharmacologic SE
dobutamine SE, 702
image interpretation, 700–701
myocardial perfusion scintigraphy, 703
Pharmacologic stress testing, 32
nuclear cardiac imaging, 684
stress echocardiography, 692
Pharmacologic testing, LHC, 923
Phase-contrast velocity mapping, 729
Phased array catheters, 807
Phentermine, diabetes, 644–645
Phentolamine, 508
Physical inactivity, CVD risk factors in women, 574
Pill-in-the-pocket approach, 370–371
Planar images, nuclear cardiac imaging, 680, 681, 684
Plaque erosion and rupture, 29
Platelet inhibitors, for stable angina, 76–77
Pleural effusions, 283
Pneumocystis jiroveci pneumonia, following cardiac transplantation, 180
Pneumothorax, pericardiocentesis, 1005
Polyarteritis nodosa, 519
Polyclonal anti-lymphocyte antibodies, in cardiac transplantation, 177, 174t
Polymorphic ventricular tachycardia, EPS
induced ventricular fibrillation, 759
interpretation, 759
Poor wound healing, 176
Portal hypertension, 185
Positive intraoperative cultures, 291
Positive predictive value (PPV), exercise electrocardiographic testing, 661
Positron camera, nuclear cardiac imaging, 680
Positron emission tomography (PET)
in hypertrophic cardiomyopathy, 130
myocardial viability testing
limitations, 709
metabolic agents, 709
perfusion agents, 709
test interpretation, 709
nuclear cardiac imaging
clinical applications, 691
metabolic radiopharmaceuticals, 690
patterns of perfusion and metabolic imaging, 690
perfusion (blood flow) tracers, 689–690
protocols, 690
stress testing, 73
Possible diagnostic group, 285
Postcatheterization care, LHC
compression/vascular closure devices, 924
sheath removal (femoral), 923
sheath removal (radial), 923–924
Post-myocardial infarction, stress echocardiography, 704
Post-PCI management in PCI
access site care
acute arterial occlusion, 947
arteriovenous fistulas, 946
pseudoaneurysms, 946
retroperitoneal hemorrhage, 946
monitoring for
contrast-induced nephropathy, 947
myocardial ischemia, 947
Post-procedural management
anticoagulation, management of
oral anticoagulant, 817
therapeutic oral anticoagulation, 817
major complications
atrial esophageal fistula, 816
cardiac perforation and tamponade, 816
death, 816
genitourinary trauma, 816
injury to conduction system, 816
pulmonary edema, 816
thromboembolism, 816
vascular access, 816
VT ablation, complications unique to
coronary artery injury, 816–817
epicardial ablation, 817
hemodynamic instability, 816
Poststenotic dilation, 258
Postural orthostatic tachycardia syndrome, 488–489
adreno-receptor agonists, 489
changes in venous function, 488
diagnosis, 489
drugs, 489
etiology, 488
hypovolemia, 488
increased sympathetic activity, 488
partial dysautonomia, 488
primary baroreflex abnormalities, 488
pyridostigmine, 489
treatment, 489
volume expansion, 489
Potential donor screening, 171
Prasugrel, 944
Pravastatin in Elderly Individuals at Risk of Vascular Disease (2002), 610
Pravastatin or Atorvastatin Evaluation and Infection Therapy-TIMI 22 (PROVE-IT-TIMI-22) (2004), 612
Preeclampsia in pregnancy, 588
Preexcitation syndromes, 313–317
atrial fibrillation, 373
LGL syndrome, 314
Mahaim fiber tachycardias, 314
Wolf-Parkinson-White syndrome
diagnostic tests, 316
risk stratification, 316
therapy, 316–317
Pregnancy
aortic dissection and, 391
atrial fibrillation, 373
Eisenmenger syndrome and, 476
heart disease in women and, 579–580
cardiovascular evaluation, 581–582
with congenital heart disease, 584–585
drug therapy for hypertension, 589t
findings in normal pregnancy, 582t
hypertensive disorders, 588–591
management principles for pregnant women with valvular heart disease, 583t
medication considerations in, 591–594
normal physiologic changes, 580–581
other cardiovascular diseases and, 588–591
risk assessment and general principles of management, 582–584
risk predictors of adverse maternal and fetal outcomes, 584t
valvular heart disease and, 585–588
Pregnancy after cardiac transplantation, 591
Prehypertension, defined, 628
Premature depolarizations, 812
Premature ventricular stimulation, 744
Preshock, 56
Pressure half-time, 320
Primary angioplasty in myocardial infarction II trial, 882
Primary pulmonary hypertension during pregnancy, 590–591
Prodrome, 481
Programmed stimulation in EPS
hemodynamic response, 740
pacing stimuli
burst pacing, 740
continuous monitoring, 742
extra stimulus technique, 740–742
Prolonged chest pain, 28
Prophylactic temporary pacing, 852
Prophylaxis, for infective endocarditis, 345t, 139, 173, 343–345, 344t
Proprotein convertase subtilisin/kexin type 9 inhibitors, 614, 621–622
Prostacyclin, 190
Prosthetic descending aortic grafts and iliofemoral vascular grafts, 884
Prosthetic valve
anticoagulation, 268
bioprosthetic valves, 268–269
immediate postoperative period, 268
mechanical valves, 268
pregnancy, 269
aortic homografts, 265
autograft, 265
cardiac catheterization, 273
cinefluoroscopy, 273
Doppler evaluation, 271
follow-up after valve surgery, 268
functions, 263
heterograft valve failure rate, 267t
imaging planes for TEE, 271
ioprosthetic vs. mechanical valve, 266t
magnetic resonance imaging, 273
mechanical and bioprosthetic valves, 270
mechanical valves
bileaflet, 265
caged ball, 266
single-leaflet tilting disk, 266
multislice gated cardiac CT, 273
normal Doppler findings
physiologic prosthetic valve regurgitation, 271
prosthetic valve clicks, 271
prosthetic valve velocities, 271
pathologic prosthetic valve regurgitation, 273
prosthetic valve stenosis
continuity equation, 272
dimensionless index, 273
pressure half-time, 273
transvalvular gradients, 271–272
valve area calculations, 272
selection
bioprosthetic, 266–267
homografts, 267
mechanical, 267–268
repair, 266
transcatheter aortic valve replacement, 267
surgical biologic valve replacement, 264t
two-dimensional echocardiography
occluders and leaflets, 270
sewing ring, 270–271
types
bioprosthetic, 263
stented bioprostheses, 263
valve repair vs. replacement, 267t
Protease-activated receptor-1 antagonist, 38
Prothrombin gene mutation, 385–386
Proximal isovelocity surface area (PISA), 229
Pseudoaneurysm, ventricular as myocardial infarction complication, 47
Pseudosevere AS, 213
Pulmonary angiography, in pulmonary embolism, 382
Pulmonary arterial hypertension (PAH), 184, 453
non-PAH groups, 191
Pulmonary artery diastolic pressure (PADP), transthoracic echocardiography, 977–978
Pulmonary artery systolic pressure (PASP), 977
Pulmonary capillary wedge pressure (PCWP), 108
Pulmonary disease, atrial fibrillation, 373
Pulmonary edema, 104
Pulmonary embolism (PE), 5, 382
diagnostic tests, 381–382
evaluation in cardiovascular CT, 724
pathophysiology, 381
symptoms, 381
treatment, 382–383
Pulmonary function tests, 188
Pulmonary hypertension (PH), 223, 247, 260, 451, 452, 871t, 874
classification, 184
controversies, 192–193
in Eisenmenger syndrome, 475–476
epidemiology, 184–185
follow-up, 193
laboratory testing, 186–187
pathogenesis, 189–190
signs and symptoms, 185–186
terminology, 184
Pulmonary vascular resistance (PVR), 184
Pulmonary veins
CMRI, 735
evaluation in cardiovascular CT, 717, 724
Pulmonary venous hypertension, 184
Pulsed-wave Doppler echocardiography, 228
Pulseless electrical activity, 352–354, 353t–354t
Pulse-volume recordings (PVR)
of lower extremities, 410
in peripheral arterial disease, 409, 410
Pulsus paradoxus, 534
Pump thrombosis, 160–162
Purulent effusions, pericardiocentesis, 1000–1001
Q
QT prolongation, 371
Quantitative pulmonary flow scans
in tetralogy of Fallot, 462
in transposition of the great arteries, 467
Quinidine, 371
R
Radiation carditis, 123
Radiation exposure, cardiovascular CT, 719t
feasibility of low-dose CT coronary angiography, 718
MDCT, estimates of radiation dose from, 718
Radiofrequency ablation, 372, 806
Radionuclide imaging
in cardiac tumors, 548
in stable angina, 73–74
stress testing, 73–74
Radiopharmaceuticals, nuclear cardiac imaging, 680–682
Ramp protocols, exercise electrocardiographic testing, 664
Randomised intervention treatment of angina 3 (RITA 3) trial, 40
Ranolazine, for stable angina, 83–84
arteries, 468–469
as late intervention, 468
prior, 467
Rating of perceived exertion (RPE), 668
Recovery postsyncope, 481
Recurrent pericarditis, medical therapies for, 529
Reduces aortic end-diastolic pressure, IABP counterpulsation, 884
Reentrant circuits, 307
Reflex-mediated syncope, 478, 486–487
Regadenoson
dipyridamole/adenosine SE, 696
nuclear cardiac imaging, 684
Regurgitant fraction, 230
Regurgitant orifice area (ROA), 230
Regurgitant volume (RV), 228, 230
Rejected diagnosis, 285
Rejection, in cardiac transplantation, 177–180, 178t
Renal arteriography, 417
Renal artery stenosis (RAS), 416–418
clinical presentation, 416
diagnostic tests, 416–417
etiology, 416
treatment, 417–418
Renal dysfunction, 288
following cardiac transplantation, 172–173
Renal function, 158
Renal insufficiency, cardiovascular CT, 718
Renal scintigraphy, 416–417
Renin-angiotensin-aldosterone system (RAAS), 99
Reperfusion therapy
benefit of, 16
fibrinolysis vs. direct PCI, 17–18
primary PCI, 18–19
time to treatment is paramount, 16–17
Rescue percutaneous revascularization, 21
benefit, 21
clinical determination, 21
Rest/redistribution, myocardial viability testing, 712
Restrictive cardiomyopathy (RCM), 872, 874t
clinical presentation, 121–122
defined, 120
diagnostic testing, 124–126
differential diagnosis, 120t, 122–124
laboratory testing, 122
pathophysiology, 121
prognosis, 128–129
and restrictive cardiomyopathies, 128
Reteplase, 20
Retrospective image acquisition (4D CT), 273
Revascularization
percutaneous
in peripheral arterial disease, 414–415
in renal artery stenosis, 417–418
surgical
in peripheral arterial disease, 415
in renal artery stenosis, 418
Rhabdomyomas, 550
Rhabdomyosarcomas, 553
Rheolytic thrombectomy, 938–939
Rheumatic fever
arthritis, 299
clinical presentation
diagnostic criteria, 297–298
major manifestations, 298
subclinical carditis, 298
diagnosing, 297t
Doppler findings in, 298t
erythema marginatum, 299
etiology, 299–300
laboratory examination and diagnostic testing
biopsies, 300
blood test, 301
echocardiography, 301
electrocardiography, 301
GAS infection, 300
radiography, 301
minor manifestations, 299
pathophysiology, 299–300
prevention
endocarditis prophylaxis, 304
vaccines targeted against GAS, 304
screening, 304
subcutaneous nodules, 299
sydenham chorea, 299
therapy
congestive heart failure, 301
corticosteroid, 301
secondary prophylaxis with penicillin, 301
Rheumatic heart disease (RHD), 251
Rheumatic pneumonitis, 299
Rheumatologic disorders, 515–517
cardiomyopathy, 515
coronary artery disease, 515
pericarditis, 515
Rheumatologic screening, myocarditis, 143
Rhythm control, atrial fibrillation, 370–372, 370
Right bundle branch block (RBBB) pattern, 5
Right coronary artery, LHC, 912, 913, 919
left anterior oblique view, 918
right anterior oblique view, 918
Right heart catheterization (RHC)
calibration and referencing, 869
cardiac index in, 108
in cardiac transplantation evaluation, 168
cardiopulmonary exercise testing, 108–109
clinical scenarios, 870–874, 871t
complications, 864t
contraindications, 864
coronary angiography, 108
in heart failure, 107–108
hemodynamic data, 862–863
indications and common uses, 863–864
intracardiac shunt, 875–876
in mitral regurgitation, 46–47
pitfalls of PA catheter, 869–870
pulmonary capillary wedge pressure, 108
in pulmonary hypertension, 187–188
right atrial pressure, 108
in right ventricular failure, 51
technique
right median cubital vein/ basilic veins, 866–867
venous introducer/sheath insertion, 864–867
in tetralogy of Fallot, 462
troubleshooting, 869t
in ventricular free wall rupture, 48
waveforms, 868
PCWP tracing, 869
pulmonary artery, 869
right atrium, 868–869
right ventricle, 869
Right heart failure, 99
Right internal mammary artery (RIMA), 912, 913
Right parasternal-left paravertebral electrode patch position
electrical cardioversion, 859
Right-sided accessory pathways, 755
Right-sided prosthetic valve thrombosis, 275
Right ventricle
dysfunction, following cardiac transplantation, 172
failure
clinical presentation, 50
right heart cardiac catheterization in, 51
treatment, 51
Right ventricular (RV) failure, 871–872, 871t, 872
Right ventricular hypertrophy, 821
Right ventricular outflow obstruction, 257
Rivaroxaban, for venous thromboembolism, 385
Rivero-Carvallo sign, 252
R-on-T phenomenon, 332
Rotational atherectomy, 937
Rubidium-82 (Rb82)
myocardial viability testing, 709
positron emission tomography, 689–690
Rupture
as myocardial infarction complication, 47–48
papillary muscle
mitral regurgitation caused by, 45–47
murmur associated with, 42, 43t
right heart cardiac catheterization in, 48
R-waves may change in amplitude, 667
S
Salt reduction in heart failure, 126
Saphenous vein bypass grafts (SVG) interventions, 929
Saphenous vein grafts (SVGs), LHC, 913–914
Sarcoidosis
defined, 123
heart failure due to, 123
ventricular tachycardia in, 330
Scandinavian Simvastatin Survival Study (4S) (1994), 611
Scar-related ventricular tachycardia, 815
concealed fusion, 814
exit site, 815
manifest fusion, 814
Scleroderma, 517
myocardial involvement, 517
pericardial disease, 517
pulmonary hypertension, 517
Screened for antibodies, 166
Seattle Criteria, 600
Secondary pulmonary valve regurgitation, 260
Second-degree mobitz type I atrioventricular block, 833
Second Strokes trial, 422
Sedation
pericardiocentesis, 1001
TEE, 990–991
Septal myectomy, for hypertrophic cardiomyopathy, 137
Serum cardiac enzymes, 144
Serum viral antibody titers, 143
17-Segment model, 698, 699, 700
Severe cardiopulmonary disease, 987
Severe de novo MR, 223
Severe peripheral vascular disease, 907
Severe three-vessel coronary artery disease, 57
SGLT-2 inhibitors, 653
Sheath, EMB, 877
Shock in aortic dissection, 396
Shock, RHC in
anaphylactic, 871
cardiogenic, 870–871
distributive, 871
hypovolemic, 870
interpreting data, 877t
SHOCK trial, 56
Shone complex, 455
Short QT syndrome, in ventricular tachycardia, 325
Short-term mechanical circulatory support devices, 881
ECMO, 900–904
IABP counterpulsation (See IABP counterpulsation)
impella device, 893–899
tandemheart, 899–900
Shunts
cardiovascular formulae, 1010
intracardiac, left-to-right, 44
systemic-to-pulmonary artery, 475
Sildenafil (Viagra), 127
Silent ischemia, 90–94
abnormal modulation of, 91
coronary artery disease, 90
diagnosis, 91
prognosis, 91–92
therapy, 91
Simplified reperfusion strategy, 26–27
Simpson’s method, transthoracic echocardiography, 976
Single-crystal camera, 679
Single intramuscular (IM), 302
Single-leaflet tilting disk, 266
Single photon emission computed tomography imaging, myocardial viability testing, 711–712
limitations, 712
test interpretation, 712
Single photon emission computerized tomography (SPECT)
cameras, nuclear cardiac imaging, 680, 685, 687
stress testing, 73–74
Single-vessel disease, stable angina, 88–89
Sinoatrial conduction time (SACT), 743
Sinoatrial exit block, 336, 337, 338
Sinoatrial node, 336
Sinus node, dysfunction, 336–343
clinical presentation, 337
diagnostic tests, 339–340
electrocardiogram findings, 339
Sinus node modification, 812
Sinus node recovery time (SNRT), 743
Sinus node reentry tachycardia, 307
Sinus rhythm
catheter ablation to maintain, 372
drugs to maintain, 371–372
surgical ablation to maintain, 372
Sinus tachycardia, 307–308
Sirolimus (Rapamune), 176
6-Minute walk test (6MWT), 188
Smoking
carotid artery disease, 419
cessation of
methods for, 64
in stable angina, 88
in peripheral arterial disease, 412
Sodium glucose transport protein subtype 2 (SGLT-2) inhibitors trials, 649–650
Sodium nitroprusside, 61
in ventricular tachycardia, 330
Spin-echo, 728
Spironolactone, for heart failure, 112, 115, 127
Splinter hemorrhages, 279
Stable angina, 71–89
clinical presentation, 71–73
defined, 71
diagnostic tests, 73–76
computed tomography, 74
coronary angiography, 74–75, 75t
echocardiography, 74
Holter monitoring, 103
magnetic resonance imaging, 74
optical coherence tomography, 75–76
stress testing, 73–74
ultrasound, 75
single-vessel disease, 88–89
treatment, 76–88
coronary artery bypass grafting, 87
lifestyle modification, 88
percutaneous coronary intervention (PCI), 84–87
pharmacologic, 76–88
recommendations for, 88–89
Stable chest pain, 721
Staphylococci, 274
StarClose Vascular Closure System, 924
Statins
heart disease in women, 576
with niacin in hyperlipidemia, 622
Statin therapy
in heart failure, 116
in stable angina, 77–78
ST-elevation myocardial infarction (STEMI), 55
differential diagnostic considerations for, 4t
short-term mortality in, 14t
Stenosis
invasive assessment, in SA, 76
renal artery, 416–418
Steno-2 trial, T2DM, 645–646
Stented bioprostheses, 263
Stent-grafting, percutaneous aortic, 400
Stenting, renal artery, 417–418
Stentless bioprostheses, 264
Stent patency, cardiovascular CT, 720–721
Stent thrombosis (ST), PCI, 934–935
BMS/DES, 936–937
duration of antiplatelet therapy, 936
patient-related factors, 935–936
procedure-related factors, 935
stent-related factors, 935
Steroids, 527–528
in cardiac transplantation, 173, 174t
Strain rate, stress echocardiography, 697–698
Strauss method, 743
Streptococcal, 274
Stress cardiomyopathy, 4, 93–94
cardiac catheterization, 94
cardiac MRI, 94
echocardiography, 94
prognosis of, 94
treatment of, 94
women, 573
Stress echocardiography, 219
pharmacologic SE, 702–703
diastolic stress echocardiography, 704–705
factors limiting sensitivity to coronary artery disease, 694t
false-positive and false-negative stress echocardiographic test results, 701t
heart disease in women, 574–575
image interpretation
exercise SE, 698–700
limitations, 701–702
pharmacologic SE, 700–701
qualitative vs. quantitative approach, 697–698
reproducibility, 700–701
17-segment model, 698
indications and choice of stressor
additional contraindications, 693
bicycle ergometry, 694
indications and contraindications, 693
methodology
equipment, 694
patient preparation, 694
performing test, 694–696
nonischemic cardiac disease, 705–706
pathophysiology, 692–693
prognostic role
cardiac transplantation, 704
diastolic dysfunction, 704
left atrial enlargement, 704
noncardiac surgery, 704
post-myocardial infarction, 704
RV dysfunction, 704
suspected/known chronic CAD, 703–704
in stable angina, 74
Stress myocardial perfusion scan, heart disease in women, 575
Stress testing, 73–74
in stable angina, 73–74
Stroke, 163
hypertensive crisis and, 506
LHC, 924–925
Structural cardiac interventions, 724
ST-segment changes, exercise electrocardiographic testing, 666
meaning of ST-elevation, 667
normal response, 664
ST-depression, 664
ST-normalization, 667
ST-segment elevation myocardial infarction (STEMI), 927
Stunned myocardium, 707
Stunning, defined, 152
Subacute free wall rupture, pericardiocentesis, 1000
Subacute IE, 279
Subaortic stenosis, 203
Subarachnoid hemorrhage (SAH), 506
Subclavian vein approach, 879–880
Submaximal exercise electrocardiographic testing, 656
Sudden cardiac death, 355–364
causes of, 355–357
defined, 355
diagnostic tests, 357–358
future considerations, 364
in hypertrophic cardiomyopathy, 131, 133, 138
incidence, 355
prevention following myocardial infarction, 68–69
prognosis, 364
risk factors for, 356
risk stratification, 138–139
therapy
acute, 358–359
cardiac resynchronization therapy, 361
implantable cardioverter-defibrillators, 360–361
pharmacologic agents, 359–360, 361
post-cardiac arrest hospital care, 359
primary prevention, 359–361
secondary prevention, 361–362
Sulfonylureas, diabetes, 651–652
Supine bicycle exercise, stress echocardiography, 695
Supraventricular tachyarrhythmias, 307–313
atrial fibrillation, 308
atrial premature depolarizations, 317
atrial tachycardias, 310–312
AV-node reentrant tachycardia, 312
AV reentrant tachycardia, 312–313
multifocal atrial tachycardia, 311–312
preexcitation syndromes, 313–317
sinus node reentry tachycardia, 307
sinus tachycardia, 307–308
Supraventricular tachycardia (SVT), 740
baseline evaluation, 749
induced tachycardia, evaluation of, 750–755
programmed stimulation, 749–750
Surgical planning, cardiovascular CT, 724
Sustained monomorphic ventricular tachycardia, EPS
BBR tachycardia, 758
important response, 758
ischemic substrate, 758
nonischemic substrate, 758–759
Swiss Interventional Study on Silent Ischemia type I (SWISSI I), 92
Sympathetic nervous system, 99
Sympathomimetic agents, stress echocardiography, 692
Syncardia total artificial heart device, 160, 161
Syncopal event, 481
Syncope
adenosine triphosphate test, 486
cardiac syncope, 488
cardiovascular causes of, 479t
causes of, 484t
clinical features suggesting specific causes, 481t
clinical presentation, 480–482
device therapy, 487
echocardiography, 484
electrocardiographic monitoring, 484
EPS, 486
etiology and pathophysiology, 478–480
Holter monitor, 485
in hypertrophic cardiomyopathy, 131
ILRs, 485
management, 482–486
medical therapy, 487
mobile cardiac outpatient telemetry, 485
orthostatic hypotension, 487
pacemaker interrogation, 484
patients with pacemakers, 484
postural orthostatic tachycardia syndrome, 488–489
prognosis of, 488
risk-stratify, 482
schematic algorithm, 483
signal-averaged electrocardiography, 485–486
specific cause of, 482
stress testing, 484
tilt table testing, 484
treatment of, 486–488
unexplained etiology, 480
Systemic disease, cardiovascular manifestations of
antiphospholipid antibody syndrome, 516–517
connective tissue diseases, 519–521
Ehlers-Danlos syndrome, 521
Loeys-Dietz syndrome, 521
Marfan syndrome, 519–521
dermatomyositis, 517
polymyositis, 517
rheumatologic disorders, 515–517
cardiomyopathy, 515
coronary artery disease, 515
pericarditis, 515
valvular disease, 515
sarcoidosis, 521–522
arrhythmias, 521
congestive heart failure, 521
pericardial involvement, 521
scleroderma, 517
myocardial involvement, 517
pericardial disease, 517
pulmonary hypertension, 517
seronegative spondyloarthropathies, 517
systemic lupus erythematosus, 515
conduction system disease, 516
coronary artery disease, 516
myocardial dysfunction, 516
pericarditis, 516
valvular disease, 516
systemic vasculitides, 517–519
Churg-Strauss syndrome, 519
giant cell arteritis, 517–518
idiopathic aortitis, 519
Kawasaki disease, 519
polyarteritis nodosa, 519
takayasu arteritis, 518–519
transesophageal echocardiogram, 516
Systemic diseases, connective tissue diseases, 185
Systemic-to-pulmonary artery shunts, 474
Systemic vascular resistance (SVR), 389
in hypertensive crisis, 500
Systemic vasculitides, 517–519
Churg-Strauss syndrome, 519
giant cell arteritis, 517–518
idiopathic aortitis, 519
Kawasaki disease, 519
polyarteritis nodosa, 519
takayasu arteritis, 518–519
Systemic venous congestion, 252
Systolic blood pressure (SBP), 669
Systolic flow reversal, 228
Systolic function, transthoracic echocardiography, 976
Systolic heart failure, 98–118
defined, 99
diagnostic testing, 105–109
pathogenesis, 99
prognosis, 117–118
signs and symptoms of, 104–105
treatment, 109–117
Systolic Hypertension in the Elderly Program (SHEP), acute, 109–112
T
Tachyarrhythmias
abnormal automaticity, 306
afterdepolarizations, categories, 306–307
induced cardiomyopathy, 104
reentry, 307
supraventricular, 307–313
atrial fibrillation, 308
atrial premature depolarizations (APDs), 317–318
atrial tachycardias, 311
AV-node reentrant tachycardia, 312
AV reentrant tachycardia, 312û313
multifocal atrial tachycardia, 311–312
preexcitation syndromes, 313–317
sinus node reentry tachycardia, 307
sinus tachycardia, 307–308
ventricular, 317–334
diagnostic evaluation, 323–334
fibrillation, 332û333
tachycardia, 318–323
Tachycardia
atrial, 310–311
automatic, 311
intra-atrial reentry, 311
multi-focal, 311–311
triggered, 311
atrioventricular-node re-entry, 312–313
atrioventricular re-entry, 313–314
diagnostic tests, 316
pathophysiology, 313
Wolf-Parkinson-White syndrome, 314, 315
Mahaim, 314
nonsustained ventricular tachycardia (NSVT), 333–334
sinus, 307–308
node reentry, 307
therapy, 800
ventricular, 318–334
Brugada criteria for, 320, 326, 318, 319, 325
catecholaminergic polymorphic, 326
clinical presentation, 318
drug-induced, 331
fascicular VTs, 324–325
focal, 324
ischemic, 326–327
Long QT syndrome, 324–325
Short QT syndrome, 326–327
therapy, 320–323
ventricular premature depolarizations (VPD), 333–334
Tachycardia-bradycardia syndrome, 336–343
Tacrolimus (Progaf), in cardiac transplantation, 175, 176t
Takayasu arteritis (TA), 518–519
Takotsubo cardiomyopathy
ECG patterns, 844
women, 573
Takotsubo syndrome, 94
Tamponade, 513
TandemHeart, 59
contraindications, 899
data, 900
described, 899
insertion technique, 899
percutaneous left ventricular assist device, 60
Technetium 99m
labeled agents in nuclear cardiac imaging, 682
nuclear cardiac imaging
factors affect image quality, 683
same-day protocol, 683
separate-day protocol, 683
Temporary cardiac pacing
indications, 851–852
pacing modes, 852–854
Tenecteplase (TNK), 20
Termination of tachycardias, temporary cardiac pacing, 851
Tetralogy of Fallot (TOF), 459–463
anatomic considerations, 459
clinical presentation, 459–460, 460
diagnostic tests, 462–463
pregnancy in women with congenital heart disease, 585
prior palliative procedures, 461t, 463
right heart cardiac catheterization in, 462
therapy, 463–464
Thallium 201 in nuclear cardiac imaging
general characteristics, 680
Therapeutic lifestyle changes (TLCs), 616–617, 616t
Therapy of specific lipid disorders
diabetic dyslipidemia, 624
elevated triglyceride levels, 623
low HDL-C, 623–624
very high LDL levels, 622–623
Thiamine deficiency, in heart failure, 103
Thiazolidinediones, diabetes, 652
Thienopyridines, 65
heart disease in women, 576
Thoracic aortic aneurysm, 401–402
causes of of, 402t
clinical presentation, 401–402
diagnostic tests, 402–403
surgical recommendations, 403
therapy, 403–404
Three-dimensional (3D) echocardiography, 244, 245, 975
Three-dimensional probe, TEE, 995, 997
Thrombectomy, 938–939
Thrombocytopenia, 176
ECMO, 902
heparin-induced, 376
pericardiocentesis, 1000
Thrombocytosis, 301
Thromboembolic risk, atrial fibrillation, 368
Thromboembolism
electrical cardioversion, 860
EMB, 880
Thrombolysis in myocardial infarction (TIMI) risk score, 12, 29, 29t
Thrombolytic therapy
in deep venous thrombosis, 378
in pulmonary embolism, 385
Thrombosis
dehiscence, 276
diagnostic testing, 275
embolic stroke, 277
mechanical failure, 277
medical therapy, 275–276
Pannus formation, 276–277
Patient Prosthesis Mismatch, 276
therapy, 275
Thromboxane A2 inhibitor, 943
Thyroid disorders, in heart failure, 103
Thyroid function tests, 367
Ticagrelor, 944–945
Ticlopidine, 943
Tilt-table testing in sinus node dysfunction, 339
Timing of Intervention in Acute Coronary Syndromes (TIMACS) trial, 41
Tirofiban, 945–946
Tissue Doppler assessment, 697
Tissue Doppler imaging mitral annular velocity, 124–125
Tissue harmonic imaging, transthoracic echocardiography, 962–963
Tobacco
cessation, methods for, 64
diabetes, 644
in peripheral arterial disease, 412
Tomographic views and cardiac anatomy
aorta and right pulmonary artery from the suprasternal notch window, 972
apical four-chamber view, 971
apical position, 973
apical five chamber (A5C), 974
apical four chamber (A4C), 974
apical three chamber (A3C), 974
apical two chamber (A2C), 974
four-chamber view from subcostal approach, 971
parasternal long-axis view in diastole, 969
parasternal position
parasternal long axis, 969, 973
parasternal short axis, 973
parasternal short-axis view
at aortic valve level, 970
at level of papillary muscles, 970
standard transthoracic examination, 968–969t
subcostal view, 974
suprasternal notch, 974
tips for transthoracic 2D examination, 973t
Topiramate, diabetes, 644–645
TOR inhibitors, in cardiac transplantation, 174t, 175–176
Torsade de pointes, 331–332
Torsades de pointes, 370
Torsades, ECG patterns, 830
Total artificial heart, 160
Transcatheter aortic valve replacement, 954
complications, 955
indications for TAVR, 953
outcomes, 955
procedure, 953
alternate access for TAVR, 955
transfemoral TAVR, 954–955
Transcutaneous pacing, temporary cardiac pacing, 852
Transducers, transthoracic echocardiography, 962, 963
Transesophageal echocardiography (TEE), 203, 227, 270, 367, 441
in aortic dissection, 393
complications, 998
contraindications, 987t
absolute, 986
bleeding, 987
esophageal infections, 987
relative, 986
severe cardiopulmonary disease, 987
in Ebstein anomaly, 473
equipment for, 988t
imaging
basic views, 991
multiplane TEE, 991–995
probe may inadvertently rotate, 991
real-time three-dimensional (3D) TEE, 991
patient preparation, 988, 989t
patient recovery, 997–998
personnel, 987–988
probe care, 998
step-by-step guide to examination
antibiotic prophylaxis, 989
begin probe insertion, 990–991
blood pressure cuff, 989
dentures, 988
electrocardiographic leads, 989
intravenous (IV) line, 988
midazolam, 990
nasal cannula, 989
pulse oximeter, 989
in tetralogy of Fallot, 462
in thoracic aortic aneurysm, 403
transesophageal probe, 988
TTE vs., 998
Transesophageal/transgastric pacing, 852
Transient ischemic attack (TIA), 420
Transmitral flow pattern, in echocardiography, 124
Transmitral peak velocity, 243
Transplant candidacy, 158
Transposition of great arteries, 464–468, 465
anatomic considerations, 464–465, 465
clinical presentation, 465–466
congenitally corrected, 469–472
anatomic considerations, 469–470, 469
clinical presentation, 470
diagnostic tests, 470–471
medical management, 471
surgical repair, 471–472
diagnostic tests, 467
late interventions, 468
natural history and surgical repair, 461t, 465
surgical follow-up and complications, 467–468
Transpulmonary gradient (TPG), 184
Transthoracic echocardiography (TTE), 534
advanced echocardiographic techniques, 974–976
in aortic dissection, 393
atrial fibrillation, 367
basic principles of
tissue harmonic imaging, 962–963
transducers, 962
transducer selection, 963
ultrasound, 962
diastolic function, 976–977
in Ebstein anomaly, 473
heart disease in women, 574–575
hemodynamics, 977–981
imaging modalities in standard echocardiograms, 963–967
in pulmonary embolism, 381–382
systolic function, 976
technical aspects and advanced image acquisition
color Doppler image, factors affecting, 982–984
imaging artifacts, 981–982
machine settings, 981
in tetralogy of Fallot, 462
in thoracic aortic aneurysm, 403
tomographic views and cardiac anatomy, 967–974
in transposition of the great arteries, 467
Transvalvular mean gradient, 243
Transvenous pacing, 59
atrial pacing, 853
pacer care, 854
patient preparation, 852
postplacement chest radiography, 854
relative contraindications, 852
technique
lead choice, 852
position, 853
sites, 852–853
testing, 853
AV interval, 854
pacing capture threshold, 854
sensing threshold, 854
ventricular pacing, 853
Traumatic hemopericardium, 1000
Treating to New Targets (TNT) (2005) trial, 612–613
Triage, 31–32
Tricuspid regurgitation
etiology, 254–255
Tricuspid stenosis
etiology and pathophysiology, 254–255
Tricuspid valve (TV) apparatus, 251
Tricuspid valve disease, 251
carcinoid heart, 251–252
coexisting valvular lesions, 253
diastolic murmur, 252
electrocardiogram, 253
elevated central venous pressure, 252
etiology, 251–252
fatigue, 252
opening snap, 252
pathophysiology, 252
physical findings, 252
rheumatic heart disease, 251
right atrial and right ventricular pressure waveforms, 253
right upper-quadrant pain, 252
signs and symptoms, 252
TS, 251
two-dimensional (2D), 253
Tricuspid valve dysfunction, 880–881
Triggered activity, 306–307
Triggered atrial tachycardia, 311
Triglycerides, 65
Trimethoprim-sulfamethoxazole (TMP-SMX), 180
Troponin, 31
cardiac in pulmonary embolism, 381
highly sensitive (Hs), 31
T-wave and U-wave changes, 667
12-Lead electrocardiogram, atrial fibrillation, 367
Twiddler syndrome, 785
Two-dimensional (2D) echocardiography, 253, 270, 964
Type A aortic dissection, 1000
Type 1 diabetes mellitus (T1DM), 639
impact on heart disease, 642
Type 2 diabetes mellitus (T2DM), 639, 640
completed randomized, double-blind, placebo-controlled CV outcome trials, 649t
impact on heart disease, 642
spectrum of insulin resistance
diagnosis of diabetes, 640–641
epidemiologic evidence, 641
long latent asymptomatic phase, 640–641
pathogenic effect of hyperglycemia, 641
steno-2 trial, 645–646
Type I Brugada pattern, ECG patterns, 841
Typical atrial flutter, ECG patterns, 824
U
Ultrafast SPECT cameras, 680
Ultrafiltration, for heart failure, 111
Ultrasound
abdominal, in aortic aneurysm, 399
Doppler, in stable angina assessment, 76
duplex
in deep venous thrombosis, 377
in peripheral arterial disease, 409–411
in renal artery stenosis, 416
evaluation, 168
intracoronary Doppler, in stable angina assessment, 76
intravascular in stable angina assessment, 75
transthoracic echocardiography, 962
Uncontrolled severe hypertension, 907
Unfractionated heparin (UFH)
in deep venous thrombosis, 378
PCI, 941
during pregnancy, 591–593
Unicuspid aortic valve (UAV), 198
United Network of Organ Sharing (UNOS), 169–170, 170t
Unstable angina (UA), 27
initial risk stratification of patients with, 28t
LHC, 908–909
Upper extremity
deep venous thrombosis, 380
peripheral arterial disease, 415
Upper reference limit (URL), 2
Upright bicycle echocardiography, 695
V
Vagal reaction, 925
Vaginal delivery, 294
Valve dysfunction
atrial fibrillation, 274
complications, 274
conduction disturbances, 274
endocarditis, 274
hemolysis
diagnostic testing, 274
pathophysiology and etiology, 274
therapy, 274–275
thrombosis, 275
prosthetic valves, 274
Valve surgery, follow-up after, 268
Valvular disease and left ventricular (LV) function, 1008–1010
Valvular disorders in heart failure, 103
Valvular heart disease
aortic/mitral regurgitation, 494
cardiovascular CT, 724
CMRI, 734
drug-induced, 331
gene expression profiling in, 567
LHC, 908–909
mitral stenosis, 494
and pregnancy, 585–586
aortic regurgitation/aortic insufficiency, 587
aortic stenosis, 587
hypertrophic cardiomyopathy, 587
mitral regurgitation, 586
mitral stenosis, 586
prosthetic heart valves, 587–588
prophylaxis for bacterial endocarditis, 494
severe aortic stenosis, 494
Valvular PR, 259
Valvular pulmonary stenosis (PS), 257
Varenicline, 64
Vascular endothelial growth factor (VEGF), 84
Vascular rejection, 181
Vasculitides, associated with aortic aneurysm and dissection, 391
Vasodilators, 61
for heart failure, 110
for mitral regurgitation, 46
pulmonary, 190–191
for ventricular septal defect, 44
Vasodilator stress test, 692–693
Vasopressin antagonists, 111
Vasopressors, 59
Vasospasm, 29
Vasovagal syncope, 478
Vaughan Williams class IA agents, 371
Vaughan Williams class IC agents, 371
Vaughan Williams class III agents, 371
Vena cava, 881
interruption, in deep venous thrombosis, 380
Venography, in deep venous thrombosis (DVT), 377
Venous thromboembolism, 376–387
deep venous thrombosis (DVT), 376–380
calf vein, 380
clinical presentation, 376
diagnostic tests, 376–378, 377t
superficial venous, 380
treatment, 378
upper extremity, 380
oral anticoagulants, 378
original and simplified pulmonary embolism severity index, 383t
overview, 376
pathogenesis, 376
prophylaxis, 385
pulmonary embolism, 382
diagnostic tests, 381–382
pathophysiology, 381
symptoms, 381
risk-adjusted management strategies, 384
standard duration of anticoagulation after, 379t
Ventilation-perfusion (V/Q) scanning, in pulmonary embolism, 382
Ventricular aneurysm, as myocardial infarction complication, 48
Ventricular arrhythmias
EPS, 744
LHC, 908–909
Ventricular ectopy in recovery, 673
Ventricular fibrillation, 674
Ventricular free-wall rupture, as MI complication, 47–48
Ventricular premature depolarizations (VPD), 333–334
Ventricular septal defect (VSD), 883
anatomic localization of, 444
anatomy
defect size, 444–445
embryology, 444
antibiotic prophylaxis, 448
associated lesions, 445
clinical presentation, 445–446
diagnostic testing
cardiac computed tomography, 447
catheterization, 446–447
echocardiography, 446
differential diagnosis, 446
Eisenmenger syndrome, 448
endocarditis, 443
genetic factors, 444
hybrid approach, 448
inlet/atrioventricular (AV) canal-type defects, 445
laboratory tests, 446
chest radiograph, 446
electrocardiogram (ECG), 446
membranous defects, 445
muscular, 443
defects, 445
as myocardial infarction complication, 42–45
clinical presentation, 42
diagnostic tests, 43–44
murmur associated with, 42, 43t
treatment, 44
natural history, 443–444
percutaneous structural heart disease
complications, 959
outcomes, 959
procedure, 958–959
pregnancy in women with congenital heart disease, 584
risk factors, 444
spontaneous closure, 443
supracristal/subaortic defects, 445
surgical closure, 447–448
therapy, 447–448
medical management, 447
transcatheter device closure of, 447
types, 445
Ventricular tachyarrhythmias
diagnostic evaluation, 323–334
ventricular fibrillation, 332–333
ventricular tachycardia, 318–334
Ventricular tachycardia, 318–334
accelerated idioventricular rhythm, 328
catecholaminergic polymorphic, 326
clinical presentation, 317–318
criteria for, 320, 326, 318, 319, 325
drug-induced, 331
ECG patterns, 826
evaluation in EPS
atrial study, 757
mapping of ventricular tachycardia, 760–762
programmed ventricular stimulation, 757–758
responses to programmed stimulation, 758–760
exercise electrocardiographic testing, 674
fascicular VTs, 324
focal, 324
hypertrophic cardiomyopathy with, 136
ischemic, 326–327
Long QT syndrome, 324–325
Short QT syndrome, 325
therapy, 320–323
Venturi effect, 52
Verapamil, 183
Veterans Affairs High-Density Lipoprotein Intervention Trial (VA-HIT) (1999), 612
Veterans Affairs Non-Q-Wave Infarction Strategies in Hospital Trial (VANQWISH) trials, 40
Viability assessment, in heart failure diagnosis, 107
Viral myocarditis, 144
Vitamin supplementation, diabetes, 644
W
Wall motion abnormalities (WMAs), 692
Warfarin
myocardial infarction, 66
PCI, 943
during pregnancy, 591
WATCHMAN device, 369
Wearable cardioverter-defibrillators, 24–25
Weight reduction, 631
West of Scotland Coronary Prevention Study (WOSCOPS) (1995), 609
Wolff-Parkinson-White pattern, 827
atrial fibrillation with, 828
ECG patterns, 827
Wolf-Parkinson-White syndrome
diagnostic tests, 316
risk stratification, 316
therapy, 316
ventricular tachycardia in, 356
Y
Yearly echocardiography, 235