1.32Does 201Tl and 123I-BMIPP mismatch uptake really reflect myocardial ischaemia in patients undergoing as screening tests of ischaemic heart disease?

2007 ◽  
Vol 14 (2) ◽  
pp. S8-S8
Author(s):  
A NAKAMURA ◽  
M MOMOSE ◽  
C KONDO ◽  
T NAKAJIMA ◽  
H HIROSHI ◽  
...  
Keyword(s):  
Heart Disease ◽  
Ischaemic Heart Disease ◽  
Myocardial Ischaemia ◽  
Screening Tests

Chronic ischaemic heart disease

2018 ◽  
pp. 179-201
Author(s):  
Bernhard L Gerber ◽  
Mouaz H Al-Mallah ◽  
Joao AC Lima ◽  
Mohammad R Ostovaneh
Keyword(s):  
Myocardial Infarction ◽  
Heart Disease ◽  
Magnetic Resonance ◽  
Ischaemic Heart Disease ◽  
Myocardial Ischaemia ◽  
Dobutamine Stress ◽  
Left Ventricular ◽  
Contractile Reserve ◽  
Additional Information ◽  
Artery Disease

Chronic ischaemic heart disease (IHD) is one of the most common cardiac conditions worldwide and is generally caused by the consequences of coronary atherosclerosis, including myocardial infarction. Clinical challenges in chronic IHD include detection of myocardial ischaemia in symptomatic patients with suspected coronary artery disease (CAD), evaluation of myocardial viability in patients with established IHD and poor left ventricular ejection fraction (LVEF) when revascularization is considered, as well as risk stratification and identification of patients with chronic IHD at high risk of complications. Cardiovascular magnetic resonance (CMR) can provide vital answers to all three of these challenges. Stress CMR is now increasingly used to detect ischaemia by means of vasodilator stress perfusion or dobutamine stress contractile reserve stress imaging. For viability assessment, late gadolinium enhancement is currently the method of choice to detect myocardial infarction, and low-dose dobutamine stress magnetic resonance can provide additional information to determine viability and guide therapy. Cardiovascular risk in patients with chronic IHD is mainly determined by left ventricular function, most commonly utilizing LVEF, as well as infarct size, infarct characteristics, and ischaemic burden, which can all be measured reliably with CMR. This chapter will review the role of CMR for the detection of myocardial ischaemia, viability, and risk.

Cardiovascular disease

2014 ◽  
Author(s):  
Anthea Hatfield
Keyword(s):  
Cardiovascular Disease ◽  
Heart Disease ◽  
Side Effects ◽  
Ischaemic Heart Disease ◽  
Myocardial Ischaemia ◽  
Cardiac Failure ◽  
Valvular Heart Disease ◽  
Recovery Room ◽  
Signs And Symptoms ◽  
Common Problems

Cardiovascular disease is common and patients coming to recovery room with any of these common problems will need special care. The essential signs and symptoms of hypertension, cardiac failure, ischaemic heart disease, and valvular heart disease are outlined. The actions and side-effects of the drugs that these patients take to control their symptoms are described. Recognizing and treating hypotension and myocardial ischaemia are very important and relevant, and they are fully discussed in this chapter.

Clinical symptoms of stable ischaemic heart disease

ESC CardioMed ◽  
2018 ◽  
pp. 1339-1343
Author(s):  
Ulrich Fischer-Rasokat ◽  
Christian Hamm
Keyword(s):  
Heart Disease ◽  
Chest Pain ◽  
Angina Pectoris ◽  
Ischaemic Heart Disease ◽  
Myocardial Ischaemia ◽  
Clinical Symptoms ◽  
Physical Exertion ◽  
Chest Discomfort ◽  
Wide Range ◽  
Very High

Ischaemic heart disease (IHD) becomes symptomatic when myocardial demand exceeds blood supply. Myocardial ischaemia leads to a wide range of symptoms, including chest pain as well as diffuse, worrisome sensations, all of which can be summarized under the term ‘chest discomfort’. Cardiac chest discomfort may be characterized according to four attributes: character, location, duration, and association with provoking or relieving factors. Typical angina pectoris, with a very high probability of significant epicardial coronary stenosis, can be diagnosed if three pre-specified criteria are met, whereas atypical angina pectoris, with only a moderate probability of IHD, and non-anginal chest pain fulfil fewer of these criteria. Angina pectoris can be quantified according to the Canadian Cardiovascular Society classification, which is based on threshold activities of angina-limited physical exertion. Some patients with IHD do not complain of chest discomfort but report symptoms such as sweating, nausea, or dyspnoea that have been demonstrated to be early indicators of IHD, denoted here as ‘angina equivalents’. Patients who do not experience any symptoms at all although myocardial ischaemia is detected are said to have ‘silent’ ischaemia. Patients with chest pain or discomfort use certain uniform hand gestures to describe the localization and character of the pain; thus, body language may be complementary to diagnostic criteria for IHD. Women are more likely to present with atypical forms of chest discomfort, and IHD is diagnosed roughly 10 years later in women than in men. Careful interpretation of patients’ descriptions of their symptoms is crucial to correctly diagnosing IHD.

scholarly journals ISCHEMIA Trial: Key Questions and Answers

2021 ◽  
Vol 16 ◽  
Author(s):  
Jose Lopez-Sendon ◽  
Raúl Moreno ◽  
Juan Tamargo
Keyword(s):  
Heart Disease ◽  
Ischaemic Heart Disease ◽  
Medical Therapy ◽  
Myocardial Ischaemia ◽  
Healthy Lifestyle ◽  
Stable Coronary Artery Disease ◽  
Symptom Control ◽  
Cardiovascular Death ◽  
Optimal Medical Therapy ◽  
Number Of Patients

A healthy lifestyle, myocardial revascularisation and medical therapy constitute the three pillars for the treatment of ischaemic heart disease. Lifestyle and optimal medical therapy should be used in all cases. However, the selection of cases for revascularisation among stable patients remains controversial. The ISCHEMIA trial compared an early invasive strategy with revascularisation plus optimal medical therapy against initial optimal medical therapy alone with revascularisation reserved for cases in which symptom control was insufficient. The study included over 5,000 patients with stable coronary artery disease and moderate to severe myocardial ischaemia. No differences were found in relevant clinical outcomes, including all-cause mortality, cardiovascular death, MI, heart failure and stroke, over a follow-up of 3.2 years. Conversely, angina control was better in patients with severe symptomatic angina. Following the tradition of all trials comparing medical therapy alone with revascularisation, the ISCHEMIA trial results are controversial, but an analysis of the design and results of the trial offers important information to better understand, evaluate and treat the growing number of patients with stable chronic ischaemic heart disease and moderate to severe myocardial ischaemia.

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