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Coronary Microvascular Obstruction in Acute Myocardial Infarction: From Mechanisms to Treatment provides a comprehensive understanding of the phenomenon of coronary microvascular obstruction (CMVO) that is the main limitation of reperfusion therapies in ST-elevation myocardial infarction. It provides in-depth coverage of the phenomenon of CMVO which heavily affects prognosis by increasing the risk of death and heart failure at follow-up. A first of its kind reference dedicated solely to this topic, it is appropriate for a wide audience, from researchers, to those who aid in the management, prevention and treatment of CMVO. Provides in-depth coverage of coronary microvascular obstruction (CMVO), spanning research, management, prevention and treatment Includes the most up-to-date information on CMVO as presented from top experts around the word Provides access to a companion website with extra material, including tables, additional references and instructional videos Gives extensive coverage on how to measure CMVO, including in-depth indexes that can be used to detect and quantify the phenomenon

Get the tools and knowledge you need for effective diagnosis, evaluation, and management of patients with acute myocardial infarction. Myocardial Infarction: A Companion to Braunwald's Heart Disease, by David A. Morrow, MD, is a comprehensive, hands-on resource that provides practical guidance from a name you trust. Concise and easy to use, this text explores the most recent tools for diagnosis and therapeutic decision-making, as well as the full range of available management strategies, providing outcomes data for each strategy. Myocardial Infarction also includes regular updates with late-breaking clinical trials, reviews of important new articles, and the latest guidance on clinical practice, all selected and masterfully edited by Dr. Eugene Braunwald. Provides thorough discussions of ECG, established and emerging biochemical markers, angiography, nuclear cardiology, echocardiography, and cardiac MRI and CT. Features an extensive treatment section that covers the latest drugs and most recent clinical trials of antiplatelet therapy, coronary revascularization, gene therapy, and approaches to reperfusion injury and ventricular remodeling. Discusses special considerations for the evaluation of acute coronary syndromes in the emergency department, and use of advanced technologies in cardiac critical care. Covers key topics such as in-hospital complications, cardiogenic shock, transitions to post-discharge care, and cardiac rehabilitation. Includes Clinical Practice/Controversy chapters that highlight management-focused, practical topics covering expert approaches for areas of uncertainty. Offers guidance on the management of special populations. Consult this title on your favorite e-reader for access to regularly added update content, to conduct rapid searches, and adjust font sizes for optimal readability.

In der vorliegenden Arbeit wurde 1) die Rolle des mitochondrialen STAT3 und der Mitochondrienfunktion bei dem Schutz durch PoCo und 2) der Einfluss von CsA auf die Phosphorylierung von kardioprotektiven Proteinen und auf die Mitochondrienfunktion in einem klinisch relevanten Tiermodell, dem Schwein mit regionaler Ischämie und Reperfusion, untersucht.Ischämische Postkonditionierung (PoCo), mehrere Zyklen von Ischämie/Reperfusion oder eine Cyclosporin A (CsA)-Infusion vor/zu Beginn der Reperfusion verringern die Infarktgröße am Herzen.PoCo reduzierte die Infarktgröße, erhöhte die STAT3-Phosphorylierung am Tyrosin705 in Myokardbiopsien und in isolierten Mitochondrien, verbessert die mitochondriale Komplex I Respiration und die Calcium-Retentionskapazität (CRC). Die STAT3-Blockade hob alle Effekte von PoCo auf. CsA reduzierte die Infarktgröße; die Proteinphosphorylierung und die Komplex I Respiration war vergleichbar mit der Kontrolle und die CRC erhöht.Die Ergebnisse dieser Arbeit weisen auf eine kausale Beteiligung der mitochondrialen STAT3-Aktivierung bei der Vermittlung der Kardioprotektion durch PoCo über eine verbesserte Mitochondrienfunktion hin. Der Schutz durch CsA wird über eine Hemmung der mitochondrialen Permeabilitäts-Transitions-Pore und nicht über eine besser erhaltene Proteinphosphorylierung vermittelt.

Although there are many books on ischemic heart disease and myocardial in­ farction, very few relate to the acute phase of the illness. Pre-hospital coronary care units have been operational for over a decade. In 1975 the first book detailing the operation and results of the out-of-hospital Belfast Mobile Coronary Care Unit was published (The Acute Coronary Attack - Pitman Medical). Nevertheless, deaths due to coronary artery disease still remain a major challenge in contemporary society. Sudden death is largely an out-of-hospital problem. Since ventricular fibril­ lation is an electrical accident and can be readily corrected when a limited area of the ventricle is depolarized, methods for its containment are essential. The purpose of this book is to project the recent advances in the acute phase of ischemic heart disease. The early chapters document the history and recent develop­ ments in the understanding of ventricular fibrillation, ventricular defibrillation and cardiopulmonary resuscitation. The etiology of ventricular arrhythmias in the acute phase of myocardial ischemia in experimental animals is discussed with particular reference to the antiarrhythmic action of drugs. Factors observed in the initiation of ventricular fibrillation in patients outside the hospital are reviewed. The practical applications both in the field of biomedical engineering as applied to mobile coro­ nary care and in the approach and impact of pre-hospital coronary care in the various communities in the United States of America, Canada, United Kingdom, and other countries in Europe are presented.

Ein Herzinfarkt trifft Menschen nur scheinbar wie ein Blitz aus heiterem Himmel. Tatsächlich entwickelt sich die Gefahr langsam, über viele Jahre. Schutz kann eine veränderte Lebensweise bieten. Der Gesundheitsratgeber informiert in leicht verständlicher Form über wirksame Vorbeugung, über Früherkennungs- und Behandlungsmethoden sowie über Wege, wie man auch nach dem Herzinfarkt ohne Angst leben kann. Viele praktische Hinweise helfen Betroffenen und Angehörigen, die notwendigen Schritte zu gehen – zu einer „herzgesunden“ Lebensweise.

Practice and Procedures are continually changing with a corresponding improvement in healthcare. Concomitantly, the demand for comprehensive and focused evidenced-based text and scientific literature covering single areas of nursing and healthcare science or treatment has also increased. The volume on Angina covers, inter alia, epidemiology of angi

This book attempts to focus on the most important clinical aspects of ischaemic heart disease. Clearly, in no way is it supposed to be a comprehensive review of the subject, but it does attempt to address the most important topics for everyday practising clinicians. The question of epidemiology is topical both in the lay and medical press and is, therefore, covered in some detail. It is the editor's opinion that proper understanding of the clinical manifestations of the disease and, therefore, subsequent investigation and treatment are based on a detailed understanding of the pathology and pathophysiology, and as a result these subjects have also been covered in detail. In the last decade there have been considerable advances in our understanding of the mechanisms of angina and also the haemodynamic and metabolic consequences of both angina and myocardial infarction. Again, if appropriate investigations and treatment are to be undertaken, they can only be done with the proper knowledge of the disease being investigated. Finally, the investigation and management of the various mani­ festations of ischaemic heart disease have been addressed. In the last ten years there has been an explosion in the drugs available for the treatment of ischaemic heart disease and how they should be used has become much more sophisticated. The place of coronary artery surgery has now been rationalized and angioplasty provides an important adjunct to treatment.

Cardiovascular diseases account for about half of total mortality in industrialised societies. This figure has declined only slightly and in few countries over the past few decades, which is disturbing in view of our increasing insight into long-term risk factors of coronary heart disease and the dramatic improvement in the acute therapy of its manifestations. One important reason for this is the high fatality during the initial hours of a coronary event, i.e. before medical treatment can be provided. Approximately one quarter of all patients suffering an acute cardiac event die prior to admission to hospital. As a result, the focus of current research has shifted from after-the-fact therapy to the triggering phase of acute coronary disease. Epidemiological observations of recent trends and newly identified determinants of coronary disease and the results of substantial pathophysiological studies of the conversion from chronic coronary disease to an acute event provide the basis for new hypotheses about the triggering mechanisms. The ultimate goal is to design more effective preventive strategies for these deadly diseases. The present extensive summary of important scientific and clinical developments in the study of the triggering and prevention of coronary syndromes that have been seen over the last ten years contains the contributions of leading experts in the field. It presents a cooperative, balanced view derived from physicians and researchers in the U.S. and Europe.

Acute coronary syndromes encompasses the spectrum of clinical disorders caused by acute ischemic heart disease -- unstable angina, ST-elevation myocardial infarction, non-ST-elevation myocardial infarction -- which account for 2 million hospitalizations and 30% of all deaths in the United States each year.ACS Essentials, Third Edition provides the latest clinical guidelines and trials for the management of acute coronary syndromes. Step-by-step guide to unstable angina, important clinical trials, common management pitfalls, drug summaries, and other cardiovascular risk reduction measures are emphasized.

Acute Coronary Syndrome covers the spectrum of clinical conditions ranging from unstable angina to non-ST elevation myocardial infarction and ST elevation myocardial infarction. These life-threatening disorders are a major cause of emergency medical care, hospitalization and mortality. Management of Acute Coronary Syndromes is designed to provide busy clinicians with a comprehensive guide to the investigation, diagnosis and treatment of these syndromes. It encompasses the latest technologies, including the use of biomarkers and non-invasive imaging procedures. For each condition, the reader is taken through all of the therapeutic options available; in each case the indications and contraindications are evaluated in the light of the latest clinical trials. Potential complications are dealt with in a similar fashion, permitting the reader to anticipate and manage problems as they arise. The authors also present evidence-based recommendations for long-term care of at-risk patients, encompassing pharmacologic therapies and lifestyle management. The book concludes with a comprehensive collection of appendices that include treatment algorithms, risk scores and a summary of the latest management guidelines. Management of Acute Coronary Syndromes is the most up to date and comprehensive evidence-based guide to managing acute coronary syndromes, in a compact and usable format. It will be of interest to busy specialist physicians in cardiovascular medicine, cardiac and vascular surgery, and critical care, as well as primary care physicians and hospitalists who care for patients with these syndromes.

The Second Edition of Primary Angioplasty provides an update on the rationale, techniques, and effectiveness of direct percutaneous mechanical revascularization for acute myocardial infarction. Through the use of'real world'methods, clinical perspectives, and mechanical support, this comprehensive resource guides interventional cardiologists and

Description based on print version record.

The past 50 years have witnessed a breathtaking evolution in the approaches to the patient with an acute ST elevation myocardial infarction. In the 1960s, the now commonplace cardiac intensive care unit was but a nascent idea. Without much to offer the patient but weeks of absolute bedrest, substantial morbidity and high rates of mortality were the norm. Just 30 years ago, seminal discoveries by DeWood and colleagues suggested that the culprit was plaque rupture with thrombosis, not progressive luminal compromise. Subsequent fibrinolyt- based strategies resulted in a halving of the mortality of acute myocardial infarction. With the introduction of balloon angioplasty in the late 1970s, a few interventional cardiologists braved the question: why not perform emergency angioplasty as a primary reperfusion strategy? Indeed, reports of successful reperfusion via balloon angioplasty appeared (mostly in local newspapers) as early as 1980. Despite being thought of as heretical by mainstream cardiology, these pioneers nonetheless persevered, proving the benefit of ‘‘state-of-the-art''balloon angioplasty compared with ‘‘state-of-t- art''thrombolytic therapy in a series of landmark trials published in the New England Journal of Medicine in March of 1993. Publication of the first edition of Primary Angioplasty in Acute Myocardial Infarction in 2002 to some extent anticipated the widespread acceptance of primary percutaneous coronary intervention as the standard of care. Since then, in all respects, the evolution of emergency percutaneous revascularization has only accelerated. The universal replacement of balloon angioplasty with stent implantation was clearly one key.

Myocardial infarctions (MIs), commonly known as heart attacks, occur in more than 1 million people in the United States each year. Approximately 60% of MI sufferers survive, and require special care, as the condition may lead to disability and put the patient at an increased risk for co-morbid conditions. This authoritative text presents clear options for rehabilitation, drug therapy, and schedules for laboratory testing for surviving myocardial infarction patients, as well as pharmacologic treatment choices.

This guide to the proper use of the ECG in diagnosing acute myocardial infarction puts the combined experience of international authorities at your fingertips for immediate use. In The 12 Lead ECG in ST Elevation MI: A Practical Approach for Clinicians, Drs. Bayés de Luna, Fiol-Sala and Antman supply the practical, specific information you need to determine which patients with ACS are showing ST elevation. To facilitate correct diagnosis and guide management, the authors use a consistent sequence to explain the ECG abnormalities for each site of coronary occlusion. A schematic of the coronary tree illustrates the point of occlusion. The second part of the book contains a self-assessment section with a series of 15 cases, each of which includes one or more 12-lead ECGs for analysis. These valuable examples help you prepare for on-the-spot interpretation in the emergency department or intensive care unit.

This straightforward guide to the recognition and management of ischemic heart disease provides clinically relevant information needed by today's medical practitioners. The book covers the disease's epidemiology, pathogenesis, clinical presentation, diagnostic tests, differential diagnosis, treatment, and prognosis. Topics include detection of myoc

In excess of 7 million people worldwide die of coronary heart disease each year. Only one-third of these heart attack victims recover completely. The remainder suffer the consequences of myocardial infarction and its ill fated remodeling process, resulting in chronic congestive heart failure. This malady alone is the leading cause of hospital admissions in the United States. New breakthroughs in stem cell therapy and tissue engineering have promised to reverse this dismal outcome by cardiovascular repair. World authorities, including scientists and regulatory authorities, have joined in a collaborative effort to present for the reader the first collective review of stem cell therapy for the treatment of cardiovascular disease. These contributions in basic science, pre-clinical and clinical experience guided by the regulatory pathways, assure a rapid course of translational research and clinical trials. The contents of this publication will become a prerequisite for those preparing to meet the challenges of this exciting and potentially rewarding field of stem cell research.

This booklet explains why heart attacks and strokes happen and how you can avoid them. It tells you what you should do to avoid becoming a victim. It gives you guidance for your children too. A lot of the damage to the blood vessels starts at a young age. Children often need help to develop healthy habits, like eating a balanced diet and being active. If you are at high risk, there is advice on the signs to look out for and what you can do to reduce your risk. If you have already had a heart attack or stroke, there is advice on how your condition can be treated and controlled, and how you can.

Il volume fornisce una rivisitazione schematica ma, nello stesso tempo, completa e aggiornata della problematica relativa alla Sindrome Coronarica Acuta, alla luce di quanto pubblicato negli ultimi dieci anni. Premettendo i concetti di elettrocardiografia e di istofisiopatologia, viene affrontata la riclassificazione nosologica della patologia coronarica acuta derivata dall'introduzione nella pratica clinica dei nuovi marker di necrosi miocardica, sottolineando anche la necessità che il Medico valuti il rischio intrinseco alla malattia attraverso il calcolo di specifici punteggi proposti dagli studi clinici. Si analizzano, quindi, i diversi percorsi terapeutici che devono essere posti in essere, sia quelli puramente farmacologici, sia quelli più'aggressivi'. Ampio spazio viene dato alle modalità d'impiego dei nuovi trattamenti antitrombotici e alle modalitö di scelta fra terapia farmacologica e approccio invasivo mediante coronarografia e angioplastica.

Acute myocardial infarction (AMI) remains a major problem in the Western world. Complete and concise, Primary Angioplasty: Mechanical Interventions for Acute Myocardial Infarction provides an update on the rationale, techniques, and effectiveness of direct percutaneous mechanical revascularization for AMI. It combines a critical review of the key studies that are the foundation of evidence-based medicine with the so-called'technology of experience.'The book puts the pathophysiologic and clinical aspects of AMI and reperfusion in an interventional perspective, highlighting the rationale for the best interventional approach to the patient with AMI. Sharing insights based on their years of experience, the chapter authors present a comprehensive review of direct angioplasty and stenting supported by a full description of cases representing different angiographic and clinical patient subsets. The innovative format includes four sections based on clinical, technical, procedural, and logistic aspects of mechanical intervention for AMI. The book may be read in a conventional way, from beginning to end, or alternatively, starting from one of the four sections, and then following all possible sequences for the remaining three sections.

In this second edition of his highly acclaimed book, Christopher P. Cannon, MD, and a team of preeminent clinical investigators have thoroughly revised and expanded every chapter to reflect the recent explosion of clinical trials on the management of acute coronary syndromes (ACS). This includes: the newer tests, such as C reactive protein; a multimarker approach to diagnosis and risk stratification; new antiplatelet agents; and combinations of thrombolytic-antithrombotic regimens. Also discussed are the latest developments in interventional cardiology, the use of cost-effectiveness in clinical trials to choose appropriate therapies, and the employment of critical pathways analysis to improve compliance with evidence-based medicine and guideline recommendations.

Leading investigators and highly experienced clinicians collect and summarize the world's literature and augment this with practical wisdom concerning this critically important form of care, including its technical, professional, and administrative aspects. Among the topics covered are the technique and technology of direct angioplasty, patient selection, regulatory issues, performance metrics, clinical trials and outcomes, adjunctive pharmacology, economics, and implications for the health care system. The practicing cardiologist will appreciate the many useful how-to tips and pointers; the cardiology fellow will value the a-to-z approach that addresses all critical issues; the administrator will learn all the details of creating, maintaining, evaluating, and justifying a successful program.

Millions of people—many of them younger than we care to believe—are living in the aftermath of a heart attack, and it is vital for them to learn how to reduce the risk factors for subsequent heart problems. This unique and important book offers advice to survivors of a heart attack and also to those trying to prevent the onset of a heart attack. Contributors include not only distinguished medical professionals but also eleven individuals who either participated in a cardiac rehabilitation program or designed a program of their own. The patients—men and women of varied ages and ethnic backgrounds—relate their own histories, providing insight into the many faces of heart disease and inspiration and hope for other heart attack survivors.The book includes:• risk factors• diets, diagnosis, and treatment• ways to prevent angina from becoming a heart attack• strategies for reversing coronary artery disease• guidelines for choosing a cardiac rehabilitation program• a description of cardiac rehabilitation in action

This newly revised and expanded reference documents the ascendancy of silent coronary artery disease from an esoteric phenomenon in the early 1970s to a key component of the ischemic spectrum in the new millennium. Containing nearly 500 citations, including work published in 1998 and 1999, the Fourth Edition of Silent Myocardial Ischemia and Infarction examines the latest pathophysiological evaluations of chest pain assesses the prevalence of newly recognized types and presentations of myocardial disease determines the most reliable and most recent noninvasive methods of detecting myocardial ischemic syndromes identifies indications for cardiac catheterization in asymptomatic patients considers patients'prognoses in light of new long-term follow-ups discusses when, if, and how silent myocardial ischemia should be treated based on current studies and more!Written by a pioneer in the field and including more than 140 tables, drawings, and photographs, Silent Myocardial Ischemia and Infarction, Fourth Edition continues to be crucial for cardiologists, cardiovascular and thoracic surgeons, internists, family physicians specializing in cardiology, public health physicians, physiologists, and medical school students in these disciplines.

Over the past three decades, impressive progress in the field of pathogenesis, prevention and therapy of ischemic heart disease has resulted in a marked decline in mortality in the Western World. However, the incidence of this devastating disease is on the rise in developing countries. The Ischemic Heart is based upon a recent symposium in Tokyo on the subject. This volume is organized into two sections: (i) Pathophysiologic Mechanisms of Ischemia-Reperfusion Injury and (ii) Preconditioning and Protection of Ischemia-Reperfusion Injury, and contains up-to-date information concerning the current concepts of ischemia-reperfusion injury, the sequence of events resulting in the loss of contractile dysfunction, and mechanisms of cardioprotection by several drugs as well as the role of ischemic preconditioning in attenuating problems associated with ischemia-reperfusion injury.