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دانلود کتاب Braunwald’s Heart Disease, 2 Vol Set: A Textbook of Cardiovascular Medicine
دانلود کتاب بیماری قلبی براونوالد، مجموعه 2 جلدی: کتاب درسی پزشکی قلب و عروق
مشخصات کتاب
Braunwald’s Heart Disease, 2 Vol Set: A Textbook of Cardiovascular Medicine
ویرایش: 12 نویسندگان: Peter Libby MD PhD, Robert O. Bonow MD MS, Douglas L. Mann MD, Gordon F. Tomaselli MD, Deepak Bhatt MD MPH FACC FAHA FSCAI FESC, Scott D. Solomon MD, Eugene Braunwald MD MD(Hon) ScD(Hon) FRCP سری: ISBN (شابک) : 0323722199, 9780323722193 ناشر: Elsevier سال نشر: 2021 تعداد صفحات: 2549 زبان: English فرمت فایل : PDF (درصورت درخواست کاربر به PDF، EPUB یا AZW3 تبدیل می شود) حجم فایل: 475 مگابایت
قیمت کتاب (تومان) : 38,000
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توجه داشته باشید کتاب بیماری قلبی براونوالد، مجموعه 2 جلدی: کتاب درسی پزشکی قلب و عروق نسخه زبان اصلی می باشد و کتاب ترجمه شده به فارسی نمی باشد. وبسایت اینترنشنال لایبرری ارائه دهنده کتاب های زبان اصلی می باشد و هیچ گونه کتاب ترجمه شده یا نوشته شده به فارسی را ارائه نمی دهد.
توضیحاتی در مورد کتاب بیماری قلبی براونوالد، مجموعه 2 جلدی: کتاب درسی پزشکی قلب و عروق
بیماری قلبی برونوالد کنونی، جامع و مبتنی بر شواهد، قابل اعتمادترین مرجع در این زمینه و منبع اصلی اطلاعات قابل اعتماد قلب برای پزشکان و کارآموزان در سراسر جهان است. نسخه دوازدهم کاملاً به روز شده، سنت برتری را با پوششی قابل اعتماد و پیشرفته از داروهای جدید، دستورالعمل های جدید، روش های تصویربرداری قدرتمندتر، و پیشرفت های اخیر در پزشکی دقیق ادامه می دهد که همچنان در حال تغییر هستند. و عمل پزشکی قلب و عروق را پیش ببرند. این متن برنده جایزه که توسط متخصصان جهانی در این زمینه نوشته و ویرایش شده است مرجع چندرسانه ای بی نظیر برای هر جنبه از این منطقه پیچیده و سریع در حال تغییر است.
- پیشنهادات. محتوای متعادل و قابل اعتماد در علم بالینی که به سرعت در حال تغییر است، تحقیقات بالینی و ترجمه، و پزشکی مبتنی بر شواهد.
- شامل 76 نویسنده مشارکت کننده جدید و 14 فصل جدید که هوش مصنوعی در پزشکی قلبی عروقی را پوشش می دهد. پوشیدنی ها؛ آنفولانزا، بیماری های همه گیر، COVID-19، و بیماری های قلبی عروقی؛ تنباکو و فرآورده های نیکوتین در بیماری های قلبی عروقی. آمیلوئیدوز قلبی؛ تأثیر محیط بر سلامت قلب و عروق و موارد دیگر.
- دارای فصل مقدماتی جدید بیماری قلبی عروقی: گذشته، حال و آینده توسط یوجین براونوالد، MD، رویکرد منحصر به فرد و رویایی خود را در زمینه قلب و عروق ارائه می دهد. دکتر براونوالد همچنین به‌روزرسانی‌های آنلاین گسترده و دوماهانه را مدیریت می‌کند که شامل \"Hot Off the Press\" (با پیوندهایی به Practice Update) و \"Late-Breaking Clinical Trials \".
- پوشش نوینی از موضوعات کلیدی مانند پروتئومیکس و متابولومیک، TAVR، دیابت قلب، و قلب و عروق.
- حاوی 1850 تصویر با کیفیت بالا، تصاویر رادیوگرافی، الگوریتم‌ها و نمودارها و دسترسی به 215 ویدئو< /b> با نمادهایی در نسخه چاپی فراخوانی شد.
- آخرین دستورالعمل‌های AHA، ACC، و ESC را برجسته می‌کند تا به وضوح معیارهای تشخیصی و بالینی را خلاصه کند. مفاهیم.
- محتوای کاملاً ویرایش شده و متمرکز را برای مرجع سریع و قابل اعتماد ارائه می دهد. گزینه‌های قالب انعطاف‌پذیر شامل یک یا دو جلد در چاپ، و همچنین یک کتاب الکترونیکی قابل جستجو با به‌روزرسانی‌های مداوم است.
- نسخه کتاب الکترونیکی پیشرفته همراه با خرید ارائه می‌شود. کتاب الکترونیکی پیشرفته شما به شما امکان می دهد به تمام متن، شکل ها و مراجع کتاب در دستگاه های مختلف دسترسی داشته باشید.
توضیحاتی درمورد کتاب به خارجی
Current, comprehensive, and evidence-based Braunwald’s Heart Disease remains the most trusted reference in the field and the leading source of reliable cardiology information for practitioners and trainees worldwide. The fully updated 12th Edition continues the tradition of excellence with dependable, state-of-the-art coverage of new drugs, new guidelines, more powerful imaging modalities, and recent developments in precision medicine that continue to change and advance the practice of cardiovascular medicine. Written and edited by global experts in the field, this award-winning text is an unparalleled multimedia reference for every aspect of this complex and fast-changing area.
- Offers balanced, dependable content on rapidly changing clinical science, clinical and translational research, and evidence-based medicine.
- Includes 76 new contributing authors and 14 new chapters that cover Artificial intelligence in Cardiovascular Medicine; Wearables; Influenza, Pandemics, COVID-19, and Cardiovascular Disease; Tobacco and Nicotine Products in Cardiovascular Disease; Cardiac Amyloidosis; Impact of the Environment on Cardiovascular Health, and more.
- Features a new introductory chapter Cardiovascular Disease: Past, Present, and Future by Eugene Braunwald, MD, offering his unique, visionary approach to the field of cardiology. Dr. Braunwald also curates the extensive, bimonthly online updates that include "Hot Off the Press" (with links to Practice Update) and "Late-Breaking Clinical Trials".
- Provides cutting-edge coverage of key topics such as proteomics and metabolomics, TAVR, diabetocardiology, and cardio-oncology.
- Contains 1,850 high-quality illustrations, radiographic images, algorithms, and charts, and provides access to 215 videos called out with icons in the print version.
- Highlights the latest AHA, ACC, and ESC guidelines to clearly summarize diagnostic criteria and clinical implications.
- Provides tightly edited, focused content for quick, dependable reference. Flexible format options include either one or two volumes in print, as well as a searchable eBook with ongoing updates.
- Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.
فهرست مطالب
Cover Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine Copyright Dedication Contributors Preface Preface to the First Edition Acknowledgments Contents Video Contents Part I: Foundations of Cardiovascular Medicine Chapter 1: Cardiovascular Disease: Past, Present, and Future The Birth Emergence of a Specialty Cardiac Imaging The Past The Present Invasive Procedures Cardiac Catheterization Percutaneous Coronary Intervention Cardiovascular Surgery Comments Hypertension The Past (null) Valvular Heart Disease The Past The Present Transcatheter Aortic Valve Replacement Arrhythmias The Past The Present Dyslipidemias The Past (null) Acute Myocardial Infarction Coronary Risk Factors Heart Failure The Past The Present Assisted Circulation The Past (null) Genomics and Genetics The Present (null) Primordial Prevention The Present The Future Inflammation The Past (null) Clonal Hematopoiesis Artificial Intelligence The Present The Future Conclusions References Chapter 2: Global Burden of Cardiovascular Disease Shifting Burden Epidemiologic Transitions Stage of Inactivity and Obesity: A Fifth Phase Different Patterns of Epidemiologic Transition Current Variations in the Global Burden High-Income Countries East Asia and Pacific Demographic and Social Indices Burden of Disease Central and Eastern Europe and Central Asia Demographic and Social Indices Burden of Disease Latin America and the Caribbean Demographic and Social Indices Burden of Disease North Africa and Middle East Demographic and Social Indices Burden of Disease South Asia Demographic and Social Indices Burden of Disease Sub-Saharan Africa Demographic and Social Indices Burden of Disease Risk Factors Tobacco Hypertension Lipids Diabetes Obesity Diet Physical Inactivity Aging Populations Genetic Fetal Influences Environmental Exposures Economic Burden CostEffective Solutions Established Cardiovascular Disease Management Risk Assessment Policy and Community Interventions Tobacco Use Salt, Dietary, and Lipid Reductions Summary and Conclusion References Chapter 3: Impact of the Environment on Cardiovascular Health Global Footprint and Impact of Pollutants on Human Health Air Pollution Composition and Sources of Air Pollution Particulate Air Pollutants Gaseous Pollutants Particulate Matter Sources, Composition, and Cardiovascular Risk Household Versus Ambient Air Pollution Assessment of Exposure Exposure-Response Function of Air Pollution, Mortality, and Cardiovascular Events Cardiovascular and Metabolic Effects of Air Pollution Ischemic Heart Disease and Cerebrovascular Events Blood Pressure and Hypertension Insulin Resistance and Diabetes Heart Failure Arrhythmia Venous Thromboembolism Chronic Kidney Disease Mechanistic Insights Into Air-Pollution and Cardiovascular Risk Windows of Exposure, Susceptibility, and Vulnerability Air Pollution Alerts and Approaches to Communicate Risk Societal and Personal Strategies to Mitigate Cardiovascular Effects of Air Pollution Climate Change Noise Pollution and Cardiovascular Disease Synthetic Chemicals and Cardiovascular Disease Metallic Pollutants and Cardiovascular Disease Challenges and Outlook For the Future References Chapter 4: Clinical Trials in Cardiovascular Medicine Clinical Trials Versus Other Types of Studies Components of Clinical Trials Rationale and Study Background Study Design Study Execution Randomization Blinding (Masking) Inclusion and Exclusion Criteria Endpoints or “Response Variables” Statistical Considerations in Trials Analysis of Primary and Secondary Endpoints Power and Sample Size Ethical Considerations and Informed Consent Equipoise in Clinical Trials Randomization to Placebo and Standard of Care Potential for Harm in Clinical Trials Monitoring of Data and Data Safety Novel Approaches to Clinical Trial Design and Execution Pragmatic (Large Simple) Trials Use of Electronic Medical Records in Clinical Trials Adaptive Designs Interpretation of Clinical Trials Registration and Reporting of Clinical Trials Understanding the Primary Results Secondary Endpoints Interpretation of Subgroups Post-hoc Analyses Conclusion References Chapter 5: Clinical Decision-Making in Cardiology Diagnostic Decisions Therapeutic Decisions Deciding When to Change Clinical Practice Based on New Clinical Research Findings Shared Decision-Making Monitoring the Quality of Clinical Decisions System 1 and System 2 Thinking Teaching Clinical Reasoning Conclusion Classic References References Online-Supplemental References Chapter 6: Impact of Health Care Policy on Quality, Outcomes, and Equity in Cardiovascular Disease What is Health Policy Insurance Coverage and Access Policy Payment and Delivery System Policy to Improve Quality and Reduce Costs Public Reporting Value-Based Payment Programs: Hospitals Value-Based Purchasing: Outpatient Alternative Payment Models Inequities in Cardiovascular Disease Risk, Care, and Outcomes Racial and Ethnic Minorities Income Urban-Rural Geography Conclusions References Part II: Individualizing Approaches to Cardiovascular Disease Chapter 7: Applications of Genetics to Cardiovascular Medicine Key Principles of Human Genetics Central Dogma Heritability Genetic Architecture Genetic Variation Characterizing Human Genetic Variation Gene Discovery Family-Based Studies Hypercholesterolemia and Coronary Artery Disease Metabolic Syndrome and Coronary Artery Disease Case-Control and Population-Based Studies Genome-Wide Association Studies for Lipids Genome-Wide Association Studies for Coronary Artery Disease Population-Based Discovery of Rare Protein-Coding Variants Associated with Coronary Artery Disease Causal Inference of Epidemiologic Associations Mendelian Randomization Principles and Applications Causal Inference for Lipoproteins Causal Inference for Adiposity Mendelian Randomization Assumption Assessments Disease Risk Prediction Pathogenicity Assessments and Monogenic Risk Monogenic Coronary Artery Disease Polygenic Risk Scoring Polygenic Coronary Artery Disease Therapeutic Response Prediction Target Discovery and Clinical Trial Prediction On-Target Therapeutic Side Effect Prediction Precision Medicine CYP2C19 Familial Hypercholesterolemia Polygenic Coronary Artery Disease Next-Generation Technologies and Therapeutics Somatic Genomics Epigenetics Single-Cell Ribonucleic Acid Sequencing Therapeutically Targeting the Genome Future Perspectives References Chapter 8: Proteomics and Metabolomics in Cardiovascular Medicine Novel Technologies in the Identification of Biomarkers Introduction to Proteomics and Metabolomics Analytic Challenges for Proteomics and Metabolomics Overview of the Discovery Process Applications of Mass Spectrometry–Based Discovery to Cardiometabolic Disease Future Directions in Biomarker Discovery References Chapter 9: Principles of Drug Therapeutics, Pharmacogenomics, and Biologics Risk Versus Benefit of Drug Therapy Clinical Trials Can Define Unexpected Adverse Drug Reactions Classes of Adverse Drug Reactions Pharmacokinetics and Pharmacodynamics Molecular and Genetic Basis for Variable Drug Response High-Risk Pharmacokinetics Other Important Pharmacogenetic Effects Optimizing Drug Doses Plasma Concentration Monitoring Dose Adjustments in Disease Drug Interactions Incorporating Pharmacogenetic Information into Prescribing Future Perspectives References Chapter 10: Biomarkers and Use in Precision Medicine Overview of Biomarkers Clinical Applications of Cardiovascular Biomarkers Novel Technologies in Biomarker Identification Clinical Measures of Biomarker Performance Sensitivity, Specificity, and Positive and Negative Predictive Value Discrimination, C-Statistics, and Receiver Operating Characteristic Curve Accuracy and Calibration Risk Reclassification External Validation and Impact Studies Practical Example: High-Sensitivity C-Reactive Protein, Lipids, and Reynolds Risk Score Conclusion References (null) Part III: Evaluation of the Patient Chapter 13: History and Physical Examination: An Evidence-Based Approach The History The General Physical Examination General Appearance Skin Head and Neck Extremities Chest and Abdomen The Cardiovascular Examination Jugular Venous Pressure and Waveform Measuring the Blood Pressure Assessing the Pulses Inspection and Palpation of the Heart Auscultation of the Heart Heart Sounds First Heart Sound (S1) Second Heart Sound (S2) Systolic Sounds Diastolic Sounds Cardiac Murmurs Systolic Murmurs Diastolic Murmurs Continuous Murmurs Dynamic Auscultation Integrated, Evidence-Based Approach to Specific Cardiac Disorders Heart Failure History Physical Examination Jugular Venous Pressure Third and Fourth Heart Sounds Rales and Edema Valsalva Maneuver Other Findings Patient with a Left Ventricular Assist Device Valvular Heart Disease Mitral Stenosis Mitral Regurgitation Aortic Stenosis Aortic Regurgitation Tricuspid Valve Disease Pulmonic Valve Disease Prosthetic Heart Valves Acute Coronary Syndromes Pericardial Disease Pericarditis Pericardial Tamponade Constrictive Pericarditis Future Directions Acknowledgments References Chapter 14: Electrocardiography The Normal Electrocardiogram Atrial Activation and the P Wave Atrial Activation and the Normal P Wave Atrial Repolarization Heart Rate Variability Atrioventricular Node Conduction and the PR Segment Ventricular Activation and the QRS Complex Normal QRS Complex The Normal ST-T Wave The QT Interval Other Repolarization Waves The U Wave The J Wave Normal Variants The Abnormal Electrocardiogram Chamber Enlargement and Hypertrophy Atrial Abnormalities Left Atrial Abnormality Diagnostic Criteria Right Atrial Abnormality Left Ventricular Hypertrophy Diagnostic Criteria Clinical Significance Right Ventricular Hypertrophy Diagnostic Criteria Clinical Significance Biventricular Hypertrophy Intraventricular Conduction Delays Fascicular Blocks Left Anterior Fascicular Block Left Posterior Fascicular Block Other Forms of Fascicular Block Left Bundle Branch Block Electrocardiogram Abnormalities Clinical Significance Right Bundle Branch Block Electrocardiogram Abnormalities Clinical Significance Multifascicular Blocks Myocardial Ischemia and Infarction Repolarization (ST-T Wave) Abnormalities QRS Changes Evolution of Electrocardiogram Changes Other Ischemic ST-T Patterns Electrocardiogram Localization of Myocardial Ischemia and Infarction Electrocardiogram Diagnosis of Myocardial Infarction with Bundle Branch Blocks Atrial Infarction Electrocardiogram Differential Diagnosis of Ischemia and Infarction Noninfarction Q Waves and Related Depolarization Changes ST-T Changes Simulating Ischemia and Infarction Drug Effects Electrolyte and Metabolic Abnormalities Calcium Potassium Clinical Issues in Electrocardiographic Interpretation Indications Reading Competency Technical Errors Computer Interpretation Future Perspectives References Guidelines: Electrocardiography Patients Without Known or Suspected Cardiovascular Disease Patients with Known or Suspected Cardiovascular Disease Special Populations Persons with Dangerous or Physically Demanding Occupations Preoperative Evaluation Screening of Athletes Cardioactive Drug Administration References Chapter 15: Exercise Physiology and Exercise Electrocardiographic Testing Exercise Physiology Total-Body Oxygen Uptake Myocardial Oxygen Demand and Supply Relationships During Exercise Technical Components of Exercise Testing Patient Preparation Patient Assessment Symptom Rating Scales Electrocardiographic Lead Systems Exercise Test Modality and Protocols Exercise Test Supervision Risks of Exercise Testing Exercise Testing in Coronary Artery Disease Exercise-Induced Symptoms Functional Capacity ST-Segment Changes ST Depression Upsloping ST Depression Lead aVR ST Elevation ST Adjustments ST Elevation Pharmacologic Influences on Interpretation Digitalis Glycosides Beta Adrenoreceptor Blockers Diagnostic Value Sensitivity and Specificity Positive and Negative Predictive Values Pre-Test and Post-Test Probability of Disease Assessment of Anatomic and Functional Extent of Disease Testing in Women Prognostic Value Predictive Variables Post–Myocardial Infarction Evaluation Preoperative Evaluation in Noncardiac Surgery Assessment of Therapy Exercise Testing in Nonatherosclerotic Heart Disease Valvular Heart Disease Aortic Stenosis Severe Acquired Aortic Valve Stenosis Moderate to Severe Congenital Valvular Aortic Stenosis Mitral Regurgitation Hypertrophic Cardiomyopathy Adult Congenital Heart Disease Additional Uses for Exercise Testing Chest Pain Units Physical Activity and Exercise Prescription Evaluation of Peripheral Artery Disease Patients with Diabetes Summary Acknowledgment Classic References References Chapter 16: Echocardiography Principles of Ultrasound and Instrumentation Principles of Image Generation Physical Principles of Ultrasound Doppler Echocardiography in Practice Assessment of Flow and Continuity Equation The Standard Adult Transthoracic Echocardiographic Examination M-Mode Echocardiography Assessment of Cardiac Structure and Function Left Ventricular Structure: Size and Mass Left Ventricular Systolic Function Left Ventricular Diastolic Function Mitral Inflow Patterns Doppler Tissue Imaging Pulmonary Venous Doppler Flow Patterns Color M-Mode and Flow Propagation Assessing Diastolic Function in Clinical Practice Right Ventricular Structure and Function Left and Right Atria Transesophageal Echocardiography The Standard Transesophageal Echocardiographic Examination Three-Dimensional Echocardiography Ultrasound Enhancing Agents Myocardial Infarction Practical Considerations in Assessment of Regional Wall Motion Echocardiographic Prognostic Indicators After Myocardial Infarction Cardiomyopathies Dilated Cardiomyopathy Hypertrophic Cardiomyopathy Other Cardiomyopathies With Regional or Global Variations in Myocardial Composition Left Ventricular Noncompaction Arrhythmogenic Cardiomyopathy Restrictive Cardiomyopathies Heart Failure Assessment of Ventricular Synchrony Assessment After Orthotopic Heart Transplantation Lung Ultrasound in Heart Failure The Athlete’s Heart Stress Echocardiography Limitations of Stress Echocardiography Risk Stratification with Stress Echocardiography Assessment of Myocardial Viability Coronary Flow Reserve and Perfusion Stress Echocardiography in Valvular Heart Disease Valvular Heart Disease Mitral Valve Mitral Stenosis Echocardiographic Features Quantification of Severity Patient Selection for Balloon Valvuloplasty Mitral Regurgitation Primary (Degenerative) Mitral Regurgitation Secondary (Functional) Mitral Regurgitation Quantitation of Mitral Regurgitation Aortic Valve Aortic Stenosis Quantitation of Severity Low-Gradient Severe Aortic Stenosis Aortic Regurgitation Tricuspid Valve Acquired Disorders of the Tricuspid Valve Quantitation of Tricuspid Regurgitation Pulmonic Valve Quantitation of Valve Dysfunction Prosthetic Valves Pericardial Disease Pericardial Effusion Pericardial Hematoma Constrictive Pericarditis Diseases of the Aorta Focal Aortopathies Aortic Emergencies Pulmonary Hypertension Infective Endocarditis Role of Echocardiography in Surgery for Endocarditis Cardiac Masses Secondary Tumors Alternative Diagnoses Pseudoneoplasms Intracardiac Thrombus Adult Congenital Heart Disease Atrial Septal Defect Secundum Atrial Septal Defect Primum Atrial Septal Defect Sinus Venosus Atrial Septal Defect Coronary Sinus Atrial Septal Defect Ventricular Septal Defect Membranous (Paramembranous) and Outlet Ventricular Septal Defects Inlet Ventricular Septal Defects Muscular Ventricular Septal Defects Transcatheter Interventions Future Directions Multimodality and Fusion Imaging Handheld Echocardiography (Point of Care Ultrasound) Recent Echocardiography Techniques Artificial Intelligence References Appropriate Use Criteria: Echocardiography References Chapter 17: Chest Radiography in Cardiovascular Disease Overview PA and Lateral CXR Approach to CXR Evaluation Radiographic Densities CXR Anatomy PA Radiograph Lateral Radiograph Common Anatomic Variants Azygous Lobe Variant Aortic Arch Variants Localization Within Cardiac Silhouette Fat Calcifications Pulmonary Vasculature Support Lines and Devices Specific Cardiovascular Conditions Congenital Heart Disease Acquired Heart Disease Valvular Heart Disease Coronary Artery Disease Heart Failure Advanced Imaging in ICU References Chapter 18: Nuclear Cardiology Principles of Imaging Single Photon Emission Computed Tomography Conventional SPECT Novel Image Reconstruction Software Novel SPECT Scanners Positron Emission Tomography Hybrid SPECT/CT, PET/CT, and PET/MR SPECT and PET Image Acquisition Radiotracers and Protocols Physiologic Basis for Stress Testing Stress Testing Protocols Exercise Stress Pharmacologic Stress Imaging Protocols General Principles SPECT Protocols Myocardial Perfusion Imaging Transthyretin Cardiac Amyloidosis Imaging PET Protocols Myocardial Perfusion Imaging 18F-FDG Metabolic Imaging Protocols Reducing Radiation Dose Patient-Centered Clinical Applications Ischemic Heart Disease Principles of Perfusion Imaging Suspected Stable Coronary Artery Disease Patients with New-Onset Chest Pain Risk Stratification with Radionuclide Myocardial Perfusion Imaging Symptomatic Patients Without Angiographic Obstructive Coronary Artery Disease Evaluation Before Organ Transplantation Suspected Acute Coronary Syndrome Patients with Nondiagnostic Electrocardiogram and Troponin Elevation Patients with Known Stable Coronary Artery Disease Patients with Prior PCI and Recurrent Symptoms Patients with Recent Myocardial Infarction Evaluated for Potential Staged PCI Patients with Prior Myocardial Infarction and Ventricular Arrhythmias Patients with Chronic Total Coronary Artery Occlusion Heart Failure and Cardiomyopathies Patients with Newly Diagnosed Left Ventricular Systolic Dysfunction Patients with Ischemic Cardiomyopathy and Heart Failure Pathophysiology of Ischemic Left Ventricular Dysfunction Radionuclide Imaging Approaches to Assess Myocardial Ischemia and Viability Myocardial Viability Imaging to Guide Revascularization in Patients with Ischemic Heart Failure Infiltrative Cardiomyopathy: Amyloidosis Inflammatory Cardiomyopathy: Sarcoidosis Infective Endocarditis Cardio-Oncology Assessment of Ventricular Function Evaluation of Coronary Artery Disease Evaluation of Primary or Metastatic Cardiac Neoplasms Machine Learning and Artificial Intelligence Translational Molecular Imaging Aortic Valve Disease References Chapter 19: Cardiovascular Magnetic Resonance Imaging Principles of Magnetic Resonance Imaging Basic Physics of Magnetic Resonance Imaging Clinical Applications of CMR Coronary Artery Disease Assessing Stable Chest Pain Syndromes CMR Assessment of Myocardial Viability and Benefit from Coronary Revascularization Cardiomyopathies Overall Approach to Undiagnosed Cardiomyopathy Hypertrophic Cardiomyopathy Arrhythmogenic Cardiomyopathy Myocarditis Cardiac Sarcoidosis Cardiac Amyloidosis Idiopathic Dilated Cardiomyopathy Other Cardiomyopathies Valvular Heart Disease Aortic Stenosis Aortic Regurgitation Mitral Regurgitation Tricuspid Regurgitation Pericardial Disease Novel CMR Imaging Techniques and Future Perspectives References Chapter 20: Cardiac Computed Tomography Basics of Cardiac Computed Tomography Different Types of Cardiac Computed Tomography Exams Coronary Artery Calcium Testing Test Performance and Acquisition Clinical Data Special Populations Clinical Indications and Management Recommendations Clinical Indications Management Recommendations Limitations of Coronary Artery Calcium Testing Coronary Computed Tomography Angiography Diagnostic Accuracy Prognostic Implications Plaque Burden and Prognosis Coronary Computed Tomography Angiography in Acute Chest Pain Coronary Computed Tomography Angiography in Non–ST Elevation Myocardial Infarction Coronary Computed Tomography Angiographyin Stable Chest Pain Selecting Appropriate Candidates for Coronary Computed Tomography Angiography Pretest Probability of Obstructive Coronary Artery Disease Patient Outcomes Following Coronary Computed Tomography Angiography Hard Clinical Outcomes Use of Invasive Angiography Following Coronary Computed Tomography Angiography Coronary Computed Tomography Angiography Plaque Characteristics High-Risk Plaque Characteristics Low-Attenuation Plaque Positive Remodeling Napkin-Ring Sign Spotty Calcifications Plaque Characteristics and Incident Risk Perivascular Fat Attenuation Physiologic Evaluation of Coronary Artery Disease Computed Tomography Fractional Flow Reserve Diagnostic Accuracy Clinical Effectiveness Coronary Tomography Perfusion Stress Computed Tomography Perfusion Comparing and Integrating Different Techniques Implications of the ISCHEMIA Trial for Coronary Computed Tomography Angiography Patient Management Considerations Patient Management Recommendations Special Populations Guidelines Assessment of Cardiovascular Structure and Function Pericardial and Myocardial Disease Valvular Heart Disease Shunts Use of Cardiac Computed Tomography for Structural Heart Disease Interventions Pre-Transcatheter Aortic Valve Replacement Post-Transcatheter Aortic Valve Replacement Evaluation Pre-Transcatheter Mitral Valve Replacement Evaluation of Left Atrial Appendage (for Thrombus, Pre-Left Atrial Appendage Occlusion Devices) Evaluation of Cardiac Masses Future Directions References Chapter 21: Coronary Angiography and Intravascular Imaging Indications for Coronary Angiography Appropriate Use Criteria Coronary Arteriography Technique Patient Preparation Access Sites Basic Technique Catheters for Diagnostic Procedures Ventriculography Left Ventriculography Aortography Right Ventriculography Selection of Contrast Media Automatic and Manual Injection of Contrast Media Angiographic Projections Coronary Anatomy Coronary Artery Anomalies Pitfalls of Coronary Angiography Myocardial Bridging Coronary Artery Spasm Angiogram Evaluation Syntax Score Quantification of the Stenosis Evaluation of Microvascular Blood Flow Special Lesion Considerations Chronic Total Occlusion Calcific Lesions Thrombotic Lesions Bifurcation Lesions Coronary Dissections Coronary Intravascular Imaging Intravascular Ultrasound Procedure Interpretation Clinical Data Plaque Lipid Core Detection Optical Coherence Tomography Clinical Applications Normal Vessel Wall Stable Coronary Artery Disease Plaque Morphology Acute Coronary Syndrome Procedure Planning and Lesion Preparation Assessment After Percutaneous Coronary Intervention Co-registration of Intravascular Imaging and X-Ray Angiography for Patients Undergoing Percutaneous Coronary Intervention Acknowledgments Classic References References Chapter 22: Invasive Hemodynamic Diagnosis of Cardiac Disease Introduction to Invasive Hemodynamic Diagnosis of Cardiac Disease Indications for Cardiac Catheterization and Hemodynamic Assessment Complications and Risks Vascular Access Arterial Access Percutaneous Radial Artery Technique Percutaneous Femoral Artery Technique Venous Access Percutaneous Femoral Vein Access Percutaneous Brachial Vein Access Percutaneous Internal Jugular Vein Access Transseptal Catheterization Left-Heart Catheterization Right-Heart Catheterization Technical Aspects and Artifacts of Pressure Measurements Fluid-Filled Pressure Systems Micromanometer Catheters and Pressure Sensor Guidewires Computations for Hemodynamic Measurements Cardiac Output Measurements Thermodilution Method Fick Method Normal Right and Left Heart Waveforms and Valvular Hemodynamics Including HOCM (LVOT Gradients) The Cardiac Cycle and Generation of Pressure Waves Normal Pressure Waveforms Atrial Pressures Pulmonary Capillary Wedge Pressure Aortic and Pulmonary Artery Pressure Waveforms Ventricular Pressure Waveforms Evaluation of Valvular Heart Disease Calculation of Stenotic Valve Orifice Areas Aortic Valve Stenosis Low-Flow, Low-Gradient Aortic Stenosis Hypertrophic Obstructive Cardiomyopathy Mitral Valve Stenosis Pulmonary and Tricuspid Valve Stenosis Aortic Regurgitation Mitral Regurgitation Pulmonary and Tricuspid Valve Regurgitation Septal Defects and Left-to-Right/Right-to-Left Shunts Pericardial Disease and Restrictive Cardiomyopathy Normal Pericardial Function and Pathophysiology of Constriction Cardiac Tamponade Physiologic and Pharmacologic Maneuvers and PV Loops Exercise Provocation Dynamic Exercise Static Exercise Pacing Tachycardia Physiologic Maneuvers and Volume Challenge Pharmacologic Challenges Dobutamine Isoproterenol Pulmonary Vasodilators Nitric Oxide Nitroprusside Pressure-Volume (PV) Relationships Acknowledgment References Chapter 23: Anesthesia and Noncardiac Surgery in Patients with Heart Disease Assessment of Risk Ischemic Heart Disease Hypertension Heart Failure Hypertrophic Cardiomyopathy The Decision to Undergo Diagnostic Testing Risk Calculators Tests to Improve Identification and Definition of Cardiovascular Disease Overview of Anesthesia for Cardiac Patients Undergoing Noncardiac Surgery Regional Anesthesia Monitored Anesthesia Care Intraoperative Hemodynamics and Myocardial Ischemia Postoperative Management Postoperative Response to Surgery Surveillance and Implications of Perioperative Cardiac Complications Strategies to Reduce the Risk Associated with Noncardiac Surgery Coronary Artery Revascularization Percutaneous Coronary Intervention and Noncardiac Surgery Pharmacologic Interventions Beta-Adrenergic Blocking Agents Statin Therapy Other Therapies Conclusion Classic References References Part IV: Preventive Cardiology Chapter 24: The Vascular Biology of Atherosclerosis Overview and Background Structure of the Normal Artery Cell Types Composing the Normal Artery Endothelial Cells Arterial Smooth Muscle Cells Layers of the Normal Artery Intima Tunica Media Adventitia Atherosclerosis Initiation Extracellular Lipid Accumulation Leukocyte Recruitment and Retention Focality of Lesion Formation Intracellular Lipid Accumulation: Foam Cell Formation Evolution of Atheroma Innate and Adaptive Immunity: Mechanisms of Inflammation in Atherogenesis Smooth Muscle Cell Migration and Proliferation Smooth Muscle Cell Death During Atherogenesis Arterial Extracellular Matrix Angiogenesis in Plaques Plaque Mineralization Complication of Atherosclerosis Arterial Stenoses and Clinical Implications Thrombosis and Atheroma Complication Plaque Rupture and Thrombosis Thrombosis Caused by Superficial Erosion of Plaques Thrombosis and Healing in Progression of Atheroma Diffuse and Systemic Nature of Plaque Susceptibility to Rupture and Inflammation in Atherogenesis Special Cases of Arteriosclerosis Restenosis After Arterial Intervention Accelerated Arteriosclerosis After Transplantation Aneurysmal Disease Infection, the Microbiome, and Atherosclerosis References Chapter 25: Primary Prevention of Cardiovascular Disease Overview Trends in Cardiovascular Disease and Risk Factors Global Trends Trends in the United States Types of Prevention: Primordial, Primary, and Secondary Cardiovascular Disease Risk Assessment Cardiovascular Health and Life’s Simple 7 Global Risk Lifetime Risk Vascular Imaging in Preventive Practice: Coronary Artery Calcium and Coronary Computed Tomographic Angiography Society Guidelines for Cardiovascular Risk Assessment and Statin Therapy Risk Factors for Cardiovascular Disease Traditional Risk Factors Smoking and e-Cigarettes Hypertension Guideline Recommendations Interventions to Reduce Blood Pressure Drug Therapy Metabolic Syndrome, Insulin Resistance, and Diabetes Interventions to Reduce Cardiovascular Risk among Patients with Diabetes Obesity Family History Risk-Enhancing Factors Social Determinants of Health Psychosocial Factors Ankle-Brachial Index Biomarkers Lipids/Lipoproteins Standard Lipid Testing Fasting versus nonfasting LDL Cholesterol HDL Cholesterol Triglycerides Alternative Lipid Measures Lipoprotein(a) Homocysteine High-Sensitivity C-Reactive Protein and Other Biomarkers of Inflammation Cardiovascular Prevention in Women Premature Menopause and Pregnancy-Associated Conditions Menopause and Postmenopausal Hormone Therapy Lifestyle Factors and Interventions Nutrition and Diet Low-Risk Populations High-Risk Populations and Randomized Trials of the Mediterranean Diet Alcohol Consumption Physical Activity Sedentary Behavior Interventions to Increase Physical Activity Pharmacologic Therapies Shared Decision-Making Statins Monitoring of Therapy Aspirin N-3 Fatty Acids Primary Prevention High-Risk Primary Prevention Updated Meta-Analyses and Summary Novel Approaches to Preventive Cardiology The Polypill in Current Practice Precision Medicine Versus Preventive Care Community Interventions Mobile Health, Remote Monitoring, and Wearables Gaps in the Evidence and Future Perspectives Regional and International Perspectives References Chapter 26: Systemic Hypertension: Mechanisms, Diagnosis, and Treatment Definitions of Hypertension Epidemiology Pathophysiology Pressure Natriuresis and Salt Sensitivity Renin-Angiotensin-Aldosterone System Sympathetic Nervous System Natriuretic Peptides Endothelium Arterial Stiffness in Hypertension Immune System in Hypertension Factors Involved in Predisposition to Hypertension Genetics Obesity A Diagnostic Approach to Primary Hypertension History and Physical Examination Blood Pressure Measurement Office Blood Pressure Measurement Office Versus Home Blood Pressure Clinical Use of Ambulatory and Home Blood Pressure Monitoring Integrating Home Blood Pressure Into Clinical Practice Laboratory and Other Complementary Tests Echocardiography Evaluation of Sodium and Potassium Intake Renin Profiling Diagnostic approach for Secondary Hypertension Endocrine Causes Primary Hyperaldosteronism Apparent Mineralocorticoid Excess States Hyperaldosteronism Associated with Sleep-Disordered Breathing Pheochromocytoma Hypercortisolism (Cushing disease) Thyroid Dysfunction Acromegaly Nonendocrine Causes Lifestyle Factors Drug-Induced Hypertension Sleep Deprivation and Sleep-Disordered Breathing Nonlifestyle, Nonendocrine Causes Intrinsic Kidney Disease Renovascular Hypertension Coarctation of the Aorta Therapeutic Options and Approaches for Primary Hypertension Goals of Therapy Blood Pressure Guidelines Dietary Approaches Effect of Lifestyle Intervention in the Older People (>65 years) Blood Pressure–Lowering Medications Therapeutic Options and Approaches For Subgroups of Hypertension Pharmacologic Intervention in the Older People (>65 years) Management of Hypertension in Chronic Kidney Disease Blood Pressure Management in Patients Undergoing Dialysis Heart Failure Resistant Hypertension Nondrug Therapy for Resistant Hypertension Device Therapy Renal Denervation Baroreceptor-Activation DEBuT-HT Rheos Pivotal Trial Barostim Neo Trial MobiusHD Device for Baroreflex Amplification Hypertensive Urgency and Emergency References Chapter 27: Lipoprotein Disorders and Cardiovascular Disease Lipoprotein Transport System Biochemistry of Lipids Lipoproteins, Apolipoproteins, Receptors, and Processing Enzymes Lipoprotein Metabolism and Transport Low-Density Lipoproteins High-Density Lipoprotein and Reverse Cholesterol Transport Lipoprotein Disorders Definitions Genetic Lipoprotein Disorders Low-Density Lipoproteins Familial Hypercholesterolemia Low-Density Lipoprotein Receptor Gene Familial Defective Apolipoprotein B Proprotein Convertase Subtilisin/Kexin Type 9 Polygenic Hypercholesterolemia Lipoprotein(a) Triglyceride-Rich Lipoproteins Polygenic Hypertriglyceridemia (also Known as Familial Hypertriglyceridemia, Formerly Type IV Hyperlipoproteinemia) Combined Hyperlipoproteinemia (also Known as Familial Combined Hyperlipidemia or Formerly Type 2B Hyperlipidemia) Dysbetalipoproteinemia (Formerly Type III Hyperlipoproteinemia) Monogenic Chylomicronemia Syndrome (Formerly Familial Hyperchylomicronemia Syndrome or Type I Hyperlipidemia) High-Density Lipoproteins Disorders of High-Density Lipoprotein Biogenesis Apolipoprotein A-I Gene Defects Tangier Disease and Familial High-Density Lipoprotein Deficiency Disorders of High-Density Lipoprotein–Processing Enzymes Lecithin-Cholesterol Acyltransferase Deficiency Cholesteryl Ester Transfer Protein Deficiency Secondary Causes of Hyperlipidemia and Metabolic Syndrome Hormonal Causes Metabolic Causes Renal Disorders Liver Disease Lifestyle Alteration in Lipids by Medications Pharmacologic Management of Lipid Risk Hydroxymethylglutaryl–Coenzyme A Reductase Inhibitors (Statins) Mechanisms of Action Pharmacology and Lipid Effects Safety, Tolerability, and Monitoring Clinical Trials and Cardiovascular Outcomes Use of Statins in Particular Populations Adults with Diabetes Older Adults Women Race and Ethnicity Advanced Heart Failure and Chronic Kidney Disease Pro-Protein Convertase Subtilisin/Kexin Type 9 Inhibitors Mechanisms of Action Effects on Lipids Safety, Tolerability, and Monitoring Clinical Outcomes Trials with Monoclonal Antibodies Clinical Recommendations Ezetimibe Fibric Acid Derivatives (Fibrates) Nicotinic Acid (Niacin) Bile Acid–Binding Resins Fish Oils and Pure Eicosapentaenoic Acid Phytosterols Novel Medications Bempedoic Acid Rare diseases: Novel approaches for Homozygous Familial Hypercholesterolemia and Monogenic Chylomicronemia Syndrome Inhibition of APO CIII Inhibition of Angiopoietin-Like Protein 3 (ANGPTL3) Inhibition of Lp(a) Clinical Approach to the Treatment of Lipoprotein Disorders Lifestyle Changes: Diet Treatment of Combined Lipoprotein Disorders Residual Cardiovascular Risk Clinical Recommendations for Assessing Residual Risk Future Perspectives Gene Therapy Societal Changes Guidelines References Chapter 28: Cardiovascular Disease Risk of Nicotine and Tobacco Products Health Effects of Tobacco Cardiovascular Effects of Tobacco Products Cigarettes Electronic Cigarettes Heated Tobacco Products Classic References References Chapter 29: Nutrition and Cardiovascular and Metabolic Diseases Energy Balance Foods Fruits and Vegetables Nuts and Beans Whole Grains, Refined Grains, Starches, Sweets Fish Red Meats Poultry, Eggs Dairy Plant Oils Beverages Sugar-Sweetened Beverages Milk Coffee, Tea Alcohol Macronutrients Carbohydrates Fats Total Fat Saturated Fats Monounsaturated Fats Polyunsaturated Fats n-6 PUFA n-3 PUFA Trans Fats Dietary Cholesterol Protein Micronutrients Sodium, Potassium Dietary Patterns Emerging Areas Food Processing Microbiome Personalized Nutrition Changing Behavior References Chapter 30: Obesity: Medical and Surgical Management Epidemiology Traditional Definition of Obesity The Puzzling Relationship of Excess Body Weight and Fat with Cardiovascular Disease Risk Assessment in Overweight/Obese Patients: Waistline as a Vital Sign Evolving Focus from Adipose Tissue Mass to Quality and Functionality Visceral Obesity Marker of Ectopic Fat Deposition Portal Free Fatty Acid Hypothesis Visceral Adipose Tissue as an Endocrine Organ Visceral Adipose Tissue: Marker of Dysfunctional Subcutaneous Adipose Tissue Key Factors Associated with Visceral Obesity Age and Sex Sex Hormones Genetics Ethnicity Hypothalamic-Pituitary-Adrenal Axis and Endocannabinoid System Drugs Lifestyle: A Key Contributor to Visceral Obesity Clinical Tools to Identify Individuals at Cardiometabolic Risk Clinical Management of Cardiometabolic Risk Key Nutritional Factors (Toward a Food-Based Approach) Physical Activity and Exercise Sleep and Stress Management Pharmacotherapy Severe Obesity: A Rapidly Expanding Subgroup of Obese Patients Summary and Perspectives References Chapter 31: Diabetes and the Cardiovascular System Scope of the Problem Diabetes Mellitus Atherosclerotic Vascular Disease Heart Failure Atrial Fibrillation Risk Stratification Coronary Heart Disease in the Patient with Diabetes Mechanistic Considerations Linking Diabetes and Atherosclerosis Prevention and Treatment of Coronary Heart Disease and Its Complications in the Patient with Diabetes Lipid Management Statins Ezetimibe PCSK9 Inhibitors Fibric acid derivatives (fibrates) Omega-3 fatty acids Inclisiran Hypertension Management Renin-Angiotensin-Aldosterone System Antagonists Angiotensin-converting enzyme inhibitors Angiotensin II receptor blockers Calcium Channel Blockers Thiazide Diuretics Beta Blockers Antihypertensive Therapy Summary Antiplatelet Therapy Daily Aspirin P2Y12 Receptor Antagonists Glucose Management Cardiovascular Effects of Selected Medications for Diabetes Metformin Sulfonylureas Insulin Dipeptidyl Peptidase 4 Inhibitors Glucagon like peptide-1 receptor agonists Sodium-Glucose Cotransporter 2 Inhibitors Other Glucose-Lowering Medications Cardiovascular Effects of More Intensive Versus Less Intensive Glucose Control Strategies Summary of Glucose Management and Treatment Guidelines Acute Coronary Syndromes Screening for Diabetes in Acute Coronary Syndrome Patients Insulin Administration and Glucose Control Antiplatelet Medications P2Y12 Receptor Antagonists Renin-Angiotensin-Aldosterone System Antagonists Beta-Adrenergic Blocking Agents Primary Invasive Strategy for Non–ST-Segment Elevation Acute Coronary Syndrome Primary Reperfusion Therapy for ST-Segment Elevation Myocardial Infarction Coronary Revascularization Considerations Optimal Medical Therapy Versus Revascularization in Diabetes Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting Heart Failure in the Patient with Diabetes Scope of the Problem Mechanistic Considerations Ischemic Heart Disease and Hypertension Prevention and Management ofHeart Failure in Diabetes Therapy of Heart Failure with Preserved Ejection Fraction in Diabetes Therapy of Heart Failure with Reduced Ejection Fraction in Diabetes Modulation of the Renin-Angiotensin-Aldosterone System Angiotensin Receptor-Neprilysin Inhibition Beta Blockers Heart Failure Considerations for Glucose Management Strategies and Antihyperglycemic Medications Atrial Fibrillation Summary and Future Perspectives Guidelines References Chapter 32: Exercise and Sports Cardiology Historical Perspective Cardiovascular Risks of Exercise Effects of Habitual Physical Activity on Cardiovascular Risk Cardiovascular Risks of Exercise The Pathology of Exercise-Related Cardiovascular Events The Relative and Absolute Risk of Exercise Approach to Common Clinical Problems in Sports Cardiology Decreased Exercise Capacity Abnormalities Found on Screening Cardiovascular Complaints in Athletes Determining Athletic Eligibility Advising Adult Athletes with Atherosclerotic Cardiovascular Disease Valve Disease Elevated “Cardiac Enzymes” Atrial Fibrillation in Endurance Athletes Accelerated Atherosclerosis Myocardial Fibrosis Noncompaction Cardiomyopathy Exercise in Arrhythmogenic Right Ventricular Cardiomyopathy Conclusion References Chapter 33: Comprehensive Cardiac Rehabilitation Evolution of Cardiac Rehabilitation Elements of Cardiac Rehabilitation Programs Structural Elements Multidisciplinary Team Facilities, Equipment, and Technology Tools Value of Cardiac Rehabilitation Recovery from a Cardiovascular Disease Event Physiologic Improvements Cardiovascular Disease Risk Factor Control Cardiovascular Events Hospital Readmission Fatal and Non-Fatal Events Safety of Cardiac Rehabilitation Cost-Effectiveness of Cardiac Rehabilitation Future Directions for Cardiac Rehabilitation Efforts to Reduce the Cardiac Rehabilitation Participation Gap Additional Patient Groups Improving the Cost-Effectiveness of Cardiac Rehabilitation Summary Classic References References Chapter 34: Integrative Approaches to the Management of Patients with Heart Disease Integrative Cardiology Utilization of Additional Therapies Why Is Integrative Cardiology Important Need for Interprofessional Collaboration Integrative Strategies for Specific Cardiac Conditions Ischemic Heart Disease Nutrition Mind/Heart Connection Meditation Tai Chi Supplements Omega-3 Multivitamins Antioxidants Hypertension Nutrition Dietary Approaches to Stop Hypertension (DASH): Diet, Potassium, and Sodium Physical Activity Mind/Heart Connection Breathing Exercises Meditation Acupuncture Dyslipidemia Nutrition Physical Activity Heart Failure Nutrition and Lifestyle Supplements Coenzyme Q10 Arrhythmias Comprehensive Lifestyle Approach Yoga Integrative Self-Care for the Cardiologist Conclusion References Part V: Atherosclerotic Cardiovascular Disease Chapter 35: Approach to the Patient with Chest Pain References Chapter 36: Coronary Blood Flow and Myocardial Ischemia Control of Coronary Blood Flow Determinants of Myocardial Oxygen Consumption Coronary Autoregulation Determinants of Coronary Vascular Resistance Endothelium-Dependent Modulation of Coronary Tone Nitric Oxide (Endothelium-Derived Relaxing Factor) Endothelium-Dependent Hyperpolarizing Factor Prostacyclin Endothelin Paracrine Vasoactive Mediators and Coronary Vasospasm Coronary Vasospasm Structure and Function of the Coronary Microcirculation Intraluminal Physical Forces Regulating Coronary Resistance Myogenic Regulation Flow-Mediated Resistance Artery Control Right Coronary Artery Flow Physiologic Assessment of Coronary Artery Stenoses Stenosis Pressure-Flow Relation Interrelation Among Distal Coronary Pressure, Flow, and Stenosis Severity Flow-and Pressure-Derived Indices ofCoronary Reserve Perfusion-Based Indices of Stenosis Severity Absolute Flow Reserve Relative Flow Reserve Indices of Stenosis Severity Based on Coronary Pressure Vasodilated Pressure Measurements: Fractional Flow Reserve Resting Coronary Pressure Measurements: Instantaneous Wave-Free Ratio Noninvasive FFRCT Using Computed Tomography and Computational Fluid Dynamics Pathophysiologic States Affecting Microcirculatory Coronary Flow Reserve Coronary Collateral Circulation Arteriogenesis and Angiogenesis Regulation of Collateral Resistance Metabolic and Functional Consequences of Ischemia Irreversible Injury and Myocyte Death Reversible Ischemia and Perfusion-Contraction Matching Acute Perfusion-Contraction Matching During Subendocardial Ischemia Short-Term Hibernation Functional Consequences of Reversible Ischemia Chronic Hibernating Myocardium Future Perspectives Classic References References Chapter 37: STElevation Myocardial Infarction: Pathophysiology and Clinical Evolution Changing Patterns in Incidence and Care Improvements in Outcome Limitations of Current Therapy Pathologic Findings Plaque Formation and Disruption Acute Coronary Syndromes Heart Muscle Gross Pathologic Findings Ultrastructural and Microscopic Findings of Ischemia Patterns of Myocardial Necrosis Coagulation Necrosis Necrosis With Contraction Bands Myocytolysis Apoptosis Current Concepts of the Cellular Events During Myocardial Infarction and Healing Modification of Pathologic Changes by Reperfusion Coronary Anatomy and Location of Infarction Right Ventricular Infarction Atrial Infarction Collateral Circulation in Acute Myocardial Infarction Myocardial Infarction with Nonobstructive Coronary Arteries Nonatherosclerotic Causes of Acute Myocardial Infarction Stress (Takotsubo) Cardiomyopathy Pathophysiology Left Ventricular Function Systolic Function Diastolic Function Circulatory Regulation Ventricular Remodeling Infarct Expansion Ventricular Dilation Effects of Treatment Pathophysiology of Other Organ Systems Clinical Features Predisposing Factors Circadian Periodicity History Prodromal Symptoms Nature of the Pain Other Symptoms Differential Diagnosis “Silent” or Atypical Presentations of ST-Elevation Myocardial Infarction Physical Examination General Appearance Heart Rate Blood Pressure Temperature and Respiration Jugular Venous Pulse Carotid Pulse The Chest Cardiac Examination Palpation Auscultation Heart sounds Murmurs Friction rubs Extremities Neuropsychiatric Findings Laboratory Findings Serum and Plasma Markers of Cardiac Damage Recommendations for Measurement of Circulating Markers of Cardiac Injury in ST-Segment Elevation MI Other Biomarkers Other Laboratory Measurements Serum Lipids Hematologic Findings Electrocardiography Q Wave and Non−Q Wave Infarction Ischemia at a Distance Right Ventricular Infarction Imaging Radiography Echocardiography Magnetic Resonance Imaging Nuclear Imaging Computed Tomography Estimation of Infarct Size Electrocardiography Cardiac markers Noninvasive imaging techniques Future Perspectives References Chapter 38: STElevation Myocardial Infarction: Management Prehospital Management Prehospital Care Emergency Medical Service Systems Prehospital Fibrinolysis Management in the Emergency Department General Treatment Measures Aspirin Control of Cardiac Pain Analgesics Nitrates Beta-Adrenergic Blocking Agents Oxygen Limitation of Infarct Size Dynamic Nature of Infarction Routine Measures for Limitation of Infarct Size Reperfusion Therapy General Concepts Pathophysiology of Myocardial Reperfusion Reperfusion Injury Reperfusion Arrhythmias Late Establishment of Patency of the Infarct Vessel Fibrinolysis Effect of Fibrinolytic Therapy on Mortality Comparison of Fibrinolytic Agents Effect on Left Ventricular Function Complications of Fibrinolytic Therapy Late Therapy Intracoronary Fibrinolysis Catheter-Based Reperfusion Strategies Surgical Reperfusion Selection of Reperfusion Strategy Referral for Angiography with Intent of Revascularization after Initial Fibrinolysis Patients Not Eligible for Reperfusion Therapy Anticoagulant and Antiplatelet Therapy Anticoagulant Therapy Effect of Heparin on Mortality Other Effects of Heparin Disadvantages of Heparin Hirudin and Bivalirudin Low-Molecular-Weight Heparins Parenteral Factor Xa Antagonists Oral Factor IIa and Factor Xa Antagonists Recommendations for Anticoagulant Therapy Adjunctive Anticoagulation for Primary Percutaneous Coronary Intervention Anticoagulation with Fibrinolysis Patients Treated Without Reperfusion Therapy Antiplatelet Therapy Antiplatelet Therapy for Percutaneous Coronary Intervention in ST-Elevation Myocardial Infarction Antiplatelet Therapy with Fibrinolysis Combination Pharmacologic Reperfusion Recommendations for Antiplatelet Therapy Hospital Management Coronary Care and Intermediate Care Units General Measures Physical Activity Pharmacologic Therapy Beta Blockers Recommendations Selection of Beta Blockers Inhibition of the Renin-Angiotensin-Aldosterone System Recommendations Nitrates Recommendations Calcium Channel Antagonists Other Therapies Magnesium Glucose Control During ST-Elevation Myocardial Infarction Other Agents Hemodynamic Disturbances Hemodynamic Assessment Monitoring of Pulmonary Artery Pressure Hemodynamic Abnormalities Hemodynamic Subsets Hypotension in the Prehospital Phase Management The Hyperdynamic State Left Ventricular Failure Therapeutic Implications Hypoxemia Diuretics Afterload Reduction Nitroglycerin Oral Vasodilators Glucose-Lowering Agents Digitalis Vasoactive Medications Beta-Adrenergic Agonists Other Positive Inotropic Agents Vasopressors Cardiogenic Shock Pathologic Findings Pathophysiology Diagnosis Medical Management Mechanical Circulatory Support Intra-Aortic Balloon Counterpulsation Percutaneous Left Ventricular Assist Devices Complications Revascularization Shock Teams Recommendations Right Ventricular Infarction Diagnosis Noninvasive Assessment Treatment Mechanical Causes of Heart Failure Free Wall Rupture Pseudoaneurysm Diagnosis Treatment Rupture of Interventricular Septum Rupture of a Papillary Muscle Differentiation Between Ventricular Septal Rupture and Mitral Regurgitation Management Arrhythmias Hemodynamic Consequences Ventricular Arrhythmias Ventricular Premature Depolarizations Management Accelerated Idioventricular Rhythm Ventricular Tachycardia and Ventricular Fibrillation Prophylaxis Management Prognosis Bradyarrhythmias Sinus Bradycardia Management Atrioventricular and Intraventricular Block First-Degree Atrioventricular Block Second-Degree Atrioventricular Block Complete (Third-Degree) Atrioventricular Block Intraventricular Block Isolated Fascicular Blocks Right Bundle Branch Block Bifascicular Block, Including Left Bundle Branch Block Use of Pacemakers in Patients with Acute Myocardial Infarction Temporary Pacing Asystole Permanent Pacing Supraventricular Tachyarrhythmias Sinus Tachycardia Atrial Flutter and Fibrillation Management Other Complications Recurrent Chest Discomfort Recurrent Ischemia and Reinfarction Diagnosis Prognosis Management Pericardial Effusion and Pericarditis Pericardial Effusion Pericarditis Dressler Syndrome Venous Thrombosis and Pulmonary Embolism Left Ventricular Aneurysm Pathogenesis Diagnosis Prognosis and Treatment Left Ventricular Thrombus and Arterial Embolism Management Convalescence, Discharge, and Post-Myocardial Infarction Care Timing of Hospital Discharge Counseling Assessment at Hospital Discharge Assessment of Left Ventricular Function Assessment of Myocardial Ischemia Exercise Testing Assessment for Electrical Instability Prophylactic Antiarrhythmic Therapy Secondary Prevention After Acute Myocardial Infarction Cardiac Rehabilitation Lifestyle Modification Depression Modification of Lipid Profile Antiplatelet Agents Inhibition of the Renin-Angiotensin-Aldosterone System Beta-Adrenergic Blocking Agents Nitrates Anticoagulants Calcium Channel Antagonists Hormone Therapy Nonsteroidal Antiinflammatory Drugs Future Perspectives and Emerging Therapies References Chapter 39: Non–ST Elevation Acute Coronary Syndromes Epidemiology Pathophysiology Clinical Assessment History Physical Examination Electrocardiography Laboratory Testing: Biomarkers Imaging Noninvasive Testing Invasive Imaging Risk Assessment Residual Risk Natural History Risk Assessment Scores Management General Measures Anti-Ischemic Therapy Nitrates Beta-Adrenergic Receptor–Blocking Agents Intravenous Beta Blockers Oral Beta Blockers Calcium Channel Blockers Antiplatelet Therapy Oral Antiplatelet Drugs P2Y12 Inhibitors Clopidogrel Prasugrel Ticagrelor Selection and Duration of DAPT Regimen and NSTE-ACS Treatment Strategy Switching Between Oral P2Y12 Inhibitors Intravenous Antiplatelet Agents Anticoagulant Therapy Heparin Low-Molecular-Weight Heparin Heparin Reversal Direct Thrombin Inhibitors Patients with Indications for Both Oral Anticoagulant and Antiplatelet Therapy Combination of Chronic Oral Anticoagulant and Antiplatelet Therapy Post NSTE-ACS Bleeding: Risk Assessment, Prevention, and Treatment Anti-Inflammatory Therapies Invasive Versus Conservative Management Timing of an Invasive Approach Predischarge Risk Stratification in Patients Managed with an Ischemia-Guided Strategy Percutaneous Coronary Intervention Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting Lipid-Lowering Therapy Discharge and Posthospital Care Groups of Special Interest Older Adults Women Diabetes Mellitus and Glucose Intolerance Heart Failure Vasospastic Angina Management Cardiac Syndrome X Cocaine, Amphetamines, and Psychoactive Substances Future Perspectives Guidelines: Non–ST Elevation Acute Coronary Syndromes Initial Evaluation Early Risk Stratification AHA/ACC Class I Recommendations Early Hospital Care Initial Antithrombotic Therapy Ischemia-Guided Strategy Versus Early Invasive Strategies AHA/ACC Class I Recommendations Anti-Ischemic Therapies Antiplatelet Therapy Combined Postdischarge Oral Anticoagulant and Antiplatelet Therapy Renin-Angiotensin-Aldosterone Inhibitors Risk Factor Modification Evidence Gaps References Chapter 40: Stable Ischemic Heart Disease Magnitude of the Problem Stable Angina Pectoris Clinical Manifestations Characteristics of Angina Assessment and Classification of Angina Pectoris Differential Diagnosis of Chest Pain Esophageal Disorders Mechanisms of Anginal Pain Biliary Colic Costochondritis Other Neurologic and Musculoskeletal Disorders Other Causes of Angina-Like Pain Physical Examination Pathophysiology Angina Caused by Increased Myocardial O2 Requirements Angina Caused by Transiently Decreased O2 Supply Importance of Pathophysiologic Considerations in Configuring Therapy Evaluation and Management Biochemical Tests Biomarkers of Myocyte Injury, Ischemia, and Hemodynamic Stress Inflammatory Biomarkers Genetic and Transcriptomic Biomarkers Noninvasive Testing Resting Electrocardiogram Resting Echocardiography Chest Roentgenography Stress Testing Computed Tomography Cardiac Magnetic Resonance Imaging Invasive Assessment Catheterization and Coronary Angiography Limitations of Angiography Advanced Structural Coronary Imaging Functional Assessment Integrated Invasive Assessment in Patients Without Obstructive CAD High-Risk Findings from Coronary Angiography Extent of Coronary Artery Disease Other Angiographic Findings Natural History and Risk Stratification Risk Stratification and Risk Models Medical Management Treatment of Associated Diseases Reduction of Coronary Risk Factors Hypertension Coronary Artery Ectasia and Aneurysms Coronary Collateral Vessels Myocardial Bridging Cigarette Smoking Management of Dyslipidemia Low High-Density Lipoprotein Cholesterol High Triglycerides Management of Diabetes Mellitus Estrogen Therapy Exercise Obesity Inflammation Counseling and Changes in Lifestyle Pharmacologic Management of Angina Beta Adrenoceptor–Blocking Agents Adverse Effects and Contraindications Calcium Antagonists Mechanism of Action First-Generation Calcium Antagonists Nifedipine Adverse Effects Characteristics of Different Beta-Blocking Agents Selectivity Intrinsic Sympathomimetic Activity Lipid Solubility Alpha Adrenoceptor–Blocking Activity Effects on Serum Lipid Levels Verapamil Diltiazem Second-Generation Calcium Antagonists Amlodipine Nicardipine Felodipine and Isradipine Nitrates Mechanism of Action Pharmacology of Nitrates Effects on the Coronary Circulation Redistribution of Blood Flow Cellular Mechanism of Action Nitrate Tolerance Mechanisms Management Nitrate Withdrawal Types of Preparations and Routes of Administration Adverse Reactions Preparations Short-Acting Nitroglycerin (Nitroglycerin Tablets and Oral Spray) Isosorbide Dinitrate Isosorbide 5-Mononitrate Topical Nitroglycerin Other Issues Related to Oral Nitrates Interaction With Cyclic Guanosine Monophosphate–Specific Phosphodiesterase Type 5 Inhibitors Other Pharmacologic Agents Ranolazine Other Antianginal Therapies Other Considerations of Medical Management of Angina Pectoris Choice of Initial Therapy Relative Advantages of Beta-Blocking Agents and Calcium Antagonists Selection of Therapy Other Antianginal Agents Ivabradine Nicorandil Metabolic Agents Combination Therapy Synthesis of an Integrated Approach to Management of Patients with Stable Angina Nonpharmacologic Treatment Approaches Revascularization Approaches in Stable Ischemic Heart Disease Approach to Decision Making Regarding Revascularization Other Antianginal Strategies Enhanced External Counterpulsation Spinal Cord Stimulation Patient Selection for Revascularization Presence and Severity of Symptoms Significance of Coronary Lesions (and Other Anatomic Considerations) Fractional Flow Reserve Presence of Left Ventricular Dysfunction and Extent of Ischemia Risks Associated with the Procedure Percutaneous Coronary Intervention Restenosis and Late Stent Thrombosis Comparisons between Percutaneous Coronary Intervention and Medical Therapy PCI Guided by Coronary Artery Hemodynamic Data Selection of Percutaneous Coronary Intervention for Revascularization Coronary Artery Bypass Grafting Minimally Invasive Coronary Artery Bypass Surgery Arterial and Venous Conduits Patency of Venous and Arterial Grafts Distal vasculature Progression of Disease in Native Arteries Effects of Therapy on Vein Graft Occlusion and Native Vessel Progression Antiplatelet Therapy Lipid-Lowering Therapy Patient Selection Surgical Outcomes and Long-Term Results Operative Mortality Perioperative Complications Relief of Angina Effects on Survival Perioperative Complications Myocardial Infarction Cerebrovascular Complications Atrial Fibrillation Renal Dysfunction Surgical Treatment in Special Groups Women Older Patients Renal Disease Patients with Diabetes ?Patients with Associated Other Vascular Disease Patients Requiring Reoperation Comparisons between Percutaneous Coronary Intervention and Coronary Artery Bypass Surgery Observational Studies Randomized Trials Coronary Bypass Surgery in Patients With Associated Vascular Disease Implications of Combined Coronary Artery Disease and Peripheral Artery Disease Carotid Artery Disease Management of Patients With Associated Vascular Disease Choosing between Percutaneous Coronary Intervention, Coronary Artery Bypass Surgery, and Medical Therapy Single-Vessel Disease Multivessel Disease Need for Complete Revascularization Other Manifestations of Coronary Artery Disease Prinzmetal (Variant) Angina Angina and Ischemia Without Obstructive Epicardial CAD Microvascular Dysfunction Evidence of Ischemia Abnormal Pain Perception Clinical Features Clinical and Diagnostic Assessment Prognosis Management Silent Myocardial Ischemia Heart Failure in Ischemic Heart Disease Ischemic Cardiomyopathy Mechanisms of Silent Myocardial Ischemia Prognosis Detection and Management of Silent Ischemia Left Ventricular Aneurysm Mitral Regurgitation Secondary to Coronary Artery Disease Management Left Ventricular Aneurysm Detection Left Ventricular Aneurysmectomy Cardiac Transplantation–Associated Coronary Arteriopathy Future Perspectives References Chapter 41: Percutaneous Coronary Intervention Background Indications Clinical Presentations Stable Ischemic Heart Disease and Stable Angina Acute Coronary Syndromes Asymptomatic or Minimally Symptomatic Patients Preoperative Considerations Patient-Specific Considerations Extent of Jeopardized Myocardium Specific Lesion Subsets Left Main Disease Multivessel Disease Chronic Total Occlusions Saphenous Vein Grafts Bifurcation Lesions Lesion Calcification Thrombotic Lesions Diabetes Mellitus Cardiomyopathy/Left Ventricular Dysfunction Ischemic Cardiomyopathy Role of Left Ventricular Dysfunction in PCI Role of PCI in Cardiogenic Shock Renal Dysfunction and Other Comorbidities Coronary Devices Balloon Angioplasty Coronary Stents Drug-Eluting Stents Zotarolimus-Eluting Stents Everolimus-Eluting Stents Sirolimus-Eluting Stents Paclitaxel-Eluting Stents Zotarolimus-Eluting Stents Everolimus-Eluting Stents Bioabsorbable Polymer Drug-Eluting Stents Bioresorbable Vascular Scaffolds Coronary Atherectomy Rotational Atherectomy Orbital Atherectomy Excimer Laser Angioplasty Thrombectomy and Aspiration Devices Embolic Protection Devices Drug-Coated Balloons Coronary Physiology Mechanical Aspiration Intravascular Imaging Mechanical Circulatory Support Vascular Access Complications Vascular Closure Devices Antiplatelet Agents Aspirin Adenosine Diphosphate (ADP) Receptor Antagonists Complications of Femoral Access Glycoprotein IIb/IIIa Inhibitors Antithrombin Agents Unfractionated Heparin Low-Molecular-Weight Heparin Bivalirudin Factor Xa Inhibitors Outcomes After Percutaneous Coronary Intervention Early Clinical Outcomes Mortality Myocardial Infarction Urgent Revascularization Angiographic Complications Stent Thrombosis Late Clinical Outcomes Outcomes Benchmarking and Procedural Volumes Future Perspectives Acknowledgments References Guidelines: Percutaneous Coronary Intervention Clinical Features Adjunctive Pharmacotherapy Appropriateness Criteria for Percutaneous Coronary Intervention Chapter 42: Diseases of the Aorta The Normal Aorta Anatomy and Physiology Physiology Evaluation of the Aorta Aortic Aneurysms Abdominal Aortic Aneurysms Pathogenesis Clinical Features Diagnostic Imaging Ultrasound/Computed Tomography/Magnetic Resonance Imaging/Aortography Screening Genetics/Molecular Genetics Natural History Ruptured Abdominal Aortic Aneurysm Management Surveillance/Medical Therapy Surgery Techniques and Outcomes Endovascular Abdominal Aortic Aneurysm Repair Thoracic Aortic Aneurysms Cause and Pathogenesis Genetically Triggered Thoracic Aortic Aneurysm Diseases Degenerative Aneurysms Aortic Dissection Kommerell Diverticulum Syphilis and Aortitis Clinical Manifestations Diagnosis Natural History Management Surgical Treatment Ascending Thoracic Aortic Aneurysms Aortic Arch Aneurysms Descending Thoracic Aneurysms Thoracoabdominal Aneurysms Endovascular Repair of Thoracic Aneurysms Medical Management Aortic Dissection Classification Cause and Pathogenesis Clinical Manifestations Symptoms Physical Findings Laboratory Findings Diagnostic Techniques Computed Tomography Magnetic Resonance Imaging Echocardiogram Transthoracic Echocardiography Transesophageal Echocardiography Aortography Selecting an Imaging Modality The Role of Coronary Angiography Integrated Diagnostic Evaluation and Management Algorithms Management Blood Pressure Reduction Management of Cardiac Tamponade Definitive Therapy Long-Term Therapy and Follow-Up Aortic Dissection Variants Aortic Intramural Hematoma Penetrating Atherosclerotic Aortic Ulcer Aortoarteritis Syndromes Bacterial Infections of the Aorta Primary Tumors of the Aorta Future Perspectives References Chapter 43: Peripheral Artery Diseases Epidemiology Risk Factors for Peripheral Artery Disease Pathophysiology of Peripheral Artery Disease Factors Regulating Blood Supply Skeletal Muscle Structure and Metabolic Function Clinical Features Symptoms Physical Findings Categorization Testing for Peripheral Artery Disease Segmental Pressure Measurement Ankle-Brachial Index Treadmill Exercise Testing Pulse Volume Recording Doppler Ultrasonography Duplex Ultrasound Imaging Magnetic Resonance Angiography Computed Tomographic Angiography Contrast-Enhanced Angiography Other Measurement Tools Prognosis Treatment Risk Factor Modification Diet Smoking Cessation Treatment of Diabetes Blood Pressure Control Lipid-Lowering Therapy Antithrombotic Therapy for Reduction of Major Adverse Cardiovascular and Limb Events Antiplatelet Monotherapy Dual Antiplatelet Therapy with Aspirin and P2Y12 Inhibition Combination Antiplatelet and Anticoagulant Therapy Other Combination Therapies Treatment of Symptoms and Prevention of Limb Vascular Events Smoking Cessation Supervised and Home-Based Exercise Training Pharmacotherapy to Improve Claudication Vasodilators Other Medical Therapies Percutaneous Transluminal Angioplasty and Stents Peripheral Artery Surgery Vasculitis Thromboangiitis Obliterans Pathology and Pathogenesis Clinical Features Diagnosis Treatment Takayasu Arteritis and Giant Cell Arteritis Fibromuscular Dysplasia Popliteal Artery Entrapment Syndrome Acute Limb Ischemia Prognosis Pathogenesis Diagnostic Tests Treatment Atheroembolism Pathogenesis Clinical Features Diagnostic Tests Treatment Acknowledgment References Chapter 44: Treatment of Noncoronary Obstructive Vascular Disease Approach to the Patient with Peripheral Artery Disease Quality of Evidence Evaluating Endovascular Treatments Endovascular Technologies Balloon Angioplasty Bare-Metal Stents Drug-Eluting Peripheral Stents Drug-Coated Balloons Controversy About Paclitaxel-Coated Balloons and Stents Covered Stents Thrombolysis Mechanical and Aspiration Thrombectomy Rotational, Orbital, and Directional Atherectomy Laser Atherectomy Cryoplasty and Intravascular Lithotripsy Medical Therapy to Improve Endovascular Durability Planning an Intervention Vascular Imaging Vascular Access Endovascular Treatment of Arterial Disease Peripheral Artery Disease of the Lower Extremities Aortoiliac Disease Femoral-Popliteal Artery Disease Tibial Disease Cervical Artery Disease Extracranial Carotid Disease Vertebral and Subclavian Artery Disease Mesenteric and Renal Artery Disease Mesenteric Artery Renal Artery Endovascular Treatment of Venous Disease Extremity Deep Venous Thrombosis Superior Vena Cava Syndrome Future Perspectives References Chapter 45: Prevention and Management of Ischemic Stroke Classification of Ischemic Stroke Stroke Risk Factors and Prevention Antithrombotic Agents for Stroke Prevention Antiplatelet Therapy for Primary Prevention Stroke Prevention in Atrial Fibrillation Secondary Prevention of Ischemic Stroke Antiplatelet Therapy Anticoagulant Therapy Management of Acute Ischemic Stroke Intravenous Recombinant Tissue Plasminogen Activator Endovascular Therapy Anticoagulation Therapy for Acute Ischemic Stroke Infective Endocarditis Diagnosis and Treatment of Patients with a Transient Ischemic Attack Conclusions Classic References References Part VI: Heart Failure Chapter 46: Mechanisms of Cardiac Contraction and Relaxation Microanatomy of Contractile Cells and Proteins Ultrastructure of Contractile Cells Subcellular Microarchitecture Mitochondrial Morphology and Function Contractile Proteins Titin and Length Sensing Molecular Basis of Muscular Contraction Actin and Troponin Complex Myosin Structure and Function Graded Effects of [Ca2+]i on Cross-Bridge Cycle Length-Dependent Activation and the Frank-Starling Effect Cross-Bridge Cycling Differs from Cardiac Contraction-Relaxation Cycle Force Transmission Calcium Ion Fluxes in Cardiac Contraction-Relaxation Cycle Calcium Movements and Excitation-Contraction Coupling Calcium Release and Uptake by Sarcoplasmic Reticulum Sarcoplasmic Reticulum Network and Ca2+ Movements Junctional Sarcoplasmic Reticulum and Ryanodine Receptor Turning Off Ca2+ Release: Breaking Positive Feedback Calcium Uptake into Sarcoplasmic Reticulum by Sarcoendoplasmic Reticulum Ca2+–Adenosine Triphosphatase Sarcolemmal Control of Ca2+ and Na+ Calcium and Sodium Channels Molecular Structure of Ca2+ and Na+ Channels T-Versus L-Type Ca2+ Channels L-Type Ca2+ Channel Localization and Regulation Sodium Channels Ion Exchangers and Pumps Sodium-Calcium Exchanger Sodium Pump (Na+, K+–Adenosine Triphosphatase) Adrenergic Signaling Systems Physiologic Fight-or-Flight Response Beta-Adrenergic Receptor Subtypes Alpha-Adrenergic Receptor Subtypes G Proteins Cyclic Adenosine Monophosphate and Protein Kinase A Adenylyl Cyclase Protein Kinase A Beta1-Adrenergic and Protein Kinase A Signaling in Ventricular Myocytes Cholinergic and Nitric Oxide Signaling Cholinergic Signaling Nitric Oxide Contractile Performance of the Heart The Cardiac Cycle Left Ventricular Contraction Left Ventricular Relaxation Left Ventricular Filling Phases Contractility Versus Loading Conditions Contractility Preload Afterload Starling’s Law of the Heart Venous Filling Pressure and Heart Volume Frank and Isovolumic Contraction Preload and Afterload Are Interlinked Force-Length Relationships and Ca2+ Transients Anrep Effect: Abrupt Increase in Afterload Wall Stress Heart Rate and Force-Frequency Relationship Treppe or Bowditch Effect Physiologic Force-Frequency Relationship and Optimal Heart Rate Myocardial Oxygen Uptake Work of the Heart Measurements of Contractile Function Measurements of Contractile Function Force-Velocity Relationship and Maximum Contractile Function in Muscle Models Isometric Versus Isotonic Contraction Pressure-Volume Loops Limitations of the Concept of Contractility Left Ventricular Relaxation and Diastolic Dysfunction Right Ventricular Function Atrial Function Future Perspectives Acknowledgment References (null) Part VII: Arrhythmias, Sudden Death, and Syncope Chapter 61: Approach to the Patient with Cardiac Arrhythmias General Approach to the History and Physical Exam History Physical Examination Signs and Symptoms Palpitations Syncope, Presyncope, and Altered Level of Consciousness Sudden Cardiac Arrest and Aborted Sudden Cardiac Death Clinical and Laboratory Testing Resting Electrocardiogram Cardiac Imaging Stress Electrocardiography Long-Term Electrocardiogram Recording: Holter Monitoring, Event Recording, and Insertable Loop Recorders In Hospital Electrocardiographic Recording Ambulatory Electrocardiographic (Holter) Recording Event Recording Head Up Tilt Invasive Electrophysiologic Testing Complications of Electrophysiologic Studies Guidelines References Guidelines Ambulatory Electrocardiography Diagnosis Assessment of Risk for SCD Efficacy of Antiarrhythmic Therapy Assessment of Pacemaker/ICD Function Monitoring for Myocardial Ischemia Clinical Competence Electrophysiologic Procedures for Diagnosis Evaluation of Sinus Node Function Acquired Atrioventricular Block Chronic Intraventricular Delay Narrow–and Wide–QRS Complex Tachycardia Prolonged QT Intervals Wolff-Parkinson-White Syndrome Nonsustained Ventricular Tachycardia Unexplained Syncope Survivors of Cardiac Arrest Palpitations Electrophysiologic Studies For Therapeutic Intervention Clinical Competence Chapter 62: Mechanisms of Cardiac Arrhythmias Foundations of Cardiac Electrophysiology The Functions of the Cardiac Electrical System The Cardiac Action Potential Physiology of Ion Channels Normal Automaticity Molecular Structure of Key Cardiac Ion Channels and Transporters Gap Junction Channels and Intercalated Discs Structure and Function of the Cardiac Electrical Network Sinoatrial Node Atrioventricular Junctional Area and Intraventricular Conduction System Atrioventricular Node Bundle of His (Penetrating Portion of Atrioventricular Bundle) Bundle Branches (Branching Portion of Atrioventricular Bundle) Terminal Purkinje Fibers Innervation of Atrioventricular Node, His Bundle, and Ventricular Myocardium Pathways of Innervation Effects of Vagal Stimulation Effects of Sympathetic Stimulation Arrhythmias and the Autonomic Nervous System Mechanisms of Arrhythmogenesis Disorders of Impulse Formation Abnormal Automaticity Triggered Activity Delayed Afterdepolarizations Major Role of Intracellular Ca2+-Handling Abnormalities in Delayed Afterdepolarization Generation Early Afterdepolarizations Long-QT Syndrome Disorders of Impulse Conduction Anatomic Reentry Functional Reentry Specific Arrhythmias Illustrating Mechanistic Principles Atrial Flutter Atrial Fibrillation Spatiotemporal Organization and Focal Discharge Remodeling of the Atria Sinus Node Reentry Atrial Reentry Atrioventricular Nodal Reentry Preexcitation Syndrome Ventricular Tachycardia Caused by Reentry Brugada Syndrome Catecholaminergic Polymorphic Ventricular Tachycardia Arrhythmogenic Right Ventricular Cardiomyopathy Ventricular Fibrillation: Fibrillation Initiation and Maintenance References Chapter 63: Genetics of Cardiac Arrhythmias The QT-Opathies Long QT Syndrome Clinical Description and Manifestations of Long QT Syndrome Phenotypic Correlates for the Three Canonical Long QT Syndrome Genotypes Calmodulinopathic Long QT Syndrome Triadin Knockout Syndrome Timothy Syndrome Clinical Description and Manifestations of Timothy Syndrome Cardiac-Only Timothy Syndrome Short QT Syndrome Clinical Description and Manifestations of Short QT Syndrome Genotype-Phenotype Correlates in Short QT Syndrome Drug-Induced Torsade de Pointes Clinical Description and Manifestations of Drug-Induced Torsade de Pointes hERG/KV11.1 Channel Blockade and Cardiac Repolarization Reserve Common Ion Channel Polymorphisms and DI-TdP Risk The Other Channelopathies Andersen-Tawil Syndrome Clinical Description and Manifestations of Andersen-Tawil Syndrome Phenotypic Correlates in KCNJ2-Mediated Andersen-Tawil Syndrome (ATS1) Ankyrin-B Syndrome Brugada Syndrome Clinical Description and Manifestations of Brugada Syndrome Phenotypic Correlates of SCN5A-Mediated Brugada Syndrome Catecholaminergic Polymorphic Ventricular Tachycardia Clinical Description and Manifestations of Catecholaminergic Polymorphic Ventricular Tachycardia Calcium Release Channel Deficiency Syndrome Early Repolarization Syndrome Clinical Description and Manifestations of Early Repolarization Syndrome Familial Atrial Fibrillation Clinical Description and Manifestations of Familial Atrial Fibrillation Idiopathic Ventricular Fibrillation Clinical Description and Manifestations of Idiopathic Ventricular Fibrillation Multifocal Ectopic Purkinje-Related Premature Contractions Progressive Cardiac Conduction Disease Clinical Description and Manifestations of Progressive Cardiac Conduction Defect Sick Sinus Syndrome Clinical Description and Manifestations of Sick Sinus Syndrome Conclusions Future Perspectives References Chapter 64: Therapy for Cardiac Arrhythmias Pharmacologic Therapy General Considerations Regarding Antiarrhythmic Drugs Drug Classification Class 0 Class IA Class IB Class IC Class ID Class II Class III Class IV Clinical Use Adverse Effects Proarrhythmia Antiarrhythmic Agents Class IA Agents Quinidine Dosage and Administration Indications Adverse Effects Procainamide Dosage and Administration Indications Adverse Effects Disopyramide Dosage and Administration Indications Adverse Effects Ajmaline Class IB Agents Lidocaine Dosage and Administration Indications Adverse Effects Mexiletine Dosage and Administration Indications Adverse Effects Phenytoin Class IC Agents Flecainide Dosage and Administration Indications Adverse Effects Propafenone Indications Adverse Effects Class II Agents Beta Adrenoceptor–Blocking Agents Dosage and Administration Indications Adverse Effects Class III Agents Amiodarone Dosage and Administration Indications Adverse Effects Dronedarone Dosage and Administration Indications Adverse Effects Sotalol Dosage Indications Adverse Effects Ibutilide Dosage and Administration Indications Adverse Effects Dofetilide Dosage and Administration Indications Adverse Effects Class IV Agents Calcium Channel Antagonists: Verapamil and Diltiazem Dosage and Administration Indications Adverse Effects Other Antiarrhythmic Agents Adenosine Dosage and Administration Indications Adverse Effects Digoxin Dosage and Administration Indications Adverse Effects Ranolazine Dosage and Administration Adverse Effects Ivabradine Dosage and Administration Side Effects Antiarrhythmic Effects of Nonantiarrhythmic Drugs New Antiarrhythmic Agents Electrotherapy for Cardiac Arrhythmias Direct-Current Electrical Cardioversion Technique Indications Results Complications Implantable Electrical Devices for Treatment of Cardiac Arrhythmias Ablation Therapy for Cardiac Arrhythmias Cooled-Tip Radiofrequency Ablation Radiofrequency Catheter Ablation of Accessory Pathways Location of Pathways Indications Results Radiofrequency Catheter Modification of AV Node for AV Nodal Reentrant Tachycardias Indications Results Junctional Tachycardia Radiofrequency Catheter Ablation of Arrhythmias Related to the Sinus Node Indications Results Radiofrequency Catheter Ablation of Atrial Tachycardia Indications Results Radiofrequency Catheter Ablation of Atrial Flutter Indications Results Ablation and Modification of Atrioventricular Conduction for Atrial Tachyarrhythmias Indications Results Radiofrequency Catheter Ablation of Atrial Fibrillation Radiofrequency Catheter Ablation of Ventricular Arrhythmias Indications Results Surgical Therapy for Tachyarrhythmias Supraventricular Tachycardias Ventricular Tachycardia Idiopathic Ventricular Tachycardia/Premature Ventricular Complexes and Nonischemic Cardiomyopathy Ischemic Heart Disease References Chapter 65: Supraventricular Tachycardias Definitions Assessment of the Patient with Palpitations Supraventricular Arrhythmia Types Atrial Premature Complexes or Ectopic Beats Atrial Tachycardias Focal Atrial Tachycardia Diagnosis and Differential Diagnosis Anatomic Distribution Sinus Node Reentry Inappropriate Sinus Tachycardia Atrial Flutter or Macroreentrant Atrial Tachycardia Epidemiology Classification of Atrial Flutter Paroxysmal Supraventricular Tachycardia ECG Characteristics and ECG Classification of PSVT Clinical Presentation Typical AVNRT Atypical AVNRT Treatment of AVNRT Acute Management Chronic Management Tachycardias due to an Accessory Pathway Accessory Pathway Epidemiology The WPW ECG Arrhythmias Associated with Accessory Pathways Orthodromic AVRT Antidromic AVRT Preexcited Tachycardia Treatment of AVRT Acute Treatment of Preexcited AF Chronic Therapy in AVRT Asymptomatic WPW Differential Diagnosis of Wide Complex Tachycardia References Chapter 66: Atrial Fibrillation: Clinical Features, Mechanisms, and Management Electrocardiographic Features Classification of Atrial Fibrillation Epidemiology of Atrial Fibrillation Mechanisms of Atrial Fibrillation Genetic Factors Causes of Atrial Fibrillation Clinical Features Diagnostic Evaluation Prevention of Thromboembolic Complications Risk Stratification Aspirin Warfarin Direct-Acting Oral Anticoagulants Low-Molecular-Weight Heparin Excision or Closure of the Left Atrial Appendage Acute Management of Atrial Fibrillation Long-Term Management of Atrial Fibrillation Pharmacologic Rate Control Versus Rhythm Control Pharmacologic Rate Control Pharmacologic Rhythm Control Rhythm Control with Agents Other Than Antiarrhythmic Drugs Nonpharmacologic Management of Atrial Fibrillation Risk Factor Modification Pacing to Prevent Atrial Fibrillation Catheter Ablation of Atrial Fibrillation Catheter Ablation Technique and Outcomes of AF Ablation Indications for Ablation and Selection of Patients Surgical Ablation of Atrial Fibrillation Ablation of the Atrioventricular Node Specific Clinical Syndromes Postoperative Atrial Fibrillation Wolff-Parkinson-White Syndrome Congestive Heart Failure Hypertrophic Cardiomyopathy Pregnancy Future Perspectives Guidelines References Guidelines: Atrial Fibrillation Prevention of Thromboembolism Pharmacologic Rate Control of AF Cardioversion of Atrial Fibrillation Maintenance of Sinus Rhythm Special Considerations in Atrial Fibrillation Postoperative Atrial Fibrillation Acute Myocardial Infarction Catheter Ablation in Heart Failure Atrial Fibrillation in Wolff-Parkinson-White Syndrome Hyperthyroidism Atrial Fibrillation During Pregnancy Hypertrophic Cardiomyopathy Pulmonary Disease Obesity and Weight Loss Device Detection of Atrial Fibrillation and Flutter Chapter 67: Ventricular Arrhythmias Premature Ventricular Complexes, Nonsustained Ventricular Tachycardias, Couplets Electrocardiographic Recognition Clinical Features Management Idiopathic Premature Ventricular Complexes/NSVT with No Structural or Electrical Heart Disease Premature Ventricular Complexes in Structural Heart Disease Premature Ventricular Complex Induced Cardiomyopathy Accelerated Idioventricular Rhythm Electrocardiographic Recognition Management Sustained Ventricular Tachycardia Monomorphic Ventricular Tachycardia Electrocardiographic Recognition Ventricular Tachycardias Versus Supraventricular Tachycardia with Aberrancy Mechanisms and Clinical Correlations Scar—Related Ventricular Tachycardia Bundle Branch Reentry and Other Purkinje System—Related Ventricular Tachycardias Focal Origin Ventricular Tachycardias Clinical Features Acute Management of Sustained Monomorphic Ventricular Tachycardia Electrical Storm Evaluation and Long-Term Management Long-Term Therapy Specific Ventricular Tachycardias Ischemic Cardiomyopathy Nonischemic Dilated Cardiomyopathy Arrhythmogenic Right Ventricular Cardiomyopathy Congenital Heart Disease Hypertrophic Cardiomyopathy Inflammatory Heart Disease Cardiac Sarcoidosis Myocarditis Chagas Disease Idiopathic Ventricular Tachycardias Outflow Tract Arrhythmias Annular Arrhythmias Crux Arrhythmias Papillary Muscle Arrhythmias Left Fascicular Reentrant Tachycardia Polymorphic Ventricular Tachycardia Electrocardiographic and Clinical Features Management Specific Disorders with Polymorphic entricular Tachycardias Acute Myocardial Infarction and Ischemia Acquired Long QT Syndrome and Torsade de Pointes Inherited Long QT syndrome Management Inherited Short QT Syndrome J Wave Syndromes: Brugada and Early Repolarization Syndromes Brugada Syndrome Management Early Repolarization and J Wave Syndromes Management Catecholaminergic Polymorphic Ventricular Tachycardias Ventricular Fibrillation Electrocardiographic Recognition Clinical Features Management Ventricular Flutter References Chapter 68: Bradyarrhythmias and Atrioventricular Block Bradyarrhythmias Sinus Bradycardia Electrocardiographic Recognition Clinical Features Management Sinus Arrhythmia Sick Sinus Syndrome Electrocardiographic Recognition Chronotropic Incompetence Tachycardia-Bradycardia Syndrome Management Atrioventricular Block (Heart Block) First-Degree Atrioventricular Block Second-Degree Atrioventricular Block High-Grade Atrioventricular Block Third-Degree (Complete) Atrioventricular Block Clinical Features Management Atrioventricular Dissociation Electrocardiographic and Clinical Features Management Autonomic/Neurally Mediated Bradycardia Electrocardiographic Recognition Clinical Features Management References Chapter 69: Pacemakers and Implantable Cardioverter-Defibrillators Types of Devices Device Radiography Types of Pacemakers Indications for Pacemakers Capture and Sensing Capture and Stimulation Electrograms and Sensing Function in Pacemakers Hemodynamic Aspects of Pacing Pacing Mode and Timing Cycles Definitions Common Pacing Modes Rate Responsive Pacing Choosing a Single- or Dual-Chamber Pacing Device Pacemaker Troubleshooting Failure to Capture Failure to Pace Unexpected Pacing at or Near the Upper Rate Unexpected Drop in Pacing Rate Pacing-Induced Proarrhythmia Pseudo-Malfunction Implantable Cardioverter-Defibrillators Types of ICDs Indications for ICDs Secondary Prevention Primary Prevention ICD System Selection Dual- versus Single-Chamber Transvenous ICDs Transvenous versus Subcutaneous ICD Systems ICD Therapy General Considerations ICD Troubleshooting Ventricular Oversensing Shocks: Diagnosis and Management Approach to the Patient with Shocks Unsuccessful Shocks Failure to Deliver Therapy or Delayed Therapy ICD Lead Failure: Presentation and Management Clinical Presentations Imaging Approach to the Patient Complications Vascular Access Complications Lead Placement Complications Pocket Hematoma and CIED Infections Subcutaneous ICD Complications Leadless Pacemaker Complications Follow-Up and Management Remote Monitoring CIED Diagnostics for Atrial Fibrillation Device Clinic Follow-Up Electromagnetic Interference Common Clinical Issues in CIED Patients Psychosocial Issues Lifestyle Issues Driving Participation in Sports Drug Interactions References Chapter 70: Cardiac Arrest and Sudden Cardiac Death Perspective Definitions Epidemiology Epidemiologic Overview Population Pools, Risk Gradients, and Time Dependence of Risk Population and Subgroup Risk Versus Individual Risk Assessment Biologic and Clinical Time-Dependent Risk Age, Race, Sex, and Heredity Age Race Sex Heredity Risk Factors for Sudden Cardiac Death General Profile of Risk for Sudden Cardiac Death Functional Capacity and Sudden Death Lifestyle and Psychosocial Factors Left Ventricular Ejection Fraction in Chronic Ischemic Heart Disease Ventricular Arrhythmias in Chronic Ischemic Heart Disease Emerging Markers of Risk for Sudden Cardiac Death Causes of Sudden Cardiac Death Coronary Artery Abnormalities Atherosclerotic Coronary Artery Disease Nonatherosclerotic Coronary Artery Abnormalities Anomalous Origin of Coronary Arteries from the Wrong Sinus of Valsalva Embolism to the Coronary Arteries Coronary Arteritis Mechanical Obstruction of Coronary Arteries Coronary Artery Spasm Ventricular Hypertrophy and Hypertrophic Cardiomyopathy Cardiomyopathy and Systolic and Diastolic Heart Failure Acute Heart Failure Valvular Heart Disease Electrophysiologic Abnormalities Long-QT Syndromes Brugada Syndrome Early Repolarization and Sudden Cardiac Death Sudden Infant Death Syndrome and Sudden Cardiac Death in Children Sudden Cardiac Death in Competitive and Recreational Athletes and During Intense Exercise Mechanisms and Pathophysiology Pathophysiologic Mechanisms of Lethal Tachyarrhythmias Coronary Artery Structure and Function Acute Ischemia and Initiation of Lethal Arrhythmias Transition from Myocardial Instability to Lethal Arrhythmias Bradyarrhythmias and Asystolic Arrest Pulseless Electrical Activity Clinical Features of Patients with Cardiac Arrest Prodromal Symptoms Onset of the Terminal Event Cardiac Arrest Progression to Biologic Death Survivors of Cardiac Arrest Hospital Course Clinical Profile of Survivors of Out-of-HospitalC ardiac Arrest Postresuscitation Electrocardiographic Changes Left Ventricular Function Coronary Angiography Blood Chemistry Long-Term Prognosis Management of Cardiac Arrest In-Hospital Interventions Community-Based Interventions Impact of Tiered Response Systems Initial Assessment and Basic Life Support Chest Thump Basic Life Support—The Initial Steps in Cardiopulmonary Resuscitation Circulation Concept of Cardiocerebral Resuscitation Airway Breathing Early Defibrillation by First Responders Advanced Life Support Defibrillation-Cardioversion Pharmacotherapy Bradyarrhythmic and Asystolic Arrest; Pulseless Electrical Activity Stabilization of Cardiac Rhythm after Initial Return of Spontaneous Circulation Postcardiac Arrest Care and Postcardiac ArrestSyndrome Cardiac Arrest in Patients with Hemodynamically Stable Acute Myocardial Infarction Cardiac Arrest in Patients with Hemodynamically Unstable Acute Myocardial Infarction Risk Identification by QT Interval Prolongation after Cardiac Arrest Long-Term Management of Survivors of Out-of-Hospital Cardiac Arrest General Care Prevention of Cardiac Arrest and Sudden Cardiac Death Methods to Estimate Risk for Sudden Cardiac Death General Medical and Cardiovascular Risk Markers Strategies to Reduce Risk for Sudden Cardiac Death Antiarrhythmic Drugs Surgical Intervention Strategies Catheter Ablation Therapy Implantable Cardioverter Defibrillators Application of Therapeutic Strategies to Specific Groups of Patients Secondary Prevention of Sudden Cardiac Death after Survival from Cardiac Arrest Primary Prevention of Sudden Cardiac Death in Patients with Advanced Heart Disease Primary Prevention in Patients with Structurally Normal Hearts or Molecular Disorders of Cardiac Electrical Activity Prediction and Primary Prevention in the General Population Sudden Death and Public Safety References Chapter 71: Hypotension and Syncope Definition Classification Vascular Causes of Syncope Orthostatic Hypotension Reflex-Mediated Syncope Neurally Mediated Hypotension or Syncope (Vasovagal Syncope) Carotid Sinus Hypersensitivity Cardiac Causes of Syncope Neurologic Causes of Transient Loss of Consciousness Metabolic Causes of Transient Loss of Consciousness Diagnostic Tests History, Physical Examination, and Carotid Sinus Massage Physical Examination Carotid Sinus Massage Laboratory Testing: Blood Tests Tilt-Table Test Cardiac Imaging Stress Tests and Cardiac Catheterization Electrocardiography Cardiac Monitoring Electrophysiologic Testing Electrophysiologic Testing Protocol Test to Screen for Neurologic Causes of Syncope Approach to the Evaluation of Patients with Syncope Management of Patients with Syncope Neurally Mediated Syncope Cardioneuroablation for Treatment of Neurally Mediated Syncope Future Perspectives References Part VIII: Diseases of the Heart Valves Chapter 72: Aortic Valve Stenosis Epidemiology Causes and Etiology Calcific Aortic Valve Disease Bicuspid Aortic Valve Disease Rheumatic Aortic Stenosis Clinical Presentation Symptoms Physical Examination Auscultation Diagnostic Testing Echocardiography Disease Course and Staging Progressive Aortic Stenosis (Stage B; Mild to Moderate Valve Obstruction) Classification of Severe Aortic Stenosis Asymptomatic Severe Aortic Stenosis (Stage C) Symptomatic Severe Aortic Stenosis (Stage D) Symptomatic Severe High-Gradient Aortic Stenosis (Stage D1) Symptomatic Severe Low-Flow, Low-Gradient Aortic Stenosis with Reduced LVEF (Stage D2) Symptomatic Severe Low-Flow, Low-Gradient Aortic Stenosis with Preserved LVEF (Stage D3) Treatment Aortic Valve Replacement Surgical Aortic Valve Replacement Transcatheter Aortic Valve Replacement Patient Selection for TAVR or SAVR Postprocedural Issues Classic References References Chapter 73: Aortic Regurgitation Causes and Pathology Valvular Disease Disease of the Aortic Root and Ascending Aorta Chronic Aortic Regurgitation Pathophysiology Clinical Presentation Symptoms Diagnostic Testing Echocardiography Cardiac Magnetic Resonance Angiography Disease Course Asymptomatic Patients Symptomatic Patients Treatment of Chronic Aortic Regurgitation Medical Therapy Surgical Treatment Indications for Valve Replacement Symptomatic Patients Asymptomatic Patients Operative Procedures Acute Aortic Regurgitation Pathophysiology and Clinical Presentation Classic References References Chapter 74: Transcatheter Aortic Valve Replacement Epidemiology, Natural History, and Treatment Alternatives for Valvular Aortic Stenosis History and Background of Transcatheter Aortic Valve Replacement (TAVR) Predicate Technologies Including Balloon Aortic Valvuloplasty The Proof-of-Concept First-in-Human Case The Early Years of TAVR Outcomes in Patients Not Suitable for Surgery Using Early TAVR Technologies Patient Surgical Risk Profiles and Comorbidity Assessments Introduction to the Heart Team TAVR Evidence-Based Clinical Research An Ecosystem for Aortic Valve Clinical Research Randomized Clinical Trials According to Surgical Risk Strata Primary Clinical Endpoints Key Secondary Outcomes Echocardiographic Findings Quality-of-Life Assessments National TAVR Registries Society-Based Guidelines and Appropriate Use Criteria TAVR Technology Evolution Anatomy (Components) of a TAVR System Rapid Progression of TAVR Technologies to the Modern Era Other TAVR Systems and Comparative Device versus Device Studies Accessory Devices for TAVR TAVR Procedural Maturation Computed Tomography Imaging for Procedural Planning Echocardiography for Diagnosis, Procedure-Planning and Follow-Up Minimalist Approach (Including Conscious Sedation Anesthesia) Alternative Vascular Access Strategies TAVR-Associated Complications Intraprocedural Complications Coronary Obstruction Vascular Complications Postprocedural Complications Neurologic Events Conduction Disturbances Paravalvular Regurgitation Prosthesis–Patient Mismatch Other Complications TAVR and Concomitant Cardiac Diseases TAVR in Surgical Bioprosthetic Aortic Valve Failure Gaps in TAVR Knowledge and Ongoing Controversies Durability of TAVR Systems Aortic Stenosis and Multivalve Disease Aortic Stenosis and Atrial Fibrillation Aortic Stenosis and Coronary Artery Disease TAVR in Low-Gradient Aortic Stenosis Treatment of Bicuspid Aortic Valve Disease TAVR for Aortic Regurgitation Managing the Young, Low-Risk Patient with AS Subclinical Leaflet Thrombosis Optimal Antithrombotic Therapies Future TAVR Directions Next Generation Valve Technology Expanded Clinical Indications Asymptomatic Severe Aortic Stenosis Moderate Aortic Stenosis The Modern Era Heart Team References Chapter 75: Mitral Stenosis Epidemiology and Secular Trends Rheumatic Mitral Stenosis Nonrheumatic Mitral Stenosis Definition of Disease and Severity Rheumatic Mitral Stenosis Pathology Clinical Pathophysiology Left Atrial Pressure Left Atrial Function Left Ventricular Function Right Ventricular Function Natural History Diagnosis Clinical Presentation Physical Examination Echocardiography Additional Diagnostic Investigations EKG and Chest X-Ray Exercise Testing in MS Other Diagnostic Tests Associated Conditions Atrial Fibrillation Pulmonary Hypertension Pregnancy Diagnosis and Treatment Percutaneous Balloon Mitral Valvuloplasty Treatment Medical Therapy Transcatheter Interventional Therapy Complications Long-Term Results Surgical Intervention Comparison with BMV Nonrheumatic Mitral Stenosis Degenerative MS Related to Mitral Annular Calcification Associated Aortic Stenosis Natural History Treatment Radiotherapy-Induced MS MS Following Interventional and Surgical Therapies Classic References References Chapter 76: Mitral Regurgitation Mitral Valve Anatomy Mitral Annulus Mitral Leaflets Mitral Valve Chordae and Papillary Muscles Mechanisms of Mitral Regurgitation Normal Mitral Valve Physiology Primary Mitral Regurgitation Clinical Presentation Symptoms Physical Examination Echocardiography Quantification of MR Severity Transesophageal Echocardiography Exercise Echocardiography Natural History Left Ventricular Volumes and Systolic Function Mitral Annular Disjunction Symptoms Management of Primary Mitral Regurgitation Medical Therapy for Primary Mitral Regurgitation Surgical Therapy for Primary Mitral Regurgitation Transcatheter Therapy for Primary Mitral Regurgitation Edge-to-Edge Repair Investigational Devices Secondary Mitral Regurgitation Pathophysiology Clinical Presentation Management of Secondary Mitral Regurgitation Medical Therapy for Secondary Mitral Regurgitation Surgical Therapy for Secondary Mitral Regurgitation Transcatheter Therapy for Secondary Mitral Regurgitation Investigational Devices Classic References References Chapter 77: Tricuspid, Pulmonic, and Multivalvular Disease Tricuspid Stenosis Causes and Pathology Pathophysiology Clinical Presentation Management Tricuspid Regurgitation Causes and Pathology Clinical Presentation Management Pulmonic Stenosis Causes and Pathology Clinical Presentation Physical Examination Management Pulmonic Regurgitation Causes and Pathology Clinical Presentation Management Multivalvular Disease Surgical Treatment of Multivalvular Disease Triple- and Quadruple-Valve Disease References Chapter 78: Transcatheter Therapies for Mitral and Tricuspid Valvular Heart Disease Mitral Stenosis Mitral Balloon Valvuloplasty Indications Mitral Regurgitation Rationale for Transcatheter Therapy Leaflet Repair with MitraClip Device Transcatheter Mitral Valve Replacement Tricuspid Regurgitation Pathophysiology Treatment Leaflet Clip Devices Valve Spacer Devices Caval Devices Tricuspid Valve Replacement Devices Summary Conclusion Classic References References Chapter 79: Prosthetic Heart Valves Types of Prosthetic Heart Valves Mechanical Valves Tissue Valves Stented Bioprosthetic Valves Stentless Bioprosthetic Valves Homografts Autografts Transcatheter Bioprosthetic Valves Medical Management and Surveillance After Valve Replacement Antithrombotic Therapy General Principles Interruption of Antithrombotic Therapy Pregnancy Infective Endocarditis Prophylaxis Clinical Assessment Echocardiography Evaluation and Treatment of Prosthetic Valve Dysfunction and Complications Prosthesis-Patient Mismatch Structural Valve Deterioration Paravalvular Leak Infective Endocarditis Hemolytic Anemia Classic References References Chapter 80: Infectious Endocarditis and Infections of Indwelling Devices Infective Endocarditis Epidemiology Pathogenesis Clinical Presentation Predisposing Cardiac Conditions Symptoms Physical Examination Diagnosis Diagnostic Testing Electrocardiogram Imaging Imaging for Diagnosis of Infective Endocarditis Imaging for Delineation of Complications of Endocarditis Local Valvular Destruction Perivalvular Extension of Infection Approach to Echocardiographic Imaging Other Advanced Imaging Embolism Indications for and Timing of Surgery Surgical Intervention Outpatient Management and Follow-Up Evaluation Cardiovascular Implantable Electronic Device Infections Epidemiology Clinical Syndromes Microbiology Pathogenesis Diagnosis Management Prophylaxis Left Ventricular Assist Device Infections Microbiology Management Prevention Guidelines References Guidelines: Infective Endocarditis Prevention Indications for Echocardiography Surgery for Active Endocarditis Chapter 81: Rheumatic Fever Epidemiology Pathogenesis Clinical Features Arthritis Carditis Valvulitis Myocarditis Pericarditis Sydenham Chorea Cutaneous and Subcutaneous Features Erythema Marginatum Other Manifestations Diagnosis Evidence of Preceding GAS Infection Natural History Management General Management Antibiotic Treatment Aspirin and Other Anti-Inflammatory Drugs Antibiotic Prophylaxis Prevention Primordial Prevention Primary Prevention Secondary Prevention Future Perspectives Classic References References Part IX: Diseases of the Myocardium, Pericardium, and Pulmonary Vasculature Bed Chapter 82: Congenital Heart Disease in the Adolescent and Adult General Considerations Access and Delivery of ACHD Care Transition to ACHD Care Clinical Evaluation Noncardiac Complications in the ACHD Patient Congenital Anatomy Congenital Nomenclature Cardiac Development Genetic Considerations Long-Term Considerations Arrhythmias in Adult Congenital Heart Disease Demographics and Prognosis Diagnostic Testing Types of Arrhythmia Bradyarrhythmia Sinus Node Dysfunction Heart Block Tachyarrhythmias Interatrial Re-Entrant Tachycardia Atrial Fibrillation Ventricular Tachycardia and Sudden Death Pacemakers and Implantable Defibrillators Heart Failure, Transplantation, and Mechanical Circulatory Support Epidemiology Clinical Features Pathophysiology Medical Therapy Cardiac Resynchronization Transplantation Mechanical Circulatory Support Palliative Care Aortopathies in Congenital Heart Disease Subacute Bacterial Endocarditis Pregnancy in Women With Congenital Heart Disease Exercise and Sports Participation Benefits of Physical Exercise Individualized Exercise Programs Competitive Sports Specific Defects Left-to-Right Shunt Lesions Atrial Septal Defects and Partial Anomalous Pulmonary Veins Anatomic Description and Prevalence Clinical Features Repairs Long-Term Outcomes and Complications Atrioventricular Septal Defects Anatomic Description and Prevalence Clinical Features Surgical Repairs Long-Term Outcomes and Complications Ventricular Septal Defects Anatomic Description and Prevalence Clinical Features Repairs Long-Term Outcomes and Complications Patent Ductus Arteriosus Anatomic Description and Prevalence Clinical Features Repairs Long-Term Outcomes and Complications Ebstein Anomaly of the Tricuspid Valve Anatomic Description and Prevalence Clinical Features and Diagnostic Testing Long-term Outcomes and Complications Unrepaired Ebstein Anomaly Tricuspid Valve Repair and Replacement Surgery Transcatheter Atrial Septal Defect/Patent Foramen OvaleClosure Ventricular Dysfunction, Heart Failure, and Transplantation Pulmonary Stenosis Anatomic Description and Prevalence Clinical Features and Diagnostic Testing Surgical Repairs Long-Term Outcomes and Complications Indications for Intervention or Re-Intervention Tetralogy of Fallot Anatomic Description and Prevalence Clinical Features and Diagnostic Testing Surgical Repair Long-Term Outcomes and Complications Anatomic Sequalae Ventricular Dilation and Dysfunction and Heart Failure Arrhythmia and Risk Stratification for Sudden Cardiac Death Transposition of the Great Arteries Anatomic Description and Prevalence Clinical Features Surgical Repairs Atrial Switch Operation Arterial Switch Operation Rastelli Operation Long-Term Outcomes and Complications Following the Atrial Switch Operation Ventricular Dysfunction Baffle Complications Atrial Arrhythmia Long-Term Complications Following the Arterial Switch Operation Coronary Artery Stenosis Aortic Dilation and Regurgitation Supravalvar Pulmonic Stenosis Long-Term Complications Following the Rastelli Operation Congenitally Corrected Transposition of the Great Arteries Anatomic Description and Prevalence Clinical Features Surgical Repairs Late Complications Double Outlet Right Ventricle Anatomic Description and Prevalence Clinical Features Repairs Long-Term Outcomes and Complications Truncus Arteriosus Anatomic Description and Prevalence Clinical Features Repairs Long-Term Outcomes and Complications Cor Triatriatum Anatomic description and prevalence Clinical Features and Diagnostic Testing Long-term Outcomes and Complications Subvalvular Left Ventricular Outflow Tract Obstruction Anatomic Description and Prevalence Clinical Features and Diagnostic Testing Repairs Long-Term Outcomes and Complications Supravalvar Aortic Stenosis Anatomic Description and Prevalence Clinical Features and Diagnostic Testing Repair Long-term Outcomes and Complications Coarctation of the Aorta Anatomic Description and Prevalence Clinical Features and Diagnostic Testing Long-Term Outcomes and Complications Interrupted Aortic Arch Vascular Rings Anatomic Description and Prevalence Clinical Features and Diagnostic Testing Surgical Repairs Long-Term Outcomes and Complications Anomalous Coronary Artery From the Pulmonary Artery Single Ventricle Anatomic Description and Prevalence Surgical Palliation Clinical Features and Diagnostic Testing Long-Term Outcomes and Complications Ventricular Dilation, Dysfunction, and Heart Failure Arrhythmia Cyanosis Protein-Losing Enteropathy and Plastic Bronchitis Abnormalities of the Aorta and Pulmonary Arteries Fontan-Associated Liver Disease Pulmonary Hypertension and Eisenmenger Syndrome Demographics and Prognosis Classification Eisenmenger Syndrome Clinical Features Management of Eisenmenger Syndrome References Chapter 83: Catheter-Based Treatment of Congenital Heart Disease in Adults Valvular Interventions Pulmonary Valvuloplasty Pulmonary Valve Replacement Pulmonary Valve Systems Melody Valve SAPIEN Valve Arterial Interventions Pulmonary Angioplasty Stenting for Coarctation of the Aorta Septal Interventions Techniques for Closure of Atrial Septal Defects Amplatzer Devices GORE Devices Techniques for Closure of Superior Sinus Venosus Atrial Septal Defects Techniques for Closure of Ventricular Septal Defects Treatment of Patent Ductus Arteriosus Amplatzer Duct Occluders (First- and Second-Generation) Amplatzer Vascular Plugs (Second- and Fourth-Generation) Nit-Occlud Device Standard Coiling Future Perspectives References Chapter 84: Cardiomyopathies Induced by Drugs or Toxins Alcohol History Epidemiology Pharmacology and Pathophysiology Alcoholic Cardiomyopathy Cardiac Arrhythmias Alcohol and Lipid Metabolism Alcohol and Coronary Artery Disease Alcohol and Hypertension Electronic Cigarettes The Effect of Electronic Cigarettes/Vaping on the Cardiovascular System E-Cigarette or Vaping Product Use Associated Lung Injury Cocaine History and Epidemiology Pathophysiology Clinical Presentation Aortic Dissection Myocardial Dysfunction Cardiac Arrhythmias Other Cardiac Stimulants Amphetamines and Methamphetamines Khat and Cathinones Marijuana Atrial Arrhythmias Ventricular Arrhythmias Acute Coronary Syndromes Neurologic Events Cannabidiol Oil Energy Drinks and Caffeine Opiates Heavy Metals Future Directions Acknowledgment References Chapter 85: Cardiovascular Abnormalities in HIV-Infected Individuals Cardiovascular Risk Factors in People Living with HIV Dyslipidemia Lipodystrophy, the Metabolic Syndrome, and Obesity Diabetes Hypertension and Chronic Kidney Disease Smoking Mechanisms of HIV-Related Atherogenesis Features of Atherosclerosis in People with HIV Coronary Disease in HIV Subjects Epidemiology Clinical Presentation Treatment Antiretroviral Therapy and Cardiovascular Disease Treatment of Lipids in the Setting of HIV Risk Assessment and Screening for Coronary Disease Other Cardiovascular Conditions Associated with HIV Pulmonary Hypertension Heart Failure Arrhythmias and Sudden Cardiac Death Cerebrovascular Disease References Chapter 86: Pericardial Diseases Acute Pericarditis Definition, Causes, Epidemiology, and Pathophysiology History and Differential Diagnosis Physical Examination Laboratory Testing Diagnosis, Natural History, and Management Recurrent Pericarditis Pericardial Effusion and Cardiac Tamponade Etiology Pathophysiology and Hemodynamics Clinical Presentation Laboratory Testing Management of Pericardial Effusion and Tamponade Pericardial Fluid Analysis Pericardioscopy and Percutaneous Biopsy Constrictive Pericarditis Physical Examination Laboratory Testing Echocardiography-Doppler Examination Cardiac Catheterization and Angiography Computed Tomography and Cardiac Magnetic Resonance Differentiating Constrictive Pericarditis from Restrictive Cardiomyopathy Management Effusive-Constrictive Pericarditis References Chapter 87: Pulmonary Embolism and Deep Vein Thrombosis Epidemiology General Considerations Clinical Risk Factors Cancer and Venous Thromboembolic Venous Thromboembolic in the Pediatric Population Hypercoagulable States Other Conditions Associated with Venous Thromboembolic Long-term Complications of Venous Thromboembolic and Risk of Subsequent Adverse Events Pulmonary Embolism in COVID-19 Infection Pathophysiology Classification of Pulmonary Embolism High-Risk Pulmonary Embolism Intermediate-Risk Pulmonary Embolism Low-Risk Pulmonary Embolism Pulmonary Infarction Paradoxical Embolism Nonthrombotic Pulmonary Embolism Post-Pulmonary Embolism Syndrome Chronic Thromboembolic Pulmonary Hypertension Diagnosis Clinical Presentation Differential Diagnosis Nonimaging Diagnostic Methods Plasma D-Dimer Assay Electrocardiogram Imaging Methods Chest Radiography Lung Ultrasound Chest Computed Tomography Echocardiography Venous Ultrasonography Lung Scanning Magnetic Resonance Imaging Pulmonary Angiography Contrast Venography Overall Strategy: An Integrated Diagnostic Approach Therapy Risk Stratification Parenteral Anticoagulation Unfractionated Heparin Low-Molecular-Weight Heparin Fondaparinux Heparin-Induced Thrombocytopenia Warfarin Anticoagulation Warfarin Overlap with Heparin Dosing and Monitoring of Warfarin Warfarin “Bridging” Novel Oral Anticoagulants Evolution of Oral Anticoagulants for Pulmonary Embolism and Deep Vein Thrombosis Treatment Managing Bleeding Complications from Anticoagulants Optimal Duration of Anticoagulation and Selection of Optimal Anticoagulant Risk of Recurrent Venous Thromboembolism after Discontinuation of Anticoagulation How to Determine the Optimal Duration of Anticoagulation Selection of an Optimal Oral Anticoagulant for Extended-Duration Anticoagulation Advanced Therapy for Acute Pulmonary Embolism High-Risk Pulmonary Embolism Advances in Catheter-Based Therapy Surgical Embolectomy Inferior Vena Cava Filters Deep Vein Thrombosis Interventions Therapy in Patients with Cancer Treatment of Superficial Thrombophlebitis Therapy in Patients with Antiphospholipid Syndrome and Factor V Leiden Therapy in Pediatric Populations Emotional Support Prevention Rationale for In-Hospital Venous Thromboembolism Prophylaxis Rationale for Venous Thromboembolism Prophylaxis at Hospital Discharge In-Hospital Risk Factors for Venous Thromboembolism and Bleeding Primary Prevention of Venous Thromboembolism in High-Risk Patients with Active Cancer Mechanical Prophylaxis in Medically Ill Patients Advances in Venous Thromboembolism Prophylaxis in Major Orthopedic Surgery Future Perspectives References Chapter 88: Pulmonary Hypertension Normal Pulmonary Circulation Pulmonary Circulatory Physiology Effect of Aging on the Pulmonary Circulation Pulmonary Venous System Pulmonary Circulatory Physiology During Exercise Classification of Pulmonary Hypertension Hemodynamic Classifications Isolated Post-Capillary Pulmonary Hypertension Clinical Classifications Heart Failure and Cardiomyopathy Valvular Heart Disease Pre-Capillary Pulmonary Hypertension Clinical Classifications Pulmonary Arterial Hypertension Hereditary Pulmonary Artery Hypertension Toxin-Induced Pulmonary Artery Hypertension Systemic Sclerosis with Pulmonary Artery Hypertension Infectious Pulmonary Artery Hypertension Subtypes Congenital Heart Disease Lung Disease and Sleep Disordered Breathing Chronic Thromboembolic Pulmonary Hypertension Pulmonary Venoocclusive Disease Portopulmonary Hypertension Combined Pre- and Post-Capillary Pulmonary Hypertension Left Heart Structural and Functional Disorders Pathology Pathobiology Pathophysiology Right Ventricular Dysfunction Systemic Manifestations of Pulmonary Hypertension Patient Presentation and Clinical Assessment Patient Medical History Physical Examination Findings Approach to Diagnosis Pulmonary function tests and sleep study Computed tomographic chest imaging and nuclear ventilation/perfusion (V/Q) scintigraphy Cardiac magnetic resonance (CMR) imaging Positron emission tomography Exercise testing Cardiac catheterization Risk Stratification Integrated Approach to Diagnosing Pulmonary Hypertension Pulmonary Venoocclusive Disease Chronic Thromboembolic Pulmonary Hypertension Treatment Pulmonary Arterial Hypertension Initial Management of Treatment-Naïve Pulmonary Arterial Hypertension Patients Therapeutic Escalation and End-Stage Disease Genetic Counseling Chronic Thromboembolic Pulmonary Hypertension Pulmonary Hypertension from Left Heart Disease Special Clinical Circumstances High-Altitude Pulmonary Edema Sarcoidosis Sickle Cell Disease Pregnancy Perioperative Management Future Perspectives Acknowledgments References Chapter 89: Sleep-Disordered Breathing and Cardiac Disease Definitions Pathophysiology Pathophysiology of Obstructive Sleep Apnea Pathophysiology of Central Sleep Apnea Risk Factors for and Recognition of Sleep-Disordered Breathing Pathophysiologic Mechanisms That Link Sleep-Disordered Breathing to Cardiovascular Diseases Sleep-Disordered Breathing and Hypertension Sleep-Disordered Breathing and Coronary Heart Disease Sleep-Disordered Breathing, Cardiac Function, and Heart Failure Sleep-Disordered Breathing and Cardiac Arrhythmias Future Perspectives References Part X: Cardiovascular Disease in Select Populations Chapter 90: Cardiovascular Disease in Older Adults What is Aging? Age-Associated Changes in Cardiovascular Structure and Function Geriatric Domains Pertinent to Cardiovascular Care Precepts of Patient-Centered Care in Older Adults Diagnosis and Risk Assessment Disease Management and Care Coordination Application of Guidelines Shared Decision Making Care Transitions, Skilled Nursing Facilities, and Long-Term Care Palliative Care and End-of-Life Care Deprescribing Coronary Heart Disease Epidemiology Presentation Risk Stratification and Diagnosis Management Ischemia with Nonobstructive Coronary Arteries (INOCA) Acute Coronary Syndromes (ACS) Epidemiology Presentation Diagnosis Management Revascularization-STEMI Revascularization-NSTE-ACS Post-ACS Care and Discharge Planning Heart Failure Epidemiology Pathophysiology Diagnosis Lifestyle HF Management Pharmacotherapy for Chronic HFrEF Nonmedicinal Options for Chronic HFrEF Heart Failure with Preserved Ejection Fraction Cardiac Amyloidosis Pulmonary Hypertension Valvular Heart Disease Aortic Stenosis Cardiac Rhythm Abnormalities Supraventricular Arrhythmias Atrial Fibrillation Venous Thromboemblic Disease Epidemiology and Diagnosis Management Syncope Background Clinical Features and Etiology Evaluation Management Prevention Hypertension Hypertension Management Dyslipidemia Diabetes Tobacco Physical Inactivity Physical Activity Prescription Cardiac Rehabilitation Obesity Diet Noncardiac Surgery and Perioperative Management Considerations in Older Adults Background Risk Assessment Perioperative Management Specific Complications Discharge Planning Peripheral Arterial Disease, Abdominal Aortic Aneurysm, Aortic Dissection References Peripheral Arterial Disease, Abdominal Aortic Aneurysm, Aortic Dissection Lower Extremity Peripheral Arterial Disease (LE-PAD) Epidemiology Diagnosis Management Abdominal Aortic Aneurysm Epidemiology Diagnosis and Management Aortic Dissection Clinical Presentation Diagnosis and Management References Chapter 91: Cardiovascular Disease in Women Background Sex, Gender, and Genetic Differences in Cardiovascular Disease Cardiovascular Risk Factors in Women Cardiovascular Disease Risk Assessment Ischemic Heart Disease in Women Symptoms of Ischemia Delays in Care of Women Diagnosis of Ischemia in Women Interventions and Medical Therapy for Ischemic Heart Disease in Women Ischemic Heart Disease: Beyond Obstructive Coronary Artery Disease Ischemia with No Obstructive Coronary Artery Disease Myocardial Infarction with Nonobstructive Coronary Artery Disease Takotsubo Cardiomyopathy Cardiac Surgery Coronary Artery Bypass Graft Valvular Heart Surgery Transcatheter Aortic Valve Intervention Transcatheter Mitral Valve Repair Peripheral Arterial Disease Heart Failure Peripartum Cardiomyopathy Heart Failure Diagnosis Heart Failure Treatment Device Use in Heart Failure Mechanical Circulatory Support Cardiac Transplantation Arrythmia and Sudden Cardiac Death Cardiovascular Disease Prevention Acknowledgments References Chapter 92: Pregnancy and Heart Disease Cardiovascular Changes in Pregnancy Evaluation Prior to Pregnancy and During Pregnancy Cardiac Findings During Normal Pregnancy Role of Cardiac Testing During Pregnancy Evaluation and Counseling Prior to and During Pregnancy Risk Stratification Management Planning General Management Principles Specific Cardiovascular Conditions Hypertension Cardiomyopathies Myocardial Infarction and Ischemic Heart Disease Native Valvular Heart Disease Prosthetic Valves and Management of Anticoagulation Arrhythmias Congenital Heart Disease Cardiac Shunts Left-Sided Obstruction Complex Congenital Lesions Unoperated Complex Congenital Lesions Ebstein Anomaly Congenitally Corrected Transposition of Great Arteries Complex Congenital: Repaired Repaired Tetralogy of Fallot Repaired Transposition of Great Arteries Fontan Cyanotic Congenital Heart Lesions Pulmonary Hypertension Marfan Syndrome and Inherited Aortopathies Contraception References Chapter 93: Heart Disease in Racially and Ethnically Diverse Populations Epidemiology of Cardiovascular Disease in Heterogeneous Populations Cardiovascular Disease in Racial and Ethnic Groups Hypertension Type 2 Diabetes Cardiovascular Disease in Other Population Groups Cardiovascular Disease Management Hypertension Coronary Heart Disease Heart Failure Potential for Emerging Scientific Research to Address Group Disparities in Cardiovascular Disease Acknowledgments References Part XI: Cardiovascular Disease and Disorders of Other Organs Chapter 94: Endemic and Pandemic Viral Illnesses and Cardiovascular Disease: Influenza and COVID-19 Introduction Influenza and Cardiovascular Risk and Disease Epidemiology of Influenza and Cardiovascular Disease Influenza and Acute Myocardial Infarction Influenza and Heart Failure Influenza and Arrhythmia Risk Influenza and Myocarditis Influenza Prevention and Therapy Influenza Vaccine Formulations Antiviral Therapies for Influenza SARS-CoV-2 and COVID-19 Epidemiology of COVID-19 and Risk Factors Comorbidities and COVID-19 Illness Racial and Ethnic Influences on COVID-19 Illness Clinical Cardiovascular Manifestations of COVID-19 Atherosclerotic Cardiovascular Syndromes: Acute Coronary Syndromes and Stroke in COVID-19 Patients Myocarditis due to COVID-19 COVID-19 and Heart Failure Arrhythmias in COVID-19 Venous and Arterial Thromboembolism in COVID-19 Multisystem Inflammatory Syndrome in Children Biomarker Evidence of Myocardial Injury Biomarkers Suggestive of Prothrombotic State Cardiac Imaging Findings in COVID-19 Effects of the COVID-19 Pandemic on Cardiovascular Health More Broadly Treatment of COVID-19 and COVID-19-Related Complications Antiviral Therapy Anti-SARS-CoV-2 Monoclonal Antibodies Corticosteroid Therapy Other Management Considerations Role of Anticoagulation in COVID-19 Anticoagulation Strategies in COVID-19 Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers in the Setting of COVID-19 Prevention of COVID-19: Vaccines Postacute Sequelae SARS-CoV-2 Infection References Chapter 95: Hemostasis, Thrombosis, Fibrinolysis, and Cardiovascular Disease Hemostatic System Vascular Endothelium Platelet Inhibition Anticoagulant Activity Fibrinolytic Activity Platelets Adhesion Activation Platelet Aggregation Coagulation Extrinsic Tenase Intrinsic Tenase Prothrombinase Fibrin Formation Contact System Fibrinolytic System Mechanism of Action of Tissue Plasminogen Activator Mechanism of Action of Urokinase Plasminogen Activator Mechanism of Action of Thrombin-Activatable Fibrinolysis Inhibitor Thrombosis Arterial Thrombosis Venous Thrombosis Inherited Hypercoagulable States Factor V Leiden Prothrombin Gene Mutation Elevated Levels of Procoagulant Proteins Antithrombin Deficiency Protein C Deficiency Protein S Deficiency Other Hereditary Disorders Acquired Hypercoagulable States Surgery and Immobilization Advanced Age Obesity Cancer Pregnancy Estrogen Therapy History of Previous Venous Thromboembolism Antiphospholipid Syndrome Treatment of Thrombosis Antiplatelet Drugs Aspirin Mechanism of Action Indications Dosages Side Effects Aspirin Resistance Thienopyridines Mechanism of Action Indications Dosages Ticagrelor Mechanism of Action Dosages Side Effects Indications Cangrelor Dipyridamole Mechanism of Action Dosages Side Effects Indications Glycoprotein IIb/IIIa Receptor Antagonists Mechanism of Action Dosages Side Effects Indications Vorapaxar Anticoagulants Parenteral Anticoagulants Heparin Mechanism of Action Pharmacology of Heparin Monitoring the Anticoagulant Effect of Heparin Dosages Limitations of Heparin Side Effects Bleeding Thrombocytopenia Osteoporosis Elevated Levels of Transaminases Low-Molecular-Weight Heparin Mechanism of Action Pharmacology of Low-Molecular-Weight Heparin Monitoring of Low-Molecular-Weight Heparin Dosages Side Effects Bleeding Thrombocytopenia Osteoporosis Fondaparinux Mechanism of Action Pharmacology of Fondaparinux Side Effects Parenteral Direct Thrombin Inhibitors Argatroban Bivalirudin Oral Anticoagulants Warfarin Mechanism of Action Pharmacology Monitoring Dosages Side Effects Bleeding Skin Necrosis Pregnancy Special Problems Direct Oral Anticoagulants Mechanism of Action Dosages Monitoring Side Effects Periprocedural Management Management of Bleeding Pregnancy Novel Anticoagulants in Development Fibrinolytic Drugs Streptokinase Anistreplase Urokinase Alteplase Tenecteplase Reteplase Future Perspectives References Chapter 96: Endocrine Disorders and Cardiovascular Disease Pituitary Hormones and Cardiovascular Disease Growth Hormone Cardiovascular Manifestations of Acromegaly Diagnosis Growth Hormone Deficiency Prolactin Disease Adrenal Hormones and Cardiovascular Disease Adrenocorticotropic Hormone and Cortisol Cushing Disease and Cushing Syndrome Diagnosis Primary Hyperaldosteronism Diagnosis Addison Disease Diagnosis Treatment Pheochromocytoma and Paraganglioma Diagnosis Parathyroid Hormone and Cardiovascular Disease Hyperparathyroidism Diagnosis Hypocalcemia Vitamin D Thyroid Hormone and Cardiovascular Disease Cellular Mechanisms of Thyroid Hormone Action on the Heart Diagnosis of Hyperthyroidism Cardiovascular Manifestations of Overt and Subclinical Hyperthyroidism Atrial Fibrillation in Overt and Subclinical Hyperthyroidism Heart Failure in Overt and Subclinical Hyperthyroidism CHD in Hyperthyroidism Pulmonary Hypertension and Autoimmune Cardiovascular Involvement Diagnosis of Overt and Subclinical Hypothyroidism Cardiovascular Effects of Overt and Subclinical Hypothyroidism Coronary Heart Disease Amiodarone and Thyroid Function Changes in Thyroid Hormone Metabolism That Accompany Cardiac Disease Future Perspectives References Pituitary Function and Cardiovascular Disease Chapter 97: Rheumatic Diseases and the Cardiovascular System Atherosclerosis and the Rheumatic Diseases Endothelial Dysfunction and Vascular Injury Rheumatoid Arthritis Atherosclerotic Disease in Rheumatoid Arthritis Systemic Lupus Erythematosus Atherosclerotic Disease in Systemic Lupus Erythematosus Atherosclerosis in Association With Other Rheumatic Diseases Vasculitides Large-Vessel Vasculitis Giant Cell Arteritis Pathogenesis Diagnosis Cardiovascular Complications Takayasu Arteritis Pathogenesis Diagnosis Cardiovascular Complications Kawasaki Disease Pathogenesis Diagnosis Cardiovascular Complications Treatment Idiopathic Aortitis Treatment of Large-Vessel Vasculitis Medium-Vessel Vasculitis Eosinophilic Granulomatosis With Polyangiitis (Churg-Strauss Syndrome) Cardiovascular Complications Investigation Treatment Polyarteritis Nodosa Cardiovascular Complications Treatment Granulomatosis With Polyangiitis (Wegener Granulomatosis) Microscopic Polyangiitis Investigation Treatment Pericarditis and Myocarditis Pericarditis Systemic Lupus Erythematosus Rheumatoid Arthritis Systemic Sclerosis Pericardial Fluid Analysis Treatment Myocarditis Systemic Lupus Erythematosus Systemic Sclerosis Myositis Other Causes of Myocarditis Treatment Valvular Heart Disease Systemic Lupus Erythematosus Treatment Seronegative Spondyloarthropathies Treatment Rheumatoid Arthritis Takayasu Arteritis Cardiac Conduction Disturbances Systemic Lupus Erythematosus and Sjögren Syndrome Systemic Sclerosis Spondyloarthropathies Polymyositis and Dermatomyositis Rheumatoid Arthritis Pulmonary Arterial Hypertension Systemic Sclerosis Pathogenesis Screening Treatment and Outcome Systemic Lupus Erythematosus Pathogenesis Clinical Findings and Diagnosis Treatment and Outcome Rheumatoid Arthritis Sjögren Syndrome Takayasu Arteritis Thrombosis in the Rheumatic Diseases Antiphospholipid Syndrome Cardiovascular Disease Treatment Behçet Disease Treatment Antirheumatic Drugs and Cardiovascular Disease Relationship Between Drug Treatment and Cardiovascular Disease B Cell Depletion Methotrexate Other Disease-Modifying Antirheumatic Drugs Glucocorticoids Statins Nonsteroidal Antiinflammatory Drugs Future Perspectives References Chapter 98: Tumors Affecting the Cardiovascular System Clinical Manifestation of Cardiac Tumors Initial Clinical Decision Making Regarding Cardiac Masses Classification of Cardiac Tumors Benign (Nonmalignant) Primary Cardiac Tumors Simple Benign Tumors Myxomas Etiology and Pathophysiology Clinical Manifestations Laboratory Testing Treatment Fibroelastoma Rhabdomyomas Lipomas Cystic Tumor of the AV Node (Previously Called Mesothelioma) Other Very Rare Benign Cardiac Tumors Complex Benign Tumors Paragangliomas Fibromas Treatment Malignant Primary Cardiac Tumors Sarcomas Clinical Manifestations Laboratory Investigations Treatment Heart Tumor Team Secondary Cardiac Tumors Treatment Direct and Indirect Complications of Neoplasia Pericardial Effusion Cardiac Tamponade Constrictive Pericarditis Superior Vena Cava Syndrome Future Perspectives References Treatment of Sarcomas Right Heart Sarcoma Left Heart Sarcoma Pulmonary Artery Sarcoma References The Superior Vena Cava Syndrome in Cancer Patients Anatomy Clinical Diagnosis Laboratory Investigation Treatment References Chapter 99: Psychiatric and Psychosocial Aspects of Cardiovascular Disease Acute Stress and Emotional Arousal Stress and Emotional Triggers of Acute Cardiovascular Events Cardiovascular Responses to Everyday Stressors and Emotions Mechanisms Underlying Acute Stress Effects Cardiovascular Consequences of Chronic Stress Childhood Adversity Socioeconomic Status Occupational Stress and Unemployment Social Discrimination and Stigmatization Caregiving Combinations of Chronic and Acute Stress Mental Health and Psychiatric Disorders Mechanisms Shared Features Across Mental Disorders Anxiety Posttraumatic Stress Disorder Depression Cognitive Impairment Evaluation and Management of Mental Health in the Cardiac Patient Current Guidelines Serotonin and Norepinephrine Dual Reuptake Inhibitors Monoamine Oxidase Inhibitors Antidepressants with Other Mechanisms of Action Antidepressants and Drug-Drug Interactions Mindfulness Exercise Chapter 100: Neuromuscular Disorders and Cardiovascular Disease Neuromuscular Diseases Muscular Dystrophies Duchenne and Becker Muscular Dystrophy Genetics and Pathogenesis Clinical Presentation Cardiovascular Manifestations Electrocardiography Imaging Arrhythmias Treatment and Prognosis Myotonic Dystrophies Genetics and Pathogenesis Clinical Presentation Cardiovascular Manifestations Electrocardiography Imaging and Heart Failure Arrhythmias Treatment and Prognosis Emery-Dreifuss Muscular Dystrophy and Associated Disorders Genetics and Cardiac Pathology Clinical Presentation Cardiovascular Manifestations Treatment and Prognosis Limb-Girdle Muscular Dystrophies Genetics and Pathophysiology Clinical Presentation Cardiovascular Manifestations Treatment and Prognosis Facioscapulohumeral Muscular Dystrophy Genetics and Pathophysiology Clinical Presentation Cardiovascular Manifestations Treatment and Prognosis Friedreich Ataxia Genetics and Pathophysiology Clinical Presentation Cardiovascular Manifestations Treatment and Prognosis Less Common Neuromuscular Diseases Associated with Cardiac Manifestations The Periodic Paralyses Genetics and Clinical Presentation Cardiovascular Manifestations Treatment and Prognosis Mitochondrial Disorders Genetics and Clinical Presentation Cardiovascular Manifestations Treatment and Prognosis Spinal Muscular Atrophy Genetics and Clinical Presentation Cardiovascular Manifestations Treatment and Prognosis Myofibrillar Myopathies Genetics and Clinical Presentation Cardiovascular Manifestations Treatment and Prognosis Guillain-Barré Syndrome Clinical Presentation Cardiovascular Manifestations Treatment and Prognosis Myasthenia Gravis Clinical Presentation Cardiovascular Manifestations Treatment and Prognosis Myoglobinopathy ABCC9-Related Intellectual Disability Myopathy Syndrome Epilepsy Cardiovascular Manifestations Treatment and Prognosis Acute Cerebrovascular Disease Cardiovascular Manifestations Treatment and Prognosis Conclusions/Future Perspectives References Chapter 101: Interface Between Renal Disease and Cardiovascular Illness The Cardiorenal Intersection Chronic Kidney Disease and Cardiovascular Risk Implications of Anemia Due to Chronic Kidney Disease Contrast-Induced Acute Kidney Injury Prevention of Contrast-Induced Acute Kidney Injury Cardiac Surgery Associated Acute Kidney Injury Acceleration of Vascular Calcification Renal Disease and Hypertension Diagnosis of Acute Coronary Syndromes in Patients with Chronic Kidney Disease Renal Dysfunction as a Prognostic Factor in Acute Coronary Syndromes Reasons for Poor Outcomes After Acute Coronary Syndromes in Patients with Renal Dysfunction Treatment of Myocardial Infarction in Patients with Renal Dysfunction Cardiorenal Syndromes Chronic Kidney Disease and Valvular Heart Disease Renal Function and Arrhythmias Consultative Approach to Severe Kidney Disease and Hemodialysis Patients Evaluation and Management of the Renal Transplant Recipient Summary References Chapter 102: Cardiovascular Manifestations of Autonomic Disorders Ovewview of Anatomy and Physiology of the Autonomic Nervous System Sympathetic, Parasympathetic, and Intrinsic Neuronal Control Baroreflex Chemoreflex Diving Reflex Pathophysiology Autonomic Dysfunction in the Setting of a Structurally Normal Heart Autonomic Dysfunction in the Setting o fIntrinsic Cardiac Disease Proarrhythmia Atrial Fibrillation Ventricular Tachycardia/Ventricular Fibrillation Investigations and Diagnosis Orthostatic Blood Pressure Valsalva Maneuver Cold Pressor Test Plasma Catecholamines Neuromodulatory Therapies Pharmacologic Therapy Sympathetic Modulation Thoracic Epidural Anesthesia/Percutaneous Stellate Block Renal Denervation Cardiac Sympathetic Denervation Augmentation of Parasympathetic Drive Vagal Nerve Stimulation Spinal Cord Stimulation Baroreceptor Stimulation Future Perspectives References Disclosure Index Relationship Codes (null) Index A (null)
