Braunwald’s Heart disease: A Textbook of Cardiovascular Medicine

Cover......Page 1
Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 2-Volume Set......Page 2
Copyright Page......Page 4
Dedication......Page 5
Acknowledgments......Page 6
Contributors......Page 7
Preface......Page 18
Preface to the First Edition......Page 19
Video Contents......Page 20
Epidemiologic Transitions......Page 24
Current Variations in the Global Burden......Page 26
High-Income Countries......Page 28
Demographic and Social Indices......Page 29
Demographic and Social Indices......Page 30
Hypertension......Page 31
Lipids......Page 32
Diabetes......Page 33
Obesity......Page 35
Diet......Page 36
Environmental Exposures......Page 37
Risk Assessment......Page 38
Salt and Lipid Reductions......Page 39
Epidemiologic Transitions......Page 40
Cost-Effective Solutions......Page 41
Informed Consent and Decision Aids......Page 42
Clinical Ethical Judgments of Futility......Page 43
Social Media and Mobile Health......Page 44
Genetics......Page 45
Conclusion......Page 46
Transplantation......Page 47
Diagnostic Decisions......Page 48
Risk Stratification......Page 52
Changing Clinical Practice Based on New Findings......Page 53
Monitoring the Quality of Clinical Decisions......Page 54
Shared Decision Making......Page 55
Defining Quality of Care......Page 56
Types of Quality Measures......Page 57
Improving Quality of Care......Page 59
Conclusion......Page 60
Improving Quality of Care......Page 61
Controlled Trials......Page 62
Factorial Design......Page 64
Selection of Endpoint of Clinical Trial......Page 66
During Course of Trial......Page 67
During Analytic Phase of Trial......Page 69
Future Perspectives......Page 70
Future Perspectives......Page 72
Missing Data......Page 73
The Core Concepts of Personalized and Precision Medicine......Page 74
Genetics......Page 75
Drug Responses and Pharmacogenetics......Page 76
Barriers to Precision Medicine......Page 77
References......Page 79
A Brief Primer on Molecular Biology......Page 80
Keywords:......Page 81
Human Genetic Variation......Page 83
Patient Case, Part II.......Page 84
Illustrative Examples......Page 86
Complex Trait Using Extremes in a Population......Page 87
Patient Case, Part III.......Page 88
Patient Case, Part IV.......Page 89
Future Perspectives......Page 90
Novel Therapeutic Approaches......Page 91
Classes of Adverse Drug Reactions......Page 92
Plasma Concentration Monitoring......Page 98
Incorporating Pharmacogenetic Information Into Prescribing......Page 99
Incorporating Pharmacogenetic Information Into Prescribing......Page 100
Overview of Biomarkers......Page 101
Clinical Applications of Cardiovascular Biomarkers......Page 102
Proteomics and Metabolomics......Page 103
Analytic Challenges......Page 104
Applications of Mass Spectrometry–Based Discovery to Cardiometabolic Disease......Page 106
Sensitivity, Specificity, and Positive and Negative Predictive Value......Page 107
Risk Reclassification......Page 108
Biomarkers: General Considerations......Page 109
Ascending Biomarker Performance......Page 110
References......Page 111
The History......Page 112
Head and Neck......Page 114
Chest and Abdomen......Page 115
Jugular Venous Pressure and Waveform......Page 116
Measuring the Blood Pressure......Page 118
Assessing the Pulses......Page 119
Diastolic Sounds......Page 120
Diastolic Murmurs......Page 121
Dynamic Auscultation......Page 122
Jugular Venous Pressure......Page 124
Rales and Edema......Page 125
Other Findings......Page 126
Mitral Regurgitation......Page 127
Prosthetic Heart Valves......Page 128
Integrated, Evidence-Based Approach to Specific Cardiac Disorders......Page 129
Future Perspectives......Page 130
References......Page 131
Ischemic Heart Disease......Page 132
Valvular Heart Disease (see also Part VIII)......Page 133
The Decision to Undergo Diagnostic Testing......Page 134
Tests to Improve Identification and Definition of Cardiovascular Disease......Page 138
Regional Anesthesia......Page 139
Postoperative Intensive Care......Page 140
Coronary Artery Revascularization......Page 141
Coronary Stenting and Noncardiac Surgery......Page 142
Temperature......Page 144
References......Page 145
12 Electrocardiography......Page 147
The Normal Electrocardiogram......Page 151
The Normal P Wave......Page 152
Normal QRS Complex......Page 153
QRS Duration......Page 154
The QT Interval......Page 155
Atrial Abnormalities......Page 156
Right Atrial Abnormality......Page 157
Left Ventricular Hypertrophy......Page 158
Clinical Significance......Page 159
Clinical Significance......Page 160
Biventricular Hypertrophy......Page 161
Other Forms of Fascicular Block......Page 162
ECG Abnormalities.......Page 163
Clinical Significance.......Page 164
Rate-Dependent Conduction Blocks......Page 165
Repolarization (ST-T Wave) Abnormalities......Page 166
QRS Changes......Page 168
Evolution of ECG Changes......Page 169
ECG Localization of Myocardial Ischemia and Infarction......Page 170
ECG Diagnosis of Myocardial Infarction with Bundle Branch Blocks......Page 171
ECG Differential Diagnosis of Ischemia and Infarction......Page 172
Noninfarction Q Waves and Related Depolarization Changes......Page 173
ST-T Changes Simulating Ischemia and Infarction......Page 174
Drug Effects......Page 175
Potassium......Page 176
Indications and Clinical Value......Page 178
Computer Interpretation......Page 179
The Abnormal Electrocardiogram......Page 180
Future Perspectives......Page 181
References......Page 183
Myocardial Oxygen Demand and Supply Relationships During Exercise......Page 184
Exercise Test Modality and Protocols......Page 186
Exercise-Induced Symptoms......Page 189
Functional Capacity......Page 190
ST Depression......Page 191
ST Adjustments......Page 192
Sensitivity and Specificity......Page 193
Testing in Women......Page 194
Predictive Variables......Page 195
Multivariable Scores......Page 196
Severe Acquired Aortic Valve Stenosis......Page 197
Adult Congenital Heart Disease......Page 198
Chest Pain Units......Page 199
Patients with Diabetes......Page 200
Exercise Testing in Nonatherosclerotic Heart Disease......Page 202
Additional Uses for Exercise Testing......Page 203
Principles of Image Generation......Page 204
Physical Principles of Ultrasound......Page 205
Assessment of Flow and Continuity Equation......Page 209
Left Ventricular Structure: Size and Mass......Page 211
Left Ventricular Systolic Function......Page 218
Mitral Inflow Patterns......Page 222
Doppler Tissue Imaging......Page 226
Right Ventricular Structure and Function......Page 227
Left and Right Atria......Page 229
Transesophageal Echocardiography......Page 230
Three-Dimensional Echocardiography......Page 232
Contrast Echocardiography......Page 233
Myocardial Infarction......Page 237
Practical Considerations in Assessment of Regional Wall Motion......Page 238
Dilated Cardiomyopathy......Page 242
Restrictive Cardiomyopathies......Page 244
Assessment After Orthotopic Heart Transplantation......Page 245
Stress Echocardiography......Page 246
Coronary Flow Reserve and Perfusion......Page 248
Mitral Valve......Page 249
Quantification of Severity......Page 251
Mitral Regurgitation......Page 252
Primary (Degenerative) Mitral Regurgitation......Page 253
Quantitation of Mitral Regurgitation......Page 254
Quantitation of Severity......Page 256
Aortic Regurgitation......Page 258
Acquired Disorders of the Tricuspid Valve......Page 259
Prosthetic Valves......Page 262
Pericardial Effusion......Page 269
Pericardial Hematoma......Page 270
Constrictive Pericarditis......Page 271
Diseases of the Aorta......Page 272
Aortic Emergencies......Page 273
Infective Endocarditis......Page 278
Role of Echocardiography in Surgery for Endocarditis......Page 280
Pulmonary Hypertension......Page 283
Cardiac Masses......Page 284
Intracardiac Thrombus......Page 286
Secundum Atrial Septal Defect......Page 288
Ventricular Septal Defect......Page 291
Inlet Ventricular Septal Defects......Page 292
Muscular Ventricular Septal Defects......Page 294
Cardiac Procedures and Future Directions......Page 296
Handheld Echocardiography......Page 298
Cardiac Procedures and Future Directions......Page 301
References......Page 308
Valvular Heart Disease......Page 300
Overview......Page 309
Diseases Affecting Heart Size and Morphology......Page 312
Congestive Heart Failure......Page 313
Valvular Heart Disease......Page 314
Acute Myocardial Infarction......Page 320
Calcific Pericarditis......Page 322
Aortic Aneurysm......Page 326
Diseases of the Aorta......Page 328
SPECT Image Display......Page 329
Technetium 99m–Labeled Tracers......Page 330
SPECT Image Interpretation and Reporting......Page 333
Lung Uptake......Page 336
Transient Ischemic Dilation of the Left Ventricle......Page 338
Gated SPECT Imaging......Page 340
First-Pass Radionuclide Angiography or Ventriculography......Page 343
Positron Emission Tomography......Page 346
PET Perfusion Tracers......Page 347
Clinical Application of PET Myocardial Perfusion Imaging......Page 348
CT Attenuation Correction for PET......Page 349
Perfusion Tracers and Coronary Blood Flow Reserve......Page 351
Mechanism of Coronary Arteriolar Vasodilator Pharmacologic Stress......Page 353
Heterogeneity of Coronary Hyperemia with Pharmacologic Stress......Page 354
Differences Between Vasodilator and Exercise Stress......Page 355
2-18F-Fluoro-2-Deoxyglucose.......Page 356
11C-Acetate.......Page 358
Patient-Related Outcomes as a “Gold Standard”......Page 359
Identification of Treatment Benefit After Risk Stratification......Page 360
Detecting the Presence and Extent of CAD......Page 362
Influence of Perfusion Tracer on CAD Detection......Page 364
Pharmacologic Stress Testing for Detecting CAD......Page 365
Detection of Preclinical CAD and Risk Stratification in Asymptomatic Patients......Page 366
Application of Radionuclide Imaging: Answering the Clinical Questions......Page 367
Assessment of Inducible Ischemia After Acute Myocardial Infarction......Page 369
Principles of Assessing Myocardial Viability by Radionuclide Techniques......Page 372
Assessment of Left Ventricular Function in Heart Failure......Page 374
Cardiac Amyloidosis......Page 375
Imaging to Assess Risk Before Noncardiac Surgery......Page 377
Imaging of Potentially Unstable Atherosclerotic Plaque and Platelet Activation......Page 378
Cardiac Pacemaker or ICD Infection......Page 379
Left Ventricular Assist Device Infection......Page 380
Acute Coronary Syndromes......Page 381
Molecular Imaging of the Cardiovascular System......Page 382
Generation of Magnetic Resonance Signal, Contrast, and Image Formation......Page 383
Assessment of Myocardial Viability and Benefit from Coronary Revascularization......Page 390
Detecting and Quantifying Myocardial Ischemia......Page 394
Myocarditis......Page 395
Idiopathic Dilated Cardiomyopathy......Page 396
Risk Stratification of Patients at Risk of Sudden Cardiac Death......Page 397
Anomalous Pulmonary Venous Connection......Page 398
Valvular Heart Disease......Page 400
Magnetic Resonance Spectroscopy......Page 401
Cardiomyopathies......Page 403
Novel Imaging Methods......Page 405
Basics of Cardiac and Coronary Computed Tomography......Page 406
Image Interpretation......Page 408
Coronary Artery Calcium Scoring......Page 409
Prognostic Implications......Page 410
Diagnostic Accuracy......Page 412
Prognostic Implications......Page 414
Relationship of Findings to Ischemia......Page 419
Use in Patients with Acute Chest Pain......Page 421
Use in Patients with Stable Suspected Coronary Artery Disease......Page 423
Assessment of Cardiovascular Structure and Function......Page 426
Structural Heart Disease Interventions......Page 427
Multimodality Imaging in Stable Ischemic Heart Disease and Heart Failure......Page 432
References......Page 436
Coronary Computed Tomographic Angiography......Page 429
Assessment of Cardiovascular Structure and Function......Page 431
Operational Aspects of Cardiac Catheterization......Page 437
Preprocedural Preparation of Patient......Page 440
Intraprocedural Care......Page 441
Percutaneous Femoral Artery Technique......Page 444
Percutaneous Radial Artery Technique......Page 447
Percutaneous Brachial Artery Technique......Page 449
Left-Heart Catheterization......Page 451
Ascending Aortography......Page 452
Fluid-Filled Systems......Page 454
Micromanometer Catheters......Page 456
Ventriculographic Method......Page 458
Aortic Valve Stenosis (see Chapter 68)......Page 462
Calculation of Stenotic Valve Orifice Areas.......Page 463
Shunt Determinations......Page 466
Shunt Quantification......Page 468
Pharmacologic Maneuvers......Page 469
Endomyocardial Biopsy......Page 471
Adjunctive Diagnostic and Therapeutic Techniques......Page 473
Intra-Aortic Balloon Pump......Page 475
Adjunctive Diagnostic and Therapeutic Techniques......Page 478
Indications for Coronary Angiography......Page 480
Appropriate Use Criteria......Page 482
Access Sites......Page 485
Catheters for Diagnostic Procedures......Page 486
Selection of Contrast Media......Page 488
Automatic and Manual Injection of Contrast Media......Page 489
Angiographic Projections......Page 490
Coronary Anatomy......Page 491
Coronary Artery Anomalies......Page 492
Coronary Artery Spasm......Page 494
Quantification of the Stenosis......Page 496
Evaluation of Microvascular Blood Flow......Page 497
Calcific Lesions......Page 498
Bifurcation Lesions......Page 499
Coronary Dissections......Page 500
Fractional Flow Reserve......Page 501
Intravascular Ultrasound......Page 503
Interpretation......Page 504
Clinical Applications......Page 505
Acute Coronary Syndrome......Page 506
Assessment After Percutaneous Coronary Intervention......Page 507
Coronary Arteriography Technique......Page 508
Coronary Intravascular Imaging......Page 509
Classification of Heart Failure......Page 510
Heart Failure Symptoms and Signs......Page 511
Physical Examination......Page 513
Electrocardiography......Page 514
Natriuretic Peptides......Page 515
Other Biomarkers......Page 516
Endomyocardial Biopsy......Page 518
Imaging Modalities......Page 519
Future Perspectives......Page 522
Imaging Modalities......Page 525
References......Page 528
Detection of Comorbid Conditions......Page 524
Subcellular Microarchitecture......Page 529
Mitochondrial Morphology and Function......Page 530
Contractile Proteins......Page 532
Myosin Structure and Function......Page 533
Graded Effects of [Ca2+]i on Cross-Bridge Cycle......Page 534
Calcium Movements and Excitation-Contraction Coupling......Page 535
Turning Off Ca2+ Release: Breaking Positive Feedback......Page 536
Calcium Uptake into Sarcoplasmic Reticulum by SERCA......Page 537
Sodium Channels......Page 538
Physiologic Fight-or-Flight Response......Page 539
Alpha-Adrenergic Receptor Subtypes......Page 540
G Proteins......Page 541
Beta1-Adrenergic and PKA Signaling in Ventricular Myocytes......Page 542
Cholinergic Signaling......Page 543
Left Ventricular Filling Phases......Page 544
Wall Stress......Page 546
Physiologic Force-Frequency Relationship and Optimal Heart Rate......Page 548
Work of the Heart......Page 549
Left Ventricular Relaxation and Diastolic Dysfunction......Page 550
Sarcolemmal Control of Ca2+ and Na+......Page 551
Contractile Performance of Intact Hearts......Page 552
Activation of Sympathetic Nervous System......Page 553
Neurohormonal Alterations of Renal Function......Page 556
Neurohormonal Alterations in the Peripheral Vasculature......Page 560
Nitric Oxide......Page 561
Alterations in Excitation-Contraction Coupling......Page 565
Sarcoplasmic Reticulum Ca2+ Reuptake and Sarcolemmal Ca2+ Elimination......Page 567
Abnormalities in Contractile and Regulatory Proteins......Page 568
Abnormalities in Cytoskeletal Proteins......Page 570
Alterations in the Myocardium......Page 572
Alterations in Left Ventricular Structure......Page 577
Future Perspectives......Page 579
Heart Failure as a Progressive Model: Left Ventricular Remodeling......Page 582
Matrix Metalloproteinases and Tissue Inhibitors of Metalloproteinases......Page 584
Metabolic Modulation......Page 585
References......Page 586
Preserved Versus Reduced Ejection Fraction......Page 587
Pathophysiology......Page 589
Congestion......Page 590
Renal Mechanisms......Page 591
Neurohormonal and Inflammatory Mechanisms......Page 592
Classification......Page 593
Physical Examination......Page 594
Predictive Models of in-Hospital Mortality......Page 595
Phase I: Urgent/Emergent Care......Page 596
In-Hospital Worsening Heart Failure......Page 598
Blood Pressure......Page 599
The Rehospitalization Problem......Page 601
Diuretics......Page 602
Nitrates......Page 604
Nesiritide......Page 605
Dobutamine......Page 606
Levosimendan......Page 607
Ultrafiltration......Page 608
Novel Therapies......Page 609
Management of the Patient With Acute Heart Failure......Page 613
The Hospitalized Patient......Page 615
Prognosis......Page 617
Biomarkers and Prognosis......Page 618
Renal Insufficiency......Page 619
Patients at High Risk for Developing Heart Failure (Stage A)......Page 621
General Measures......Page 622
Activity......Page 623
Loop Diuretics......Page 625
Thiazide and Thiazide-Like Diuretics.......Page 626
Mineralocorticoid Receptor Antagonists......Page 627
Vasopressin Antagonists......Page 628
Diuretic Treatment of Heart Failure......Page 629
Electrolyte and Metabolic Disturbances......Page 630
Diuretic Resistance......Page 631
Device-Based Therapies......Page 632
Side Effects of ACEI Use......Page 633
Side Effects of ARB Use......Page 634
Angiotensin Receptor Neprilysin Inhibitors......Page 636
Beta Blockers......Page 637
Side Effects of MRAs......Page 639
Cardiac Glycosides......Page 640
Management of Atherosclerotic Disease......Page 641
Patients with Cancer......Page 642
Cardiac Resynchronization Therapy......Page 643
Sleep-Disordered Breathing......Page 644
Future Perspectives......Page 645
Etiology and Prognosis......Page 646
Treatment of Patients With Left Ventricular Dysfunction and Current or Prior Symptoms (Stage C)......Page 647
Comorbidities in Heart Failure Patients......Page 650
Surgical/Percutaneous/Transcatheter Interventional Treatment of Heart Failure......Page 651
References......Page 652
Genetic Variations in Beta-Adrenergic Receptor System......Page 653
Positive Inotropic Effect......Page 654
Therapeutic Drug Monitoring......Page 655
References......Page 656
Mortality......Page 657
Left Ventricular Relaxation......Page 658
Determinants of Left Ventricular Relaxation......Page 660
Methods of Measurement......Page 662
Determinants of Left Ventricular Pressure-versus-Volume Relationship......Page 663
Prevalence and Prognosis for Decreased Diastolic Distensibility......Page 664
Diagnostic Criteria......Page 665
Demographic Features......Page 666
Comorbid Conditions......Page 670
Acute Decompensated Heart Failure in Patients with HFpEF......Page 671
Diastolic Properties......Page 672
Noninvasive Estimation of Left Ventricular Diastolic Filling Pressure.......Page 673
Charm.......Page 676
Topcat.......Page 677
NEAT-HFpEF.......Page 678
Remote Monitoring Systems to Help Tailor Management......Page 679
Clinical Features......Page 680
References......Page 682
Therapy......Page 681
References......Page 683
Reference......Page 684
Multisite Stimulation in Cardiomyopathy Trials......Page 685
CONTAK CD......Page 686
Randomized Controlled Trials of CRT in NYHA Class I and II Patients......Page 687
Limitations of CRT......Page 688
Prophylactic Defibrillator Implantation in Patients with Nonischemic Dilated Cardiomyopathy Trial......Page 689
Device-Based Heart Failure Diagnostics......Page 690
Implantable Hemodynamic Monitors......Page 691
Randomized Controlled Trials of Cardiac Resynchronization Therapy......Page 692
Implantable Devices to Monitor Heart Failure......Page 693
References......Page 694
Risks of Coronary Artery Bypass Grafting......Page 695
Benefits of Coronary Artery Bypass Grafting......Page 696
Mitral Valve......Page 697
Aortic Valve......Page 700
Left Ventricular Reconstruction......Page 701
Evaluation of the Potential Recipient......Page 702
The Cardiac Donor......Page 703
Immunosuppression......Page 704
Rejection......Page 705
Hypertension......Page 707
Cardiac Allograft Vasculopathy......Page 708
Valve Surgery in Patients with Left Ventricular Dysfunction......Page 709
Cardiac Transplantation......Page 710
References......Page 711
Destination Therapy......Page 712
Design of Ventricular Assist Devices......Page 713
Patient Selection, Comorbidity, and Timing of Intervention......Page 714
Intra-Aortic Balloon Pump......Page 717
Extracorporeal Life Support and Extracorporeal Membrane Oxygenation......Page 718
HeartMate II......Page 719
HVAD......Page 721
Future Perspectives......Page 722
Future Perspectives......Page 724
Continuous-Flow Rotary Pumps......Page 725
References......Page 726
References......Page 727
References......Page 728
Human Pluripotent Stem Cells......Page 729
Differentiation Into Cardiac Lineages......Page 730
Tissue Engineering......Page 731
Directed Reprogramming......Page 732
Modeling of Cardiovascular Genetic Disorders with Human PSCs......Page 733
Cardiovascular Precision Medicine with Human PSCs......Page 735
Regeneration......Page 736
Future Perspectives and Prospects for Cardiac Repair......Page 737
Secondary (Subspecialty) Palliative Care......Page 738
Hospice......Page 740
Timing of Discussions......Page 741
Advance Care Planning Documentation......Page 743
Ongoing Role for Cardiovascular Treatments......Page 745
Medical Decision Making Near the End of Life......Page 747
Psychosocial Support and the Site for the End of Life......Page 748
Death Not as Failure......Page 749
References......Page 750
Palpitations......Page 751
Sudden Cardiac Arrest and Aborted Sudden Cardiac Death......Page 752
Cardiac Imaging......Page 754
Holter Monitoring and Event Recording......Page 755
Head-Up Tilt-Table Testing......Page 759
Tachyarrhythmias (see Chapters 37-39)......Page 760
References......Page 762
Clinical Description and Manifestations......Page 764
Phenotypic Correlates for the Three Canonical LQTS Genotypes......Page 767
Triadin Knockout Syndrome......Page 769
Clinical Description and Manifestations......Page 770
IKr Channel Blockers and the “Repolarization Reserve”......Page 771
Clinical Description and Manifestations......Page 772
Phenotypic Correlates of SCN5A-Mediated Brugada Syndrome (BrS1)......Page 773
Clinical Description and Manifestations......Page 774
“Ankyrin-B Syndrome”......Page 775
Long-QT Syndrome......Page 776
Early Repolarization Syndrome......Page 777
Future Perspectives......Page 778
Physiology of Ion Channels......Page 779
Phases of the Cardiac Action Potential......Page 783
Normal Automaticity......Page 789
Loss of Membrane Potential and Development of Arrhythmias......Page 791
Molecular Structure of Ion Channels......Page 793
Gap Junction Channels and Intercalated Discs......Page 796
Sinoatrial Node......Page 797
Atrioventricular Node......Page 801
Terminal Purkinje Fibers......Page 805
Pathways of Innervation......Page 806
Effects of Sympathetic Stimulation......Page 808
Disorders of Impulse Formation......Page 810
Delayed Afterdepolarizations......Page 813
Major Role of Intracellular Ca2+-Handling Abnormalities in DAD Generation......Page 815
Parasystole......Page 817
Anatomic Reentry......Page 819
Atrial Flutter......Page 820
Spatiotemporal Organization and Focal Discharge......Page 822
Atrioventricular Nodal Reentry......Page 823
Catecholaminergic Polymorphic Ventricular Tachycardia......Page 825
Ventricular Fibrillation: Initiation and Maintenance......Page 826
Disorders of Impulse Conduction......Page 827
Physical Examination......Page 829
Electrocardiogram......Page 830
Additional Tests......Page 831
Ambulatory Electrocardiographic (Holter) Recording......Page 833
Implantable Loop Recorder......Page 835
Intraventricular Conduction Disturbance......Page 838
Sinus Node Dysfunction......Page 840
Tachycardia......Page 841
Palpitations......Page 842
Complications of Electrophysiologic Studies......Page 843
Clinical Competence......Page 846
Survivors of Cardiac Arrest......Page 848
Clinical Competence......Page 850
References......Page 852
References......Page 845
Class III......Page 853
Class IV......Page 855
Proarrhythmia......Page 856
Adverse Effects.......Page 858
Indications.......Page 859
Ajmaline......Page 860
Adverse Effects.......Page 861
Propafenone......Page 862
Beta Adrenoceptor–Blocking Agents......Page 863
Amiodarone......Page 864
Adverse Effects.......Page 865
Dosage.......Page 866
Adverse Effects.......Page 867
Indications.......Page 868
Indications.......Page 869
Ranolazine......Page 870
Technique......Page 871
Indications......Page 872
Cooled-Tip Radiofrequency Ablation......Page 873
Location of Pathways......Page 874
Radiofrequency Catheter Modification of AV Node for AV Nodal Reentrant Tachycardias......Page 876
Radiofrequency Catheter Ablation of Arrhythmias Related to the Sinus Node......Page 877
Radiofrequency Catheter Ablation of Atrial Tachycardia......Page 878
Results......Page 879
Radiofrequency Catheter Ablation of Ventricular Arrhythmias......Page 881
Indications......Page 884
Surgical Therapy for Tachyarrhythmias......Page 885
Ischemic Heart Disease......Page 886
Pharmacologic Therapy......Page 887
Electrotherapy for Cardiac Arrhythmias......Page 888
Clinical Features......Page 889
Electrocardiographic Recognition......Page 893
Electrocardiographic Recognition......Page 896
Clinical Features......Page 897
Management......Page 899
Tachycardias Involving the Atrioventricular Junction......Page 900
Electrocardiographic Recognition......Page 901
Electrophysiologic Features......Page 902
Clinical Features......Page 903
Electrocardiographic Recognition......Page 904
Diagnosis of Accessory Pathways......Page 905
Electrocardiographic Recognition......Page 906
Electrophysiologic Features of Preexcitation......Page 907
Accessory Pathway Conduction......Page 911
Recognition of Accessory Pathways......Page 912
“Wide-QRS” Tachycardias......Page 913
Prevention......Page 914
References......Page 916
Classification of Atrial Fibrillation......Page 917
Mechanisms of Atrial Fibrillation......Page 918
Clinical Features......Page 919
Risk Stratification......Page 920
Novel Oral Anticoagulants......Page 921
Acute Management of Atrial Fibrillation......Page 922
Pharmacologic Rate Control Versus Rhythm Control......Page 923
Pharmacologic Rhythm Control......Page 924
Radiofrequency Catheter Ablation......Page 925
Radiofrequency Catheter Ablation Versus Cryoballoon Ablation for Atrial Fibrillation......Page 927
Ablation of the Atrioventricular Node......Page 928
Postoperative Atrial Fibrillation......Page 929
Percutaneous Coronary Intervention for Coronary Artery Disease......Page 930
Prevention of Thromboembolic Complications......Page 931
Cardioversion of Atrial Fibrillation (Table 38G.3)......Page 933
Maintenance of Sinus Rhythm (Table 38G.4)......Page 936
Acute Myocardial Infarction......Page 937
Reference......Page 939
Specific Clinical Syndromes......Page 932
Clinical Features......Page 940
Management......Page 941
Electrocardiographic Recognition......Page 943
Clinical Features......Page 945
Acute Management of Sustained Ventricular Tachycardia......Page 946
Long-Term Therapy for Prevention of Recurrences......Page 948
Catecholaminergic Polymorphic Ventricular Tachycardia......Page 949
Electrophysiologic Features......Page 950
Clinical Features......Page 952
J Wave Syndromes......Page 953
Brugada Syndrome......Page 954
Outflow Tract Tachycardias......Page 956
Electrocardiographic Recognition......Page 958
Idiopathic Ventricular Tachycardias......Page 959
Sinus Arrhythmia......Page 960
Management......Page 961
Management......Page 964
Second-Degree Atrioventricular Block......Page 965
Third-Degree (Complete) Atrioventricular Block......Page 968
Management......Page 969
References......Page 971
Electrocardiographic and Clinical Features......Page 972
Management......Page 973
Principles: Capture, Sensing, and Hemodynamics of Pacing......Page 974
Definitions......Page 981
Programming to Avoid Unnecessary Right Ventricular Pacing......Page 983
Pacemaker Troubleshooting......Page 985
Pacing at a Rate Inconsistent With Programming......Page 986
ICD Leads and Generators......Page 988
Transvenous versus Subcutaneous ICD Systems......Page 991
Dual- versus Single-Chamber Transvenous ICDs......Page 992
Implant Testing.......Page 994
ICD Sensing and Detection......Page 997
Strategic Programming to Reduce Shocks and ATP......Page 998
Approach to the Patient with Shocks......Page 1003
Failure to Deliver Therapy or Delayed Therapy......Page 1005
Imaging......Page 1006
CIED Diagnostics for Atrial Fibrillation......Page 1008
Implantable Cardioverter-Defibrillators......Page 1013
Follow-up; Common Clinical Issues in CIED Patients......Page 1015
Prevention and Termination of Tachyarrhythmias......Page 1016
Selection of Pacemakers......Page 1017
Expert Consensus Statement on Use of ICD Therapy......Page 1018
References......Page 1020
Definitions......Page 1022
Incidence and the Population Burden of Sudden Cardiac Death......Page 1023
Population and Subgroup Risk Versus Individual Risk Assessment......Page 1024
Biologic and Clinical Time-Dependent Risk......Page 1025
Heredity......Page 1026
General Risk Profile......Page 1027
Left Ventricular Ejection Fraction in Chronic Ischemic Heart Disease......Page 1029
Nonatherosclerotic Coronary Artery Abnormalities......Page 1030
Ventricular Hypertrophy and Hypertrophic Cardiomyopathy......Page 1032
Acute Heart Failure......Page 1033
Congenital Heart Disease......Page 1034
Brugada Syndrome......Page 1035
Early Repolarization and Sudden Cardiac Death......Page 1036
Sudden Cardiac Death in Competitive and Recreational Athletes and During Intense Exercise......Page 1038
Coronary Artery Structure and Function......Page 1040
Clinical Features of Patients With Cardiac Arrest......Page 1041
Progression to Biologic Death......Page 1042
Left Ventricular Function......Page 1044
Community-Based Interventions......Page 1045
Importance of Electrical Mechanisms......Page 1047
Chest Thump......Page 1049
Concept of Cardiocerebral Resuscitation......Page 1050
Early Defibrillation by First Responders......Page 1052
Defibrillation-Cardioversion......Page 1054
Bradyarrhythmic and Asystolic Arrest; Pulseless Electrical Activity......Page 1056
Post–Cardiac Arrest Care and Post–Cardiac Arrest Syndrome......Page 1057
Cardiac Arrest in Patients with Hemodynamically Unstable Acute Myocardial Infarction......Page 1058
General Care......Page 1059
Prevention of Cardiac Arrest and Sudden Cardiac Death......Page 1060
Ambulatory Monitoring......Page 1061
Implantable Defibrillators......Page 1062
Primary Prevention of SCD in Patients with Advanced Heart Disease......Page 1063
Prediction and Primary Prevention in the General Population......Page 1065
Perspective......Page 1066
Causes of Sudden Cardiac Death......Page 1067
Management of Cardiac Arrest......Page 1068
Sudden Death and Public Safety......Page 1069
Vascular Causes of Syncope......Page 1070
Reflex-Mediated Syncope......Page 1071
Cardiac Causes of Syncope......Page 1072
Physical Examination......Page 1073
Tilt-Table Test......Page 1074
Cardiac Monitoring......Page 1075
Electrophysiologic Testing Protocol......Page 1076
Approach to the Evaluation of Patients With Syncope......Page 1077
Neurally Mediated Syncope......Page 1078
Future Perspectives......Page 1079
References......Page 1080
Endothelial Cells......Page 1081
Tunica Media......Page 1083
Adventitia......Page 1085
Extracellular Lipid Accumulation......Page 1086
Focality of Lesion Formation......Page 1087
Intracellular Lipid Accumulation: Foam Cell Formation......Page 1088
Smooth Muscle Cell Migration and Proliferation......Page 1089
Angiogenesis in Plaques......Page 1090
Plaque Rupture and Thrombosis......Page 1091
Thrombosis Caused by Superficial Erosion of Plaques......Page 1092
Restenosis After Arterial Intervention......Page 1094
Aneurysmal Disease......Page 1095
Structure of the Normal Artery......Page 1096
Special Cases of Arteriosclerosis......Page 1097
Rethinking Core Approaches to Primary Prevention......Page 1098
Merging Epidemiology and Randomized Trial Evidence: Why Measure Risk Factors?......Page 1099
Smoking......Page 1100
Interventions for Smoking Cessation......Page 1102
Hypertension......Page 1103
Interventions to Reduce Blood Pressure......Page 1105
Low-Density Lipoprotein (LDL) Cholesterol......Page 1106
High-Density Lipoprotein (HDL) Cholesterol......Page 1107
Interventions to Raise HDL Cholesterol......Page 1108
Metabolic Syndrome, Insulin Resistance, and Diabetes......Page 1109
Aspirin for Primary Prevention......Page 1110
Interventions to Increase Appropriate Use of Aspirin......Page 1112
High-Sensitivity C-Reactive Protein......Page 1113
Interventions for Primary Prevention in Patients With Elevated hsCRP Levels......Page 1114
Interventions to Reduce Alternative Markers of Inflammation......Page 1116
Direct Plaque Imaging......Page 1117
Interventions Based on Vascular Imaging......Page 1118
Interventions for Prevention Based on Genotype......Page 1119
Physical Activity......Page 1120
Obesity and Weight Loss......Page 1122
Intervention Studies of Weight Loss......Page 1123
Dietary Supplements......Page 1124
Moderate Alcohol Consumption......Page 1125
Postmenopausal Hormone Therapy......Page 1126
Community-Based and Multiple–Risk Factor Intervention Programs......Page 1127
Hypertension......Page 1128
The “Polypill” Concept......Page 1129
Obesity and Weight Loss......Page 1130
Postmenopausal Hormone Therapy......Page 1131
Community-Based and Multiple–Risk Factor Interventions......Page 1132
Prevalence......Page 1133
Genetic Determinants......Page 1134
Neural Mechanisms......Page 1135
Vascular Mechanisms......Page 1138
Hormonal Mechanisms: Renin-Angiotensin-Aldosterone System......Page 1139
White Coat Hypertension......Page 1142
Masked Hypertension......Page 1143
Cardiovascular Disease Risk Stratification......Page 1145
Impaired Coronary Vasodilator Reserve and Heart Failure......Page 1146
Acute Renal Diseases......Page 1148
Mechanisms......Page 1149
Primary Aldosteronism and Other Forms of Mineralocorticoid-Induced Hypertension......Page 1150
Differential Diagnosis: Mendelian Forms of Hypertension......Page 1151
Coarctation of the Aorta......Page 1152
Diagnosis and Evaluation......Page 1153
DASH Diet Pattern......Page 1155
Sodium Consumption and Blood Pressure......Page 1156
Obesity and Body Weight......Page 1157
Barriers to Adoption and Maintenance of Lifestyle Change and Possible Solutions......Page 1158
Antihypertensive Drugs......Page 1159
Clinical Use......Page 1160
Clinical Use......Page 1161
Side Effects......Page 1162
Clinical Use and Side Effects......Page 1163
Clinical Use......Page 1164
Recent Trials......Page 1165
Recent Observational Studies on Cardiac J-Curve Hypothesis......Page 1167
Systolic Hypertension in Elderly Patients......Page 1168
Hypertension in Patients with Diabetes Mellitus and Normal Renal Function......Page 1172
Hypertension in Patients with Diabetic Nephropathy......Page 1173
Hypertension in Non-Hispanic Black Patients......Page 1174
Pediatric and Adolescent Hypertension......Page 1175
Perioperative Management of High Blood Pressure......Page 1176
Acute Ischemic or Hemorrhagic Stroke......Page 1177
Acute Heart Failure......Page 1178
Blood Pressure Thresholds and Goals of Therapy......Page 1179
Resistant Hypertension......Page 1180
Lifestyle Modification......Page 1181
Practical Clinical Approach to Ambulatory Hypertensive Patients......Page 1183
When to Start or Intensify Drug Therapy......Page 1184
References......Page 1186
Special Considerations in Management......Page 1182
48 Lipoprotein Disorders and Cardiovascular Disease......Page 1187
Lipoprotein Metabolism and Transport......Page 1188
High-Density Lipoprotein and Reverse Cholesterol Transport......Page 1192
Definitions......Page 1193
Proprotein Convertase, Subtilisin/Kexin Type 9.......Page 1194
Triglyceride-Rich Lipoproteins......Page 1195
Familial Combined Hyperlipidemia......Page 1196
Metabolic Causes......Page 1197
Statin Pharmacology......Page 1198
Older Patients......Page 1199
Advanced Heart Failure......Page 1200
Fibric Acid Derivatives (Fibrates)......Page 1201
PCSK9 Inhibitors......Page 1202
Novel Agents......Page 1203
Gene Therapy......Page 1204
Pharmacologic Management of Lipid Risk......Page 1205
Lipid Management......Page 1206
References......Page 1209
Fruits and Vegetables......Page 1210
Whole Grains, Refined Grains, Starches, and Sweets......Page 1211
Fish......Page 1213
Dairy Foods......Page 1214
Carbohydrates......Page 1215
n-3 PUFAs......Page 1216
Sodium......Page 1217
Dietary Patterns......Page 1218
Foods and Cardiovascular Risk......Page 1221
Beverages and Cardiometabolic Diseases......Page 1222
Sodium and Potassium Consumption and Cardiovascular Disease......Page 1223
Intervention Strategies......Page 1224
Risk Assessment in Overweight/Obese Patients: Waistline as Key Indicator......Page 1225
Marker of Ectopic Fat Deposition......Page 1228
Visceral Adipose Tissue as an Endocrine Organ......Page 1230
Age and Sex......Page 1231
Key Nutritional Factors (Toward a Food-Based Approach)......Page 1232
Severe Obesity and Bariatric Surgery......Page 1233
Summary and Perspectives......Page 1235
Visceral Obesity......Page 1236
Summary and Perspectives......Page 1237
Atrial Fibrillation......Page 1238
Lipid Management......Page 1240
Statins......Page 1241
Angiotensin-Converting Enzyme Inhibitors.......Page 1242
Metformin.......Page 1243
Sulfonylureas.......Page 1246
Dipeptidyl Peptidase 4 (DPP4) Inhibitors.......Page 1247
Glucagon Like Peptide (GLP)-1 Receptor Agonists.......Page 1248
Cardiovascular Effects of More Intensive Versus Less Intensive Glucose Control Strategies......Page 1249
Insulin Administration and Glucose Control......Page 1250
P2Y12 Receptor Antagonists......Page 1251
Coronary Revascularization Considerations......Page 1252
Mechanistic Considerations......Page 1253
Modulation of the Renin-Angiotensin-Aldosterone System......Page 1254
Heart Failure Considerations for Glucose Management Strategies and Antihyperglycemic Medications......Page 1255
Coronary Heart Disease in the Patient with Diabetes......Page 1256
Blood Pressure......Page 1258
Coronary Revascularization......Page 1260
References......Page 1261
Heart Failure in the Patient with Diabetes......Page 1257
Gaseous Pollutants......Page 1263
Air Pollution and Cardiovascular Mortality......Page 1264
Myocardial Infarction......Page 1265
Pathophysiology......Page 1266
Occupational Exposures......Page 1267
References......Page 1268
Cardiovascular Response to Exercise and Exercise Training......Page 1269
Cardiovascular Risks of Exercise......Page 1270
Decreased Exercise Capacity......Page 1272
Cardiovascular Complaints in Athletes......Page 1273
Valve Disease......Page 1274
Noncompaction Cardiomyopathy......Page 1275
Emerging Issues in the Cardiac Care of Athletes......Page 1276
Basic Principles of Exercise Physiology and Training......Page 1277
Patients with Angina Pectoris......Page 1278
Patients with Heart Failure......Page 1279
Program Structure......Page 1280
Future Perspectives......Page 1281
References......Page 1282
Ischemic Heart Disease......Page 1283
Environment......Page 1284
Biofeedback......Page 1285
Red Yeast Rice......Page 1286
Yoga......Page 1287
Arrhythmias......Page 1288
Myocardial Ischemia or Infarction......Page 1289
Pulmonary Conditions......Page 1290
Physical Examination......Page 1291
Troponins.......Page 1292
Immediate Management......Page 1293
Chest Pain Protocols and Units......Page 1295
Imaging Tests......Page 1296
Emergency Triage......Page 1297
Immediate Management......Page 1298
Coronary Autoregulation......Page 1299
Determinants of Coronary Vascular Resistance......Page 1300
Nitric Oxide (Endothelium-Derived Relaxing Factor)......Page 1302
Paracrine Vasoactive Mediators and Coronary Vasospasm......Page 1304
Coronary Vasospasm......Page 1305
Structure and Function of the Coronary Microcirculation......Page 1306
Flow-Mediated Resistance Artery Control......Page 1309
Stenosis Pressure-Flow Relation......Page 1310
Concept of Maximal Perfusion and Coronary Reserve......Page 1311
Relative Flow Reserve......Page 1312
Fractional Flow Reserve......Page 1314
Pathophysiologic States Affecting Microcirculatory Coronary Flow Reserve......Page 1317
Impact of Microcirculatory Abnormalities on Physiologic Measures of Stenosis Severity......Page 1319
Arteriogenesis and Angiogenesis......Page 1320
Metabolic and Functional Consequences of Ischemia......Page 1322
Functional Consequences of Reversible Ischemia......Page 1323
Chronic Hibernating Myocardium......Page 1325
Future Perspectives......Page 1330
Control of Coronary Blood Flow......Page 1331
Metabolic and Functional Consequences of Ischemia......Page 1332
Improvements in Outcome......Page 1333
Limitations of Current Therapy......Page 1335
Pathologic Findings......Page 1336
Acute Coronary Syndromes......Page 1337
Coagulation Necrosis......Page 1338
Current Concepts of the Cellular Events During Myocardial Infarction and Healing......Page 1342
Coronary Anatomy and Location of Infarction......Page 1345
Collateral Circulation in Acute Myocardial Infarction......Page 1347
Prognosis in MINOCA......Page 1348
Systolic Function......Page 1349
Ventricular Remodeling......Page 1351
Pathophysiology of Other Organ Systems......Page 1352
Blood Viscosity......Page 1353
Silent ST-Elevation Myocardial Infarction with Atypical Features......Page 1354
Palpation......Page 1355
Cardiac-Specific Troponins......Page 1356
Recommendations for Measurement of Circulating Markers......Page 1357
Serum Lipids......Page 1358
Electrocardiography......Page 1360
Magnetic Resonance Imaging......Page 1361
Future Perspectives......Page 1362
Clinical Features......Page 1364
Laboratory Findings......Page 1365
Prehospital Care......Page 1366
Prehospital Fibrinolysis......Page 1367
Management in the Emergency Department......Page 1368
Nitrates......Page 1369
Dynamic Nature of Infarction......Page 1370
General Concepts......Page 1371
Fibrinolysis......Page 1372
Effect of Fibrinolytic Therapy on Mortality......Page 1373
Complications of Fibrinolytic Therapy......Page 1376
Intracoronary Fibrinolysis......Page 1378
Referral for Angiography with Intent of Revascularization After Initial Fibrinolysis......Page 1379
Patients Not Eligible for Reperfusion Therapy......Page 1380
Disadvantages of Heparin.......Page 1382
Adjunctive Anticoagulation for Primary PCI (See Chapter 62).......Page 1384
Antiplatelet Therapy for PCI in ST-Elevation Myocardial Infarction......Page 1387
Coronary Care and Intermediate Care Units......Page 1388
Physical Activity......Page 1389
Beta Blockers......Page 1390
Inhibition of the Renin-Angiotensin-Aldosterone System......Page 1391
Nitrates......Page 1392
Glucose Control During ST-Elevation Myocardial Infarction......Page 1393
Hemodynamic Subsets......Page 1394
Therapeutic Implications......Page 1395
Nitroglycerin......Page 1396
Pathophysiology......Page 1397
Intra-Aortic Balloon Counterpulsation......Page 1399
Revascularization......Page 1400
Recommendations......Page 1401
Diagnosis......Page 1402
Treatment......Page 1403
Diagnosis......Page 1404
Rupture of a Papillary Muscle......Page 1406
Management......Page 1407
Arrhythmias......Page 1408
Prophylaxis......Page 1409
Complete (Third-Degree) Atrioventricular Block......Page 1410
Bifascicular Block, Including Left Bundle Branch Block......Page 1411
Diagnosis......Page 1412
Left Ventricular Aneurysm......Page 1413
Timing of Hospital Discharge......Page 1414
Exercise Testing.......Page 1415
Secondary Prevention After Acute Myocardial Infarction......Page 1417
Antiplatelet Agents (See Chapter 93)......Page 1418
Anticoagulants (See Chapter 93)......Page 1419
Future Perspectives and Emerging Therapies......Page 1421
Reperfusion Therapy......Page 1422
Emerging Therapies......Page 1424
Community Preparedness and Systems Goals for Reperfusion Therapy......Page 1425
Antiplatelet Therapy......Page 1426
Transfer to a Hospital Capable of Performing PCI after Fibrinolytic Therapy......Page 1427
Coronary Angiography and PCI in Patients Initially Managed with Fibrinolytic Therapy or in Those with No Reperfusion (Table 59G.7)......Page 1428
Routine Medical Therapies......Page 1429
Posthospitalization Plan of Care......Page 1430
References......Page 1432
Other Complications......Page 1423
Pathophysiology......Page 1433
History......Page 1434
Physical Examination......Page 1435
Laboratory Testing: Biomarkers......Page 1436
Invasive Imaging......Page 1437
General Measures......Page 1439
Nitrates......Page 1440
Calcium Channel Blockers......Page 1441
Aspirin (Acetylsalicylic Acid, ASA)......Page 1442
Clopidogrel......Page 1443
Ticagrelor......Page 1444
Heparin......Page 1445
Oral Factor Xa Inhibitors......Page 1446
Bleeding: Risk Assessment, Prevention, and Treatment......Page 1447
Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting......Page 1448
Lipid-Lowering Therapy (See Also Chapters 45 and 48)......Page 1449
Diabetes Mellitus and Glucose Intolerance (See Also Chapter 51)......Page 1450
Prinzmetal Variant Angina......Page 1451
Future Perspectives......Page 1452
Emerging Therapies......Page 1455
Combined Postdischarge Oral Anticoagulant and Antiplatelet Therapy......Page 1456
Use of Performance Measures and Registries......Page 1460
References......Page 1461
Management......Page 1453
Lipid-Lowering Therapy......Page 1454
Characteristics of Angina (See Chapter 56)......Page 1462
Biliary Colic......Page 1464
Angina Caused by Increased Myocardial Oxygen Requirements......Page 1465
Biomarkers of Myocyte Injury, Ischemia, and Hemodynamic Stress......Page 1466
Resting Electrocardiogram......Page 1467
Stress Testing (See Chapters 13, 14, and 16)......Page 1468
Computed Tomography (See Chapter 18)......Page 1470
Catheterization, Angiography, and Coronary Arteriography......Page 1471
Functional Assessment......Page 1473
Treatment of Associated Diseases......Page 1474
Hypertension (See Chapters 46 and 47)......Page 1475
Low High-Density Lipoprotein Cholesterol.......Page 1476
Inflammation (See Chapters 44 and 45)......Page 1477
Counseling and Changes in Lifestyle......Page 1480
Beta Adrenoceptor–Blocking Agents......Page 1481
Calcium Antagonists......Page 1482
Verapamil.......Page 1484
Mechanism of Action......Page 1486
Topical Nitroglycerin.......Page 1487
Ranolazine......Page 1489
Selection of Therapy......Page 1490
Synthesis of Integrated Approach to Management of Patients with Chronic Angina......Page 1491
Extent of Ischemia and Presence of Left Ventricular Dysfunction......Page 1492
Percutaneous Coronary Intervention......Page 1493
Comparisons Between Percutaneous Coronary Intervention and Medical Therapy......Page 1494
Fractional Flow Reserve Strategy......Page 1495
Selection of Percutaneous Coronary Intervention for Revascularization......Page 1496
Surgical Outcomes and Long-Term Results......Page 1497
Operative Mortality......Page 1499
Effects on Survival......Page 1500
Older Patients (see Chapter 88)......Page 1502
Observational Studies......Page 1503
Randomized Trials......Page 1504
Multivessel Disease......Page 1507
Transmyocardial Laser Revascularization......Page 1509
Chest Pain with a Normal Coronary Arteriogram......Page 1510
Prognosis......Page 1511
Silent Myocardial Ischemia......Page 1512
Mitral Regurgitation Secondary to Coronary Artery Disease......Page 1513
Management......Page 1515
Noninvasive Tests......Page 1516
Other Manifestations of Coronary Artery Disease......Page 1520
Specific Patient Subsets......Page 1522
Risk Stratification......Page 1523
Risk Factor Modification......Page 1524
Pharmacologic Therapy......Page 1526
Patient Follow-Up......Page 1528
References......Page 1533
Medical Management......Page 1517
Pharmacologic Management of Angina......Page 1518
Comparisons Between Percutaneous Coronary Intervention and Coronary Artery Bypass Surgery......Page 1519
Clinical Presentations......Page 1534
Extent of Jeopardized Myocardium......Page 1535
Complete Versus Ischemia-Targeted Intervention for Multivessel Disease......Page 1536
Vascular Access......Page 1539
Balloon Angioplasty......Page 1540
Coronary Stents......Page 1542
Bioabsorbable Polymers and Drug-Eluting Stents......Page 1544
Adenosine Diphosphate Receptor Antagonists......Page 1545
Factor Xa Inhibitors......Page 1546
Angiographic Complications......Page 1547
Outcomes Benchmarking and Procedural Volumes......Page 1548
Indications......Page 1549
Outcomes After Percutaneous Coronary Intervention......Page 1551
Guidelines for Training......Page 1553
References......Page 1558
Antiplatelet Agents......Page 1550
Evaluation of the Aorta......Page 1559
Pathogenesis......Page 1560
Diagnostic Imaging......Page 1562
Techniques and Outcomes.......Page 1563
Thoracic Aortic Aneurysms......Page 1564
Genetically Triggered Thoracic Aortic Aneurysm Disorders......Page 1565
Clinical Manifestations......Page 1568
Diagnosis......Page 1570
Ascending Thoracic Aortic Aneurysms.......Page 1572
Thoracoabdominal Aneurysms.......Page 1574
Endovascular Repair of Thoracic Aneurysms.......Page 1576
Classification......Page 1578
Cause and Pathogenesis......Page 1579
Symptoms......Page 1580
Physical Findings......Page 1581
Laboratory Findings......Page 1583
Ultrasound......Page 1585
Role of Coronary Angiography......Page 1587
Definitive Therapy......Page 1589
Long-Term Therapy and Follow-Up......Page 1597
Aortic Intramural Hematoma......Page 1602
Bacterial Infections of the Aorta......Page 1605
Aortic Aneurysms......Page 1609
Surgical Therapy and Outcomes with Thoracoabdominal Aortic Aneurysms......Page 1614
Primary Tumors of the Aorta......Page 1611
Class I......Page 1612
References......Page 1613
Risk Factors for Peripheral Artery Disease......Page 1615
Pathophysiology of Peripheral Artery Disease......Page 1617
Symptoms......Page 1618
Physical Findings......Page 1619
Segmental Pressure Measurement......Page 1620
Pulse Volume Recording......Page 1621
Duplex Ultrasound Imaging......Page 1622
Risk Factor Modification......Page 1623
Treatment of Diabetes......Page 1626
Antiplatelet Therapy......Page 1627
Exercise Training......Page 1628
Pharmacotherapy to Improve Claudication......Page 1629
Peripheral Artery Surgery......Page 1631
Pathology and Pathogenesis......Page 1633
Fibromuscular Dysplasia......Page 1634
Pathogenesis......Page 1635
Pathogenesis......Page 1637
Clinical Features......Page 1639
Treatment......Page 1640
Acute Limb Ischemia......Page 1641
Medical Management of Patients With Peripheral Artery Disease......Page 1642
Revascularization Strategies for Patients With Peripheral Artery Disease......Page 1643
Acknowledgement......Page 1645
Secondary Prevention......Page 1646
Secondary Prevention......Page 1648
Primary Prevention......Page 1650
Secondary Prevention......Page 1654
Secondary Prevention......Page 1656
Management of Acute Ischemic Stroke......Page 1658
Endovascular Therapy......Page 1659
Anticoagulation and Platelet Antiaggregant Therapy......Page 1663
Future Perspectives......Page 1664
References......Page 1665
Approach to the Patient With Peripheral Artery Disease......Page 1666
Drug-Eluting Peripheral Stents......Page 1667
Drug-Coated Balloons......Page 1668
Thrombolysis and Thrombectomy......Page 1669
Vascular Access......Page 1670
Peripheral Artery Disease of the Lower Extremities......Page 1671
Aortoiliac Disease......Page 1672
Femoral-Popliteal Artery Disease......Page 1673
Extracranial Carotid Disease......Page 1676
Vertebral and Subclavian Disease......Page 1678
Renal Artery......Page 1679
Future Perspectives......Page 1681
Endovascular Technologies......Page 1682
Endovascular Treatment of Venous Disease......Page 1683
The Heart Valve Clinic......Page 1684
Changes in First and Second Heart Sounds......Page 1685
Stress Testing......Page 1686
Cardiac Catheterization......Page 1689
References......Page 1690
Causes and Pathology......Page 1691
Hypertrophic Myocardial Remodeling......Page 1692
Left Ventricular Systolic Function......Page 1693
Symptoms......Page 1695
Asymptomatic Patients......Page 1697
Symptomatic Patients......Page 1700
Transcatheter Aortic Valve Replacement......Page 1701
Valvular Disease......Page 1704
Aortic Root Disease......Page 1705
Symptoms......Page 1706
Echocardiography......Page 1707
Asymptomatic Patients with Chronic Aortic Regurgitation......Page 1708
Indications for Valve Replacement......Page 1711
Operative Procedures......Page 1713
Pathophysiology......Page 1715
Classic References......Page 1716
Aortic Stenosis: Clinical Presentation and Diagnostic Testing......Page 1717
Aortic Regurgitation: Disease Course and Treatment......Page 1718
Bicuspid Aortic Valve Disease......Page 1719
Pathophysiology......Page 1720
Dyspnea......Page 1722
Other Auscultatory Findings.......Page 1723
Interval Between Acute Rheumatic Fever and Mitral Valve Obstruction......Page 1724
Drug Treatment......Page 1725
Percutaneous Balloon Mitral Valvotomy......Page 1727
Surgical Valvotomy......Page 1730
Causes and Pathology......Page 1731
Left Ventricular Compensation......Page 1735
Assessment of Myocardial Contractility......Page 1736
Auscultation.......Page 1738
Differential Diagnosis......Page 1740
Echocardiography......Page 1741
Disease Course......Page 1744
Medical Treatment of Primary Mitral Regurgitation......Page 1745
Surgical Treatment of Primary Mitral Regurgitation......Page 1747
Surgical Results......Page 1749
Indications for Surgery......Page 1750
Echocardiography......Page 1751
Surgical Treatment of Secondary Mitral Regurgitation......Page 1752
Medical Management of Acute Mitral Regurgitation......Page 1753
Surgical Treatment of Acute Mitral Regurgitation......Page 1754
Mitral Stenosis......Page 1755
Chronic Primary Mitral Regurgitation......Page 1756
Acute Mitral Regurgitation......Page 1757
Clinical Presentation and Diagnosis......Page 1758
Management......Page 1759
Clinical Presentation and Diagnosis......Page 1760
Hemodynamic Findings......Page 1761
Management......Page 1762
Causes and Pathology......Page 1763
Echocardiography......Page 1764
Multivalvular Disease......Page 1765
Tricuspid Regurgitation......Page 1766
Multivalvular Disease......Page 1767
Stented Bioprosthetic Valves......Page 1768
Transcatheter Bioprosthetic Valves......Page 1769
Choice of Valve Replacement Procedure and Prosthesis......Page 1770
Clinical Assessment......Page 1771
Evaluation and Treatment of Prosthetic Valve Dysfunction and Complications......Page 1772
Paravalvular Regurgitation......Page 1773
Prosthetic Valve Thrombosis......Page 1774
References......Page 1775
Transcatheter Aortic Valve Replacement......Page 1777
Evidence Base......Page 1778
Minimalist Techniques......Page 1779
Indications......Page 1780
Leaflet Repair with MitraClip Device......Page 1781
Transcatheter Mitral Valve Replacement......Page 1784
Aortic Stenosis......Page 1785
Conclusion......Page 1786
Surgery and Transcatheter Intervention......Page 1787
Choices in Valve Surgery......Page 1791
Bridging Therapy......Page 1792
Native Valve Disorders......Page 1793
References......Page 1795
Infective Endocarditis......Page 1796
Staphylococcal Species......Page 1797
Culture-Negative Endocarditis......Page 1798
Predisposing Cardiac Conditions......Page 1799
Diagnosis......Page 1800
Other Blood Testing......Page 1802
Imaging for Diagnosis of Infective Endocarditis......Page 1803
Local Valvular Destruction.......Page 1805
Perivalvular Extension of Infection.......Page 1806
Embolism.......Page 1807
Antimicrobial Therapy......Page 1808
Viridans Group Streptococci and Streptococcus Gallolyticus......Page 1809
Staphylococci......Page 1811
Surgical Intervention......Page 1816
Clinical Syndromes......Page 1817
Prophylaxis......Page 1818
Indications for Echocardiography......Page 1822
Surgery for Active Endocarditis......Page 1823
References......Page 1824
Infective Endocarditis: Epidemiology, Microbiology, Pathogenesis, Clinical Presentation......Page 1820
Coronary Artery Stent Infections......Page 1821
Pathogenesis......Page 1825
Arthritis......Page 1827
Carditis......Page 1828
Diagnosis......Page 1829
Treatment......Page 1830
Future Perspectives......Page 1832
General Considerations......Page 1833
Morphologic Left Ventricle......Page 1835
Congestive Heart Failure......Page 1836
Palliative Surgical Interventions......Page 1837
Eisenmenger Syndrome......Page 1838
Transplantation......Page 1839
Atrioventricular Block......Page 1840
Physical Assessment......Page 1841
The Chest Radiograph......Page 1842
3. Atrioventricular Relationship......Page 1875
Transesophageal and Three-Dimensional Echocardiography......Page 1878
Therapeutic Catheterization......Page 1880
Morphology......Page 1881
Clinical Features......Page 1882
Follow-Up......Page 1883
Atrioventricular Septal Defect......Page 1884
Clinical Issues......Page 1885
Complete Atrioventricular Septal Defect.......Page 1886
Isolated Ventricular Septal Defect......Page 1887
Pathophysiology......Page 1888
Clinical Features......Page 1889
Tetralogy of Fallot (Including Tetralogy with Pulmonary Atresia)......Page 1891
Children.......Page 1893
Interventional Outcomes......Page 1895
Tricuspid Atresia (Absent Right Atrioventricular Connection)......Page 1896
Management Options.......Page 1897
Clinical Features.......Page 1899
The Fontan Patient (Fig. 75.30)......Page 1900
Complications and Sequelae......Page 1901
Natural History......Page 1902
Definition and Natural History.......Page 1903
Arterial Switch Operation.......Page 1904
Indications for Reintervention.......Page 1905
Congenitally Corrected Transposition of the Great Arteries......Page 1906
VSD Patch and Left Ventricular–to–Pulmonary Artery Conduit Repair.......Page 1908
Double-Outlet Right Ventricle......Page 1909
Localized Aortic Coarctation......Page 1910
Follow-Up.......Page 1911
Clinical Findings......Page 1912
Clinical Features......Page 1913
Clinical Features......Page 1914
Complex Congenital Mitral Valve Regurgitation.......Page 1916
Clinical Features.......Page 1917
Clinical Features......Page 1918
Pulmonary Stenosis with Intact Ventricular Septum......Page 1919
Clinical Features......Page 1921
Interventional Options and Outcomes......Page 1923
Pulmonary Vein Stenosis......Page 1925
Management Options and Outcomes......Page 1926
Other......Page 1928
Pulmonary Valve Replacement......Page 1930
Pulmonary Angioplasty......Page 1931
Amplatzer Devices......Page 1932
Amplatzer Duct Occluders (First- and Second-Generation)......Page 1933
Septal Interventions......Page 1934
The Dilated Cardiomyopathies......Page 1936
Genetics of Dilated Cardiomyopathy......Page 1941
Clinical Genetics of Familial Dilated Cardiomyopathy......Page 1942
Approach to Clinical Genetic Evaluation, Including Genetic Testing......Page 1944
Genomic Cause of Arrhythmogenic Right Ventricular Cardiomyopathy......Page 1945
Approach to Clinical Genetic Evaluation, Including Clinical Genetic Testing......Page 1948
Clinical Management of Left Ventricular Noncompaction......Page 1950
Clinical Features......Page 1953
Restrictive and Infiltrative Cardiomyopathies......Page 1954
Amyloid Light-Chain Amyloidosis......Page 1956
Familial and Senile Systemic Amyloidosis......Page 1957
Diagnosis......Page 1959
Clinical Features......Page 1961
Fabry Disease......Page 1962
Hemochromatosis......Page 1967
Löffler (Eosinophilic) Endocarditis......Page 1969
The Dilated Cardiomyopathies......Page 1971
Restrictive and Infiltrative Cardiomyopathies......Page 1972
Definition, Prevalence, and Nomenclature......Page 1974
Mitral Valve Apparatus......Page 1975
Left Ventricular Outflow Tract Obstruction......Page 1977
Microvascular Dysfunction......Page 1979
Electrocardiographic Findings......Page 1980
Epidemiology of Sudden Death; Risk Stratification Strategies......Page 1982
Prevention of Sudden Death......Page 1986
Drugs......Page 1987
Surgical Myectomy......Page 1988
Treatment of Atrial Fibrillation......Page 1989
Gender, Race, and Genetic Basis and Testing......Page 1990
Classic References......Page 1991
Management......Page 1992
References......Page 1993
Epidemiology......Page 1994
Viruses......Page 1995
Bacteria......Page 1997
Protozoa......Page 1998
Trichinosis......Page 2000
Viral Infection......Page 2001
References......Page 2002
Innate Immunity......Page 2003
References......Page 2005
Acquired Immunity......Page 2004
Clinical Syndromes......Page 2006
References......Page 2007
Cardiac Imaging......Page 2008
Treatment......Page 2010
Specific Etiologic Agents......Page 2011
Prognosis and Treatment......Page 2012
Ethanol and Heart Failure......Page 2013
Coronary Artery Disease......Page 2014
Sudden Death......Page 2015
Cocaine-Related Myocardial Ischemia and Infarction......Page 2016
Amphetamines......Page 2018
Inhalants......Page 2019
Lead......Page 2020
Alcohol......Page 2021
Environmental Exposure......Page 2022
Anthracyclines......Page 2023
Alkylating and Alkylating-Like Agents......Page 2025
ErbB Antagonists (Trastuzumab, Pertuzumab, T-DM1)......Page 2026
Vascular Endothelial Growth Factor Receptor Inhibitors......Page 2027
Radiation Therapy......Page 2028
Identifying Cancer Patients at Risk for Cardiovascular Disease......Page 2029
Cardioprotective Strategies Before and During Therapy......Page 2032
Cardiovascular Care of Cancer Survivors......Page 2033
Cardiovascular Care of the Cancer Patient......Page 2034
References......Page 2035
Lipid Abnormalities......Page 2036
Atherosclerosis in HIV Patients......Page 2037
Epidemiology......Page 2039
Antiretroviral Therapy and Cardiovascular Disease......Page 2040
Treatment of Hyperlipidemia in HIV Patients......Page 2041
Biomarkers and Signs of Coronary Disease in HIV Patients......Page 2042
Pulmonary Hypertension......Page 2043
Cardiomyopathy and Left Ventricular Abnormalities......Page 2044
Cardiovascular Risk Factors in HIV Patients......Page 2045
Other Cardiovascular Conditions in HIV Patients......Page 2046
Anatomy and Physiology of the Pericardium......Page 2047
History and Differential Diagnosis......Page 2049
Laboratory Testing......Page 2050
Diagnosis, Natural History, and Management......Page 2051
Pathophysiology and Hemodynamics......Page 2054
Laboratory Testing......Page 2057
Management......Page 2059
Clinical Presentation......Page 2062
Cardiac Catheterization and Angiography......Page 2063
Differentiating Constrictive Pericarditis from Restrictive Cardiomyopathy......Page 2065
Management......Page 2066
Nontuberculous Bacterial Pericarditis......Page 2067
Metastatic Pericardial Disease......Page 2068
Hemopericardium......Page 2069
Pericardial Effusion and Cardiac Tamponade......Page 2070
Specific Etiologies of Pericardial Disease......Page 2071
State-of-the-Art Findings in Pulmonary Embolism......Page 2072
Cardiopulmonary Dynamics......Page 2073
Submassive Pulmonary Embolism......Page 2074
Upper Extremity Deep Vein Thrombosis......Page 2075
Clinical Risk Factors......Page 2076
Clinical Presentation......Page 2077
Chest Radiography......Page 2078
Magnetic Resonance Imaging......Page 2079
Unfractionated Heparin......Page 2080
Heparin-Induced Thrombocytopenia......Page 2081
Managing Bleeding Complications from Anticoagulants......Page 2082
Aspirin for Extended-Duration Anticoagulation......Page 2083
Surgical Embolectomy......Page 2084
Chronic Thromboembolic Pulmonary Hypertension......Page 2085
Mechanical Prophylaxis in Medically Ill Patients......Page 2086
Classification of Pulmonary Embolism......Page 2087
Advanced Therapy......Page 2088
Prevention......Page 2089
Definition......Page 2090
Idiopathic Pulmonary Arterial Hypertension......Page 2092
Drug- and Toxin-Induced Pulmonary Arterial Hypertension......Page 2093
Echocardiogram......Page 2094
Treatment......Page 2099
Calcium Channel–Blocking Agents......Page 2100
Prostanoids......Page 2101
Soluble Guanylate Cyclase Stimulators......Page 2102
Longitudinal Assessment......Page 2103
Definition......Page 2105
Epidemiology and Natural History of Pulmonary Hypertension in Chronic Obstructive Pulmonary Disease......Page 2106
Treatment of Pulmonary Hypertension in Patients With Chronic Obstructive Pulmonary Disease......Page 2107
Group 4. Chronic Thromboembolic Pulmonary Hypertension......Page 2108
Pulmonary Hypertension Registries......Page 2110
References......Page 2111
Lymphangioleiomyomatosis......Page 2113
Metastatic Tumor Emboli......Page 2114
Cerebrovascular and Peripheral Arterial Disease (see also Chapters 64 and 65)......Page 2115
Oxidative Stress......Page 2116
Renin-Angiotensin System......Page 2117
Treatment and Medication Interactions......Page 2118
Bronchial Asthma......Page 2119
Lung Transplantation......Page 2120
Pathophysiology of Obstructive Sleep Apnea......Page 2121
Risk Factors for and Recognition of Sleep-Disordered Breathing......Page 2122
Sleep-Disordered Breathing and Hypertension......Page 2124
Sleep-Disordered Breathing and Coronary Heart Disease......Page 2126
Sleep-Disordered Breathing, Cardiac Function, and Heart Failure......Page 2127
Future Perspectives......Page 2128
Overview of Sleep-Disordered Breathing and Cardiovascular Disease......Page 2129
What Is Aging?......Page 2131
Vasculature......Page 2132
Resting Cardiac Function......Page 2133
Aerobic Exercise Capacity......Page 2134
Multimorbidity......Page 2135
Polypharmacy......Page 2136
Frailty......Page 2137
Disability......Page 2138
Presentation......Page 2139
Management (see also Chapter 62)......Page 2140
Care Following an Acute Coronary Syndrome; Discharge Planning......Page 2141
Diagnosis......Page 2142
Diuretics......Page 2143
Pharmacotherapy for Chronic HFpEF......Page 2144
Aortic Stenosis......Page 2145
Mitral Regurgitation......Page 2146
Atrial Fibrillation......Page 2147
Implantable Cardioverter-Defibrillators......Page 2148
Prognosis and Management Complexity......Page 2149
Diagnosis......Page 2150
Diagnosis and Management......Page 2151
Primary and Secondary Prevention of Stroke......Page 2152
Hypertension Management......Page 2153
Dyslipidemia......Page 2154
Cardiac Rehabilitation......Page 2155
Specific Complications and Their Management......Page 2156
Disease Management and Care Coordination......Page 2157
Palliative Care and End-of-Life Decisions......Page 2158
References......Page 2159
Hypertension (See also Chapters 46 and 47)......Page 2163
Metabolic Syndrome (See also Chapters 45 and 50)......Page 2164
Breast Cancer Therapy (See also Chapter 81)......Page 2165
Ischemic Heart Disease in Women......Page 2166
Diagnosis of Ischemic Heart Disease......Page 2167
Acute Coronary Syndrome and Angina......Page 2168
Microvascular Angina (See also Chapter 57)......Page 2169
Coronary Artery Bypass Grafting and Valve Surgery......Page 2170
Diagnosis of Heart Failure......Page 2171
Acknowledgments......Page 2172
References......Page 2173
Hemodynamic Changes of Pregnancy......Page 2176
Risk Stratification......Page 2177
Echocardiography......Page 2178
Labor and Delivery......Page 2179
Shunt Lesions......Page 2180
Complete Transposition of the Great Arteries......Page 2181
Marfan Syndrome (see also Chapter 75)......Page 2182
Mechanical Prostheses......Page 2183
Unfractionated Heparin.......Page 2184
Hypertrophic Cardiomyopathy (see also Chapter 78)......Page 2185
Coronary Artery Disease and Pregnancy-Associated Myocardial Infarction (see also Chapter 58)......Page 2186
Hypertension (see also Chapter 46)......Page 2187
Contraception......Page 2188
Specific Cardiovascular Conditions......Page 2189
Contraception......Page 2190
Hemodynamic Changes in Pregnancy......Page 2193
Cardiovascular Disease in Other Population Groups......Page 2195
Hypertension......Page 2196
Coronary Heart Disease......Page 2198
Heart Failure......Page 2199
Hypertension......Page 2200
Reimagining Challenges......Page 2201
Cardiovascular Manifestations of Acromegaly......Page 2202
Prolactin Disease......Page 2203
Cushing Disease and Cushing Syndrome......Page 2204
Addison Disease......Page 2205
Pheochromocytoma......Page 2206
Hypocalcemia......Page 2207
Cellular Mechanisms of Thyroid Hormone Action on the Heart......Page 2208
Diagnosis of Thyroid Function Disorders......Page 2209
Autoimmune Involvement of the Cardiovascular System in Patients with Graves’ Disease and Hashimoto Disease......Page 2210
Treatment of Overt Hyperthyroidism......Page 2211
Treatment of Overt Hypothyroidism......Page 2212
Subclinical Hypothyroidism......Page 2213
Amiodarone and Thyroid Function (see also Chapter 36)......Page 2214
Adrenal Function and Cardiovascular Disease......Page 2215
Thyroid Involvement in Cardiovascular Disease......Page 2216
Vascular Endothelium (see also Chapter 44)......Page 2217
Platelets......Page 2218
Platelet Aggregation......Page 2219
Fibrin Formation......Page 2220
Fibrinolytic System......Page 2221
Mechanism of Action of Thrombin-Activatable Fibrinolysis Inhibitor......Page 2222
Factor V Leiden......Page 2223
Other Hereditary Disorders......Page 2224
Sex Hormone Therapy (see also Chapter 92)......Page 2225
Mechanism of Action......Page 2226
Indications......Page 2227
Dipyridamole......Page 2228
Side Effects......Page 2229
Pharmacology of Heparin.......Page 2230
Bleeding.......Page 2231
Pharmacology of Low-Molecular-Weight Heparin.......Page 2232
Side Effects.......Page 2233
Pharmacology.......Page 2234
Dosages.......Page 2235
Dosages.......Page 2236
Management of Bleeding.......Page 2237
Streptokinase......Page 2238
Alteplase......Page 2239
Antiplatelet Agents......Page 2240
Anticoagulants......Page 2241
Endothelial Dysfunction and Vascular Injury......Page 2242
Atherosclerosis and Systemic Lupus Erythematosus......Page 2243
Atherosclerosis in Association With Other Rheumatic Diseases......Page 2244
Takayasu Arteritis......Page 2245
Diagnosis......Page 2246
Idiopathic Aortitis......Page 2247
Treatment of Large-Vessel Vasculitis......Page 2248
Eosinophilic Granulomatosis With Polyangiitis (Churg-Strauss Syndrome)......Page 2249
Treatment......Page 2250
Systemic Sclerosis......Page 2251
Systemic Sclerosis......Page 2252
Treatment......Page 2253
Systemic Sclerosis......Page 2254
Clinical Findings and Diagnosis......Page 2255
Antiphospholipid Syndrome (see also Chapter 93)......Page 2256
Treatment......Page 2257
Glucocorticoids......Page 2258
Future Perspectives......Page 2259
References......Page 2260
Classification of Cardiac Tumors......Page 2261
Benign Primary Cardiac Tumors......Page 2262
Treatment......Page 2264
Other Rare Benign Cardiac Tumors......Page 2266
Clinical Manifestations......Page 2268
Secondary Cardiac Tumors......Page 2269
Treatment......Page 2270
Clinical Diagnosis......Page 2272
Future Perspectives......Page 2273
Malignant Primary Cardiac Tumors......Page 2274
Direct and Indirect Complications of Neoplasia......Page 2275
96 Psychiatric and Behavioral Aspects of Cardiovascular Disease......Page 2276
Stressful and Emotional Triggers of Acute Cardiovascular Events (See Also Chapter 51)......Page 2277
Acute Stress and Cardiovascular Disease: Clinical Implications......Page 2278
Adverse Childhood Experiences......Page 2279
Depression......Page 2280
Mental Health and Psychiatric Disorders: Clinical Implications......Page 2281
General Considerations......Page 2282
Selective Serotonin Reuptake Inhibitors......Page 2283
Benzodiazepine Medications......Page 2284
References......Page 2285
Evaluation and Management of Mental Health in the Cardiac Patient......Page 2286
Cardiovascular Manifestations......Page 2287
Imaging......Page 2289
Genetics......Page 2290
Treatment and Prognosis......Page 2291
Cardiovascular Manifestations......Page 2293
Genetics......Page 2296
Genetics......Page 2297
Cardiovascular Manifestations......Page 2298
Treatment and Prognosis......Page 2299
Genetics and Clinical Presentation......Page 2300
Treatment and Prognosis......Page 2301
Treatment and Prognosis......Page 2302
Cardiovascular Manifestations......Page 2303
Treatment and Prognosis......Page 2304
Acute Cerebrovascular Disease......Page 2306
Chronic Kidney Disease and Cardiovascular Risk......Page 2307
Implications of Anemia Due to Chronic Kidney Disease......Page 2308
Prevention of Contrast-Induced Acute Kidney Injury......Page 2310
Cardiac Surgery and Acute Kidney Injury......Page 2311
Renal Disease and Hypertension......Page 2313
Renal Dysfunction as a Prognostic Factor in Acute Coronary Syndromes......Page 2314
Reasons for Poor Outcomes After Acute Coronary Syndromes in Patients with Renal Dysfunction......Page 2315
Treatment of Myocardial Infarction in Patients With Renal Dysfunction (see also Chapters 59 and 60)......Page 2316
Cardiorenal Syndromes......Page 2319
Renal Function and Arrhythmias......Page 2321
Consultative Approach to Severe Kidney Disease and Hemodialysis Patients......Page 2322
Evaluation and Management of the Renal Transplant Recipient......Page 2324
References......Page 2325
Arterial Baroreceptors......Page 2327
Chemoreflexes and the Diving Reflex......Page 2328
Valsalva Maneuver......Page 2329
Plasma Catecholamines......Page 2331
Autonomic Disorders......Page 2332
Baroreflex Failure......Page 2333
Congenital Disorders of Autonomic Function with Symptoms Present From Birth......Page 2334
The Synucleinopathies......Page 2336
Multiple System Atrophy.......Page 2339
Autoimmune Autonomic Failure......Page 2341
Guillain-Barré Syndrome......Page 2342
Norepinephrine Transporter Deficiency......Page 2343
Overview of Autonomic Circulatory Control......Page 2345
Future Perspectives......Page 2346
Institution and Company Codes......Page 2347
Contributors......Page 2349