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Home , Bruit, Pulsus bisferiens

Index

A congenital coronary anomalies, 412 Aldosterone inhibitors, 73 Abdominal aortic aneurysms (AAA), 290–292 congenital coronary AV fstula, 416 Aldosterone-producing adenomas, 102 Abdominal , 18 coronary , ectopic origin of, 414, 416 Alirocumab, 115, 138 Abdominal ultrasonography, aorta diseases, corrective procedures/surgical palliation, Allergy, 45 290 404 Alogliptin, 106 Abnormal waveforms, dextrocardia and cardiac malposition, 412 Alpha-blocking agents, 100 17 Eisenmenger syndrome, 411 Ambulatory BP monitoring (ABPM), 95 Abnormal myocardium, 234 left-to-right shunt lesions Ambulatory cardiac rhythm monitoring, 355 Abnormal point of maximal impulse, 20 ASD, 388–391 American Board of Internal Medicine (ABIM), Abnormalities of the Aorta, 36 PDA, 393, 394 2, 4 ACCSAP questions and answers, 5, 7 VSD, 391, 393 American Board of Internal Medicine (ABIM) Acromegaly, 380 obstructive lesions Answer Options List, 5, 6 Acute aortic regurgitation, 26 coarctation of aorta, 396, 397 American Board of Internal Medicine (ABIM) Acute aortic syndromes discrete subaortic membrane, 395, 396 Answer Options List and Sample aortic dissection, 297–301 LVOT obstruction, 394, 395 Cases, 5 aortic transsection, 302 RVOT obstruction American College of (ACC)/ intramural hematoma, 301 Ebstein anomaly, 404 American Heart Association (AHA) PAU, 301 pulmonic , 399 Clinical Practice Guideline vasculitides, 302, 303 TOF, 400, 403 recommendations, 3, 4 Acute coronary syndrome (ACS), 60, 109, 140 TGA American College of Cardiology (ACC)/ Acute glomerular disease, 90 CC-TGA, 406, 410 American Heart Association (AHA) Acute intra-thoracic pathology, 12 D-TGA, 405, 407 guidelines Class I and III Acute kidney disease, 90 univentricular heart and Fontan recommendations, 6 Acute limb ischemia (ALI), 275 revision, 410 Amiodarone, 312 Acute mitral regurgitation, 25 Adult onset Still’s disease, 373, 374 Amiodarone-induced disease, 378 Acute myocardial infarction (AMI), 63, 157 Advanced heart failure Amyloidosis, 49, 376, 377 Acute myocardial injury, 63 cardiac transplantation, 528, 530 Anacrotic notch, 20 Acute pericarditis, 238 characteristics, 525 Anatomic compression, 242 clinical evaluation and examination, 225, inotropes, 525 Anderson-Fabry disease, 50 226 left ventricular assist devices, 527 index values, 181 clinical presentation and diagnosis, 224, management, 525, 526 Angina pectoris, 129, 130 225 palliative Care, 527 Anginal equivalents, 11 epidemiology, 224 Aging and Angiographic method, 199 etiology, 224 epidemiology, 88 Angiography strategy, 65, 66, 70 follow-up, 227 ISH, 88, 90 Angiotensin converting enzyme (ACE) management, 225–227 orthostatic hypotension, 90 inhibition, 101 Acute (PE), 12 polypharmacy, 90 Angiotensin converting enzyme (ACE)- Acute vascular injury, 90 systolic and diastolic blood pressure, inhibitors, 73, 101–103, 142 Adenosine, 185, 317 differences in, 88, 89 Angiotensin II receptor blockers (ARB), 73 Adrenal computed tomography, 93 Air embolism, 209 Angiotensin receptor blockers (ARBs), 102, Adrenal hyperplasia, 91 Alcohol use disorder, 382 103, 142 Adult congenital heart disease (ACHD), 41, 42 Aldosterone antagonists, 142 Ankylosing spondylitis (AS), 368

661 662 Index

Anomalous coronary , 207, 416 outcomes after surgical AVR, 162 Atrial myxoma, 27–29 classifcation of, 209 outcomes after surgical TAVR, 162 Atrial pressure, 197 Anthracyclines, 567 pathophysiology and hemodynamics, 422, Atrial septal defect (ASD), 25, 388–391 Antiarrhythmic medications, 346 423 Atrial (AT), 309 Anticoagulants, 73 presentation, 162 Atrioventricular area (AVA), 200 bivalirudin, 70, 73 severe AS, management of, 427, 428 Atrioventricular (AV) block, 327–329, 336 enoxaparin, 69, 70, 73 Aortic transsection, 302 Atrioventricular (AV) conduction disturbances, fbrinolytics, 70 , 38 349 therapy, 159 Aortic valve replacement (AVR), 162, 427–428 Atrioventricular dyssynchrony, 513 unfractionated heparin, 69, 73 outcomes, 162 Atrioventricular nodal reentrant tachycardia Anticoagulation, 166 Aortic valve stenosis, 423 (AVNRT), 315, 316, 645, 646 Antihypertensive therapy, 97 Aortography, aorta diseases, 290 Atrioventricular reentrant tachycardia (AVRT), Antimetabolites, 572 Apical infarct and , 51 316–317, 647 Antiplatelet agents, 140, 141 Apical pansystolic murmur, 465 Atrioventricular-search hysteresis, 333 Antiplatelet drugs, 67–69, 159 Apixaban, 313 Atypical claudication, 13 Aorta anatomy, 289 apoB, 113 , 26 Aorta diseases Arrhythmias, 357 Autoimmune diseases acute aortic syndromes in pregnancy, 169 adult onset Still’s disease, 373, 374 aortic dissection, 297–301 in women, 159, 160 IgG4-RD, 374 aortic transsection, 302 Arrhythmogenic right ventricular dysplasia, 49 systemic sclerosis, 373 intramural hematoma, 301 Arterial , 18 Azathioprine, 227 PAU, 301 Arterial Elastance (Ea), 237 vasculitides, 302, 303 As Low As Reasonably Achievable (ALARA), B aortic anatomy, 288 45, 192 Bacterial pericarditis, 225 aortic aneurysms ASCVD, see Atherosclerotic cardiovascular Balloon aortic valvuloplasty (BAV), 428 AAA, 290–292 disease (ASCVD) Baseline electrocardiographic abnormalities, defnitions, 290 ASD, Atrial septal defect (ASD), see 186 TAA, 293–297 Aspirin, 67, 72, 86, 87, 140, 159 Bayesian approach, 133 general history and , in and major Beck’s triad, 230 289 bleeding, 87 Benign systolic murmur, 24 imaging modalities Aspirin in Reducing Events in the Elderly Beta-blockers, 44, 65, 74, 100, 142, 143, 159, aortography, 290 (ASPREE), 87 186, 511, 513 CT, 290 Aspirin to Reduce Risk of Initial Vascular β-1 selective blockers, 169 CXR, 289 Events (ARRIVE), 86 Bicuspid aortic valve (BAV), 28, 394, 395 echocardiography and ultrasonography, A Study of Cardiovascular Events in Diabetes Bifascicular block, 330 289 (ASCEND), 86 Bilateral adrenal hyperplasia, 102 MRI, 290 Asynchronous pacing, 333 Bilateral patchy alveolar, 34 Aortic aneurysms Atherosclerotic cardiovascular disease Bile acid sequestrants, 115 AAA, 290–292 (ASCVD), 83, 86, 117, 120, 139 Bivalirudin, 70, 73 defnitions, 290 assessment of, 83, 84 Biventricular hypertrophy, 625 TAA, 293–297 diabetes, 108 Biventricular pacing, 336 Aortic coarctation, 37, 93, 398 frequency of risk assessment, 85 Blood pressure, 12, 99, 299 Aortic dissection, 12, 36, 37, 101 moderate/high-intensity statin therapy for, categories, in adults, 95 classifcation, 297 117 Boot-shaped heart, 32 defnition, 297 risk-enhancing factors, 84 Brachial access, 193 diagnosis, 299, 300 risk reduction, principles of Bradyarrhythmias, 308, 349 epidemiology, 298 aspirin use, 86, 87 Breathing reserve etiology, 298 nutrition and diet, 85 clinical utility, 187 history and examination, 298, 299 physical activity and exercise, 85, 86 defnition of, 187 late complications, 300 shared decision making, 85 Brockenbrough sign, 24 sequelae of, 299 tobacco use, 86 Bruce Protocol, 177 of, 301 social determinants, of health and primordial Bruce Treadmill Protocol, 177 treatment, 300 prevention, 83 Brugada syndrome, 350, 659 Aortic regurgitation (AR), 12, 26, 428 Atherosclerotic (ARAS) Bypass grafts, 207 aortic valve replacement for, 433 imaging studies, 276 assessment, 430, 431 physical examination, 276 etiology, 428 presentation, 276 C management, 432, 433 prevalence, 275 Calcifcation, 36 natural history, 432 treatment, 276, 277 Calcium channel blockers (CCBs), 65, 102, 143 pathophysiology and hemodynamics, 428, Atorvastatin, 114 Canadian Cardiovascular Society (CCS) 429 Atrial fbrillation (AF), 310–313 Classifcation, 130 severity, 431 clinical presentation, 160 Canaglifozin, 107, 108, 138 (AS), 428 epidemiology, 159 Canakinumab, 131 assessment, 423–426 risk factors, 160 Candidal vulvovaginitis, 108 etiology, 422 prevention in, 160 Cangrelor, 69 management of severe AS, 427, 428 treatment, 160 Cardiac arrhythmia, 349 natural history, 426, 427 Atrial futter (AFL), 314–315 Cardiac biomarkers, 63 Index 663

Cardiac catheterization, 425, 431–432, 541 CT angiography (CTA), 40–44 normal chest X-ray (CXR) fndings, 32 arterial access, 193 non-contrast coronary calcium score pericardial abnormalities, 35, 36 chronic thrombotic occlusion, 212, 213 (CCS), 40 valvular prostheses on CXR, 38 contraindications, 192 intra and extra cardiac structures, evaluation Cardiac output, 176 contrast agents of, 42, 44 Cardiac output augmentation, 176 CIN, 196 percutaneous valvular procedures, pre- Cardiac rehabilitation, 159 nonionic low-osmolar contrast agents, procedural planning for, 42 Cardiac resynchronization therapy (CRT), 161, 196 post revascularization/percutaneous 334–336, 525 prophylaxis, 196 coronary intervention, 41 ACC/AHA/Heart Rhythm Society (HRS) severe reactions, 196 Cardiac computed tomography angiography recommendations, 335, 336 coronary angiography, 200 (CCTA), 135 impact, 335 angiographic projections, 204 Cardiac imaging, 181 patient-selection, 335 anomalous coronary arteries, 207 categories of, 181 superior beneft from, 161 assessing coronary lesions, 209 indications for, 183, 184 Cardiac sarcoidosis, 49, 374, 375 bypass grafts, 207 types of, 182 collateral circulation, 207–209 cardiac magnetic resonance imaging, caveats, 228, 229 complications, 209 183 clinical evaluation and examination, 230 contraindications, 204 nuclear MPI agents, 182 diagnostic pericardiocentesis without coronary spasm, 205 transthoracic echocardiography, 182 tamponade, 231 dampening of pressure wave, 205 Cardiac ischemia, 127 echocardiography in, 229 indications, 200, 204 Cardiac limitations to exercise, 176 impaired cardiac flling, 227 limitations, 209 Cardiac magnetic resonance (CMR) imaging, management, 230, 231 normal coronary anatomy, 204, 205, 209 54, 183, 578 pericardial biopsy, 231 TIMI criteria, 207 advantages and disadvantages of, 45 purulent pericarditis, 231 endomyocardial biopsy, indications, 211 indications right heart hemodynamics, 228 intravascular diagnostics, 209 amyloidosis, 49 ventricular interdependence, 228 fractional fow reserve (FFR), 209 Anderson-Fabry disease, 50 Cardiac transplantation, 161, 188 instantaneous wave-free ratio (iFR), 210 arrhythmogenic right ventricular Cardiac troponins, 63 intravascular ultrasound (IVUS), 210 dysplasia, 49 Cardiac tumor, 50 optical coherence tomography (OCT), cardiac tumor, 50 Cardiac venous anatomy, 43 210 cardiomyopathy, 47 Cardioactive drugs, 326 left heart catheterization, 193 congenital heart disease, 50 Cardiomegaly, 34 complications, 196 hemochromatosis, 49 Cardiomyopathy, 47 coronary angiography, 193 hypertrophic cardiomyopathy, 49 dilated cardiomyopathy left ventriculography, 193–195 ischemic cardiomyopathy, 47 defnition, 536 pressure assessment in, 195 ischemic heart disease, 46 disease-specifc evaluation, 538 transseptal catheterization, 195 left atrial (LA) anatomy, 51 endomyocardial biopsy, 538 mechanical circulatory support myocarditis, 47 etiology, 537 contraindications, 212 non-compaction cardiomyopathy, 49 initial diagnostic evaluation, 537, 538 indications, 212 non-ischemic cardiomyopathy, 47 treatment and prognosis, 539 intraaortic balloon counterpulsation pericardial disease, 51 hypertrophic cardiomyopathy (IABP), 212 pulmonary , evaluation of, 51 defnition, 542–543 left atrium to aorta assist device, 212 sarcoidosis, 47 diagnostic evaluation, 543–545 left ventricle to aorta assist device, 212 valvular heart disease, 51 etiology, 543 radiation safety, 192 viability, 46 history/physical examination, 543–545 right heart catheterization (RHC) myocarditis, 48 treatment and prognosis, 545–548 cardiac output, 198, 199 CMR T2 assessment for restrictive and infltrative cardiomyopathy complications, 197 early global relative gadolinium (Gd) defnition, 539 indications for, 197 assessment for, 48 diagnostic evaluation, 540–542 pressure measurement, 197–199 safety, 52 endomyocardial, 540 shunts, 199, 200 scan sequences history/physical examination, 540–542 stenotic valve area, calculation of, 200, bright blood imaging, 46 myocardial, 539 201 dark blood imaging, 45 treatment and prognosis, 542 structural heart intervention late gadolinium enhancement, 46 Cardio-oncology left atrial appendage (LAA) closure, 211 MR angiography, 46 anthracycline, 567 transcatheter aortic valve replacement perfusion, 46 atrial fbrillation, 571 (TAVR), 211 phase contrast, 46 cardiotoxicity, 567 vascular closure devices, 197 typical magnetic feld strengths, 45 fuoropyrimidines, 568 Cardiac computed tomography (CT) Cardiac malposition, 412 immune checkpoint inhibitors, 569, 570 acquisition modes, 39 Cardiac noninvasive imaging pericarditis, 572 advantages and disadvantages of, 39 chest radiography QTc prolongation, 572 assessment abnormal chest X-ray (CXR) fndings, radiation-induced heart disease, 569 adult congenital heart disease, 41, 42 32, 34 risk factors, 566, 567 ventricular morphology and function, 42 abnormalities of the aorta, 36, 38 thromboembolic disease, 571 electrophysiology procedures, pre- advantages, 31 trastuzumab, 568 procedural planning for, 42 cardiopulmonary abnormalities/diseases Cardiopulmonary resuscitation, pregnancy, 170 indications of on CXR, 34, 35 Cardiotoxicity, 567 664 Index

Cardiovascular disease (CVD), 83, 138, 140, aortic dissection, 12 iodinated contrast, side-effects related to, 142 differential diagnosis for, 11, 60 45 in pregnancy pericarditis, 11 ionizing radiation, 45 arrhythmias, 169 typical angina, 11 VTA, 243 cardiopulmonary resuscitation, 170 Chest radiography (CXR), 38 Congenital absence of , 36 contraception, 166 aorta diseases, 289 Congenital aortic valvular stenosis, 394, 395 with delivery, 163 artifcial valve, 53 Congenital coronary anomalies, 412 echocardiographic features of, 164 Chest X-ray, VTE, 242 Congenital coronary AV fstula, 416 interventions during pregnancy, 170 Chlorthalidone-based diuretic therapy, 97 Congenital heart disease, 50, 404 normal hemodynamics of, 163 Cholesterol, 111 Congenitally corrected transposition of great peri-partum cardiomyopathy (PPCM), Cholesterol absorption inhibitors (Ezetimibe), arteries (CC-TGA), 406, 410 168, 169 115 Constrictive pericarditis, 12, 519 physical exam fndings with normal Cholesteryl ester transfer protein (CETP) cardiac CT and chest x-ray, 233 pregnancy, 164 defciency, 119 cardiac MRI, 233 pre-conception counseling, 164, 165 Cholesteryl ester transfer protein (CETP) echocardiography, 232 pre-eclampsia, 166 inhibitors, 140 effusive-constrictive pericarditis, 235 pregnancy-associated myocardial Chronic aortic regurgitation, 26 hemodynamics, 231 infarction, 168 Chronic heart failure management, 235 prosthetic valves, 166–168 causes, 518–519 restriction or constriction, 234 vaginal delivery, 169 evaluation, 521 , 28 risk, moderate/high-intensity statin therapy management Continuous positive airway pressure (CPAP), for, 117 chronic surveillance, 522 93 in United States and globally, 156 comorbid conditions, 522 Contrast allergy, 196 in women device therapy, 525 Contrast induced nephropathy (CIN), 45, 196 atrial fbrillation, 159, 160 dietary modifcation, 523 Coronary angiography, 136, 170, 193, 200, heart failure, 160, 161 exercise therapy, 525 215–220 ischemic heart disease, 157–159 HFpEF, 525 ACC/AHA Consensus Guidelines for, valvular heart disease, 162 medical therapy, 523, 525 215–220 Cardiovascular implantable electronic device ongoing routine clinical assessment, 522 angiographic projections, 204 (CIED) infection pathophysiology, 520, 521 anomalous coronary arteries, 207 clinical presentation, 476 prognosis, 521 assessing coronary lesions, 209 diagnosis, 476 Chronic kidney disease (CKD), 90, 96 bypass grafts, 207 epidemiology, 476 Chronic mitral regurgitation, 25 collateral circulation, 207–209 ICD and PPM, 476 Chronic pericarditis, 227 complications, 209 management, 477, 478 Chronic thromboembolic pulmonary contraindications, 204 risk factors, 477 hypertension, 252, 267, 268 coronary spasm, 205 suppressive antibiotics, 477 Chronic thrombotic occlusion (CTO), 212, 213 dampening of pressure wave, 205 Cardioversion, SVT, 319 Chronic tricuspid regurgitation, 25 fractional fow reserve (FFR), 137 Carotid artery disease, 278, 279 Churg Strauss Syndrome, 372, 373 indications for, 136, 200, 204, 209 Carotid artery , 20 Circulatory , 20 instantaneous fow ratio (iFR), 137 Carotid bruits, 18 Cirrhosis, 383 intra-coronary imaging modalities, 137 Carotid sinus syncope, 349, 357 Classic claudication, 13 intravascular ultrasound (IVUS), 137 Catheter ablation, 312, 319, 320 Claudication limitations, 209 Catheter ablation versus antiarrhythmic drug types of, 13 normal coronary anatomy, 204, 205, 209 therapy (CABANA), 320 vascular and neurogenic, 14 optical coherence tomography (OCT), 137 Catheter-based aortography, 290 Clopidogrel, 68, 140, 159 TIMI criteria, 207 Catheter-based valvular interventions, 170 Coarctation, 36 Coronary artery bypass grafting (CABG), 144, Catheter directed therapy (CDT), 250 Coarctation of aorta, 27, 396, 397 145 Cauda equina syndrome, 28 Cocaine use disorder, 381, 382 Coronary artery bypass graft surgery (CABGS), Caudal, 204 Coeur en sabot, 33 41, 65, 67–69, 72, 158 Centrally-acting alpha-2 agonists, 100 Colesevelam, 119 Coronary artery calcium (CAC) scores, 84, 117, Cerebrovascular accident, 196 Collateral circulation, 207–209 135 Cervical venous hum, 27 Complete heart block (CHB), 330 Coronary artery disease (CAD), 53, 103, 367 Chagas myocarditis, 556 Computed tomographic angiography (CTA), 56, adjunctive therapies Channelopathies, 350 66 ACE, 73 CHD, Coronary heart disease (CHD), see indication for, 40–44 aldosterone inhibitors, 73 Check list for initial test-takers in setting of prior test results, 41 diet and lifestyle counseling, 74 ECG, 5–7 Computed tomographic pulmonary angiography implantable cardioverter defbrillator general Study materials, 4 (CTPA), 243 placement, 74 imaging study section, 5 Computed tomography (CT), 54 lipid management, 73 multiple choice questions, 5 acquisition modes, 39 anti-ischemic therapies Checkpoint-inhibitor myocarditis, 556 aorta diseases, 290 beta-blockers, 65 Chelation therapy, 144 medications in calcium channel blockers, 65 (CP), 129, 224 to avoid, 44 nitrates, 65 acute coronary syndrome, characteristics beta-blockers, 44 oxygen, 65 and likelihood ratio for, 11 sublingual/transdermal nitroglycerin, 44 detection of acute intra-thoracic pathology, 12 safety acute symptoms, 40 Index 665

non-acute symptoms, 40 type 2 diabetes (T2D), 103 Early thrombolytic therapy, 158 pre-operative coronary assessment, 40 glycemic control and complications Ebstein anomaly, 404 diagnosis macrovascular complications, 108 ECGSource website, 5, 7 cardiac biomarkers, 63 microvascular complications, 108 Echocardiogram, 132 electrocardiogram, 60, 61 medication for exercise testing, 354, 355 history and physical examination, 60 dipeptidyl protease-4 (DPP4) inhibitors, syncope, 354 prevalence of, 126 106 VTC, 243 risk and lipoprotein disorders, 113 glucagon-like peptide-1 (GLP-1) Eclampsia, 101 risk stratifcation, 64 agonists, 106 Edoxaban, 313 signs and symptoms, 64 insulin, 107 Effusive-constrictive pericarditis, 235 STEMI metformin, 105 Ehlers-Danlos syndrome, type IV, 293 anticoagulants, 73 sodium-glucose transport protein 2 Eisenmenger syndrome, 25, 411 antiplatelet drugs, 72 (SGLT 2), 107 Ejection fraction (EF), 236 reperfusion, 70, 72 sulfonylureas, 105 Electrical alternans, 230 unstable angina/NSTEMI thiazolidinediones, 105 Electrical cardioversion, 318, 319 anticoagulants, 69, 70 moderate/high-intensity statin therapy for, , 60, 61 antiplatelet drugs, 67–69 117 basics, 618–620 initial angiography strategy, 65, 66, 70 prevention of clinical disorders, 653, 655, 656, 658 Coronary artery dissection, 209 lifestyle modifcation, 104, 105 conduction abnormalities, 635, 637 Coronary artery, ectopic origin of, 414, 416 metformin, 105 criteria, 5, 6 Coronary artery spasm, 158 women, elderly and patient with, 11 hypertrophy, 624 Coronary AV fstula, 416 Diabetes Prevention Program (DPP), 111 left ventricular hypertrophy, 626 Coronary computed tomography angiography Diagonal artery, 207 myocardial infarction, 629, 630 (CCTA), 135 Diaphragm, 32 pacemaker, 623 Coronary heart disease (CHD), 40, 96 Diastolic blood pressure (DBP), 88, 89, 95 pericarditis, 632 Coronary revascularization, 491 Diastolic murmurs, 26, 28 pre-excitation pattern, 639 Coronary spasm, 205, 206 Diastolic whoop, 26 rate-related aberration, 649 Corrigan (water hammer) pulse, 20, 26 Dicrotic pulse, 19 right ventricular hypertrophy, 628 Coumadin, 274 Dicrotic wave, 19 supraventricular complexes, 641, 642, 646 Cranial, 204 Digoxin, 169, 312 ventricular complexes, 647 Critical limb ischemia (CLI), 275 Dihydropyridine calcium channel blockers, 143 ventricular rhythms, 649 Culture negative , 473, 474 Dilated cardiomyopathy Electron beam computed tomography (EBCT), Cushing’s syndrome, 93, 379, 380 defnition, 536 135 CVD, see Cardiovascular disease (CVD) disease-specifc evaluation, 538 Electrophysiologic (EP) study, syncope, 356 Cytarabine, 572 endomyocardial biopsy, 538 Electrophysiology procedures, pre-procedural etiology, 537 planning for, 42 initial diagnostic evaluation, 537, 538 Elevated blood pressure, 94, 95 D treatment and prognosis, 539 Elevated hemidiaphragm, 34 Dabigatran, 313 Dipeptidyl protease-4 (DPP4) inhibitors, 106 Elevated troponin level, 76 Dampening of pressure waveform, 205 Dipyridamole, 185 Embolization, 471 Dapaglifozin, 107, 108, 138 Direct renin inhibitor aliskiren, 101 Emergent peripheral angiography, 196 DBP, Diastolic blood pressure (DBP), see Discrete subaortic membrane, 395, 396 Empaglifozin, 107, 108, 138 DDD, dual-chamber pacing, 332 DOACs, 160 End-diastole, 17 Deep venous thrombosis (DVT), 279, 280, 282 Dobutamine, 186, 187 End-diastolic pressure volume relationship defnitions, 243 Dofetilide, 312 (EDPVR), 237 diagnosis, 244 DOO, asynchronous pacing modes, 333 End-expiration, 17 diagnostic algorithm for, 281 Dronedarone, 312 Endocarditis prophylaxis, 475–476 intervention for, 250 Drug eluting stents (DES), 158 Endocrinopathies Wells’ Score, 244 Drug-induced hypertension, 93 amiodarone-induced thyroid disease, 378 de Musett’s head bob, 26 D-transposition of the great arteries, 405, 407 , 377, 378 Dense epidural anesthesia, 163 Dual anti-platelet therapy (DAPT), 67, 140 Endomyocardial biopsy, 513 Depression, 157 after acute coronary syndrome, 140 indications, 211 Descending aortic dissection, 12 after percutaneous stent placement, 140 Endothelin receptor antagonists, 264 Dextrocardia, 412, 413 indications, 140 Endovascular revascularization, 275 Dextrocardia with situs inversus, 32, 33 without recent ACS or stent, 141 End-systolic pressure volume relationship Dextroposition, 32 Duke treadmill score (DTS), 133, 181 (ESPVR), 237 Dextroversion, 32 Duroziez’s sign, 26 Enhanced External Counterpulsation (EECP), Diabetes mellitus (DM), 94, 157 Dynamic ST-segment, 179 144 and cardiac risk Dyspnea Enlarged cardiac silhouette, 33 acute coronary syndrome (ACS), 109 cardiac causes Enoxaparin, 69, 70, 73 glucose control, 109 ACS, 13 Eosinophilic granulomatosis with polyangiitis hyperlipidemia, treatment of, 108 heart failure, 13 (EGPA) syndrome, 372, 373 thiazolidinediones, CHF, and MI, 109 differential diagnosis, 13 Eosinophilic myocarditis, 556 classifcations Esophageal rupture/perforation, 12 gestational diabetes, 104 E Evolocumab, 115, 138 prediabetes, 104 Early invasive strategy, 158 Exam tips type 1 diabetes (T1D), 103 ECG section, 4 666 Index

exam format familial defective apolipoprotein B (FDB), cardiac transplantation, 161 certifcation format, mainrenance of, 2 119 HF with preserved ejection fraction, 161 ECG and imaging studies, 2 familial hypercholesterolemia (FH), 118, HF with reduced ejection fraction, 160 initial certifcation format, 2 119 implantable cardioverter-defbrillator, multiple choice questions, 2 genetic disorders affecting HDL, 119 161 imaging studies section, 4 Gestational diabetes, 104 mechanical circulatory support, 161 multiple choice questions, 2, 3 (GCA), 302, 369, 370 medical therapies for, 161 Excessive alcohol consumption, 97 Giant cell myocarditis, 554 presentation and causes, 160 Exenatide, 106 GLP1 agonists, 108 Heart failure with preserved ejection fraction Exercise induced polymorphic ventricular Glucagon-like peptide-1 (GLP-1) agonists, 106 (HFpEF), 161, 237, 266, 519 tachycardia, 344 Glucagon-like peptide 1 receptor agonists Heart failure with reduced ejection fraction Exercise intensity, 176, 188 (GLP-1 RAs), 138 (HFrEF), 160, 170, 237 Exercise physiology for clinician, 175, 176 Glucose control, 109 Heart rate, 176 quantifcation of work, 176 Glycemic control, 109 , 20, 24 Exercise stress testing, 176, 180, 424 Glycoprotein IIb/IIIa inhibitor (GpIIb/IIIa), 69, Hemochromatosis, 49, 376 absolute contraindications for, 180 72, 159 Hemodynamic data, 181 complications, 177 Good cholesterol, 120 Hemodynamic monitoring, 505–506 diagnostic considerations, 178, 179 Gorlin formula, 200, 201 Hemodynamic pressure tracings, 541 indications for, 177 GRACE score, components of, 65 Hemoglobin A1c (HbA1c), 131 modality selection, 177 , 26 Hemopericardium, 12 prognostic assessment, 181 Guanylate cyclase stimulators, 264 Hepatic pathway, 112 relative contraindications for, 180 HF, Heart failure (HF), see treadmill protocols, 177 High-degree atrioventricular block, 180 Exhalation, 17 H High density lipoprotein (HDL), 157 Expiration, 19 Hampton hump, 34, 242 High density lipoprotein cholesterol (HDL-C), External work, 176 HDL-C, see High density lipoprotein 111, 113–115, 120 Extracellular volume (ECV) measurement, 46 cholesterol (HDL-C) Higher residual risk of stroke, 160 Extracorporeal membrane oxygenation Heart failure (HF), 13, 14, 34, 53, 96, 97, 471 High-intensity statin therapy, 138 (ECMO), 251, 560 acute HF syndromes, 504–511 High risk pulmonary embolism, 283, 284 Extremities, 18 classifcation systems, 500, 501 Hila, 32 Ezetimibe, 115, 138, 139 defnition, 518 Hilar enlargement, 34 endomyocardial biopsy, 513 Hill’s sign, 26 epidemiology, 498 History F fulminant myocarditis, 513 common chief complaints Familial chylomicronemia syndrome, 119 hemodynamic profles, 505 associated physical exam fndings, 13 Familial defective apolipoprotein B (FDB), 119 indications, 504 chest pain, 11 Familial hypercholesterolemia (FH), 118, 119 initial assessment claudication, 13, 14 Familial thoracic syndrome, cardiac catheterization, 503 dyspnea, 13 293 chest X-ray, 501 , 12 Fascicular ventricular tachycardia, 344 diagnostic evaluation, 504 site of pain and location of arterial Female sex, 158, 160 echocardiography, 503 stenosis, 14 Femoral artery, 193 electrocardiogram, 502 general history, 10 Femoral bruits, 18 endomyocardial biopsy, 504 allergies, 10 Fibrates, 114, 115 laboratory tests, 502 chief complaint, 10 Fibrinolysis, 70, 72 physical examination, 501–504 family history, 11 Fibrinolytics, 70 presentation, 501 medications, 10 (FMD), 158, 277 initial management, 512 past medical history, 10 Fick equation, 176 after admission, 505 of present illness, 10 Fick method, 198 hemodynamic profles, 504 , 11 Finnish Diabetes Prevention Study (DPS), 104, management of congestion, 506, 507 social history, 10 111 support hemodynamics, 508–511 Human immunodefciency virus (HIV), 381 Fludarabine, 572 maintenance therapy Human immunodefciency virus (HIV) Fluoropyrimidines, 569 ACEi, 511 myocarditis, 556 Fontan revision, 410, 411 aldosterone antagonists, 511 Hybrid approach, 210 Fractional fow reserve (FFR), 66, 128, 137, ARB, 511 Hydralazine, 100 209 ARNI, 511 Hydroxymethylglutaryl-coenzyme A reductase Free fatty acids (FFA), 112 beta blocker therapy, 511 inhibitors, 114 Fulminant myocarditis, 513 CRT, 512 Hypercholesterolemia, 157 Fungal endocarditis, 474 hydralazine + isosorbide dinitrate, 512 Hypercortisolism, 379, 380 ICD, 512 Hyperglycemia, 97 G pathophysiology treatment of, 105 Gallavardin phenomenon, 24 myocardial structure and function, 498 Hyperlipidemia, 120 Gemcitabine, 572 perpetuating factors, 500 ACC/AHA guidelines for, 118 Genetic disorders, affecting HDL, 119 triggering mechanisms, 499, 500 treatment of, 108 Genetic dyslipidemias, management of in women Hypertension, 87, 88, 157 familial chylomicronemia syndrome, 119 cardiac resynchronization therapy and aging and hypertension (CRT), 161 epidemiology, 88 Index 667

ISH, 88, 90 atrioventricular (AV) block, 327–329 ALARA principles, 45 orthostatic hypotension, 90 intraventricular block, 329, 330 non-stochastic/deterministic effects, 45 polypharmacy, 90 permanent pacing, 332 stochastic effect, 54 systolic and diastolic blood pressure, additional indications, 333 stochastic effects, 45 differences in, 88, 89 coding/nomenclature, 332, 333 Ischemic cardiomyopathy, 47, 518 defnition of, 94–95 sinoatrial exit block, 326, 327 Ischemic cascade, 128 diagnosis Inappropriate sinus tachycardia (IST), 309 Ischemic heart disease, 46, 126 SPRINT, 94 Increased translucency in lung felds, 34 Ischemic heart disease in women techniques, 95 Inducible ischemia, 181 medical/non-pharmacological, 158, 159 evaluation of, 91 Infections/toxins pathophysiology, 157 and heart failure, 97 alcohol use disorder, 382 presentation, 157 pathophysiology and epidemiology of cocaine use disorder, 381, 382 revascularization, 158 aging, 88, 90 HIV, 381 risk factors, 157 essential hypertension, 88 Lyme disease, 380, 381 Isolated systolic hypertension (ISH), 88, 90 secondary, 90, 91, 93 medication induced valvular heart disease, Isovolumic contraction, 236 risk, association with, 95 382, 383 Isovolumic relaxation, 236 secondary causes of Infective endocarditis (IE) IVC flter, role of, 251 acromegaly, 380 clinical signs and symptoms, 468 Cushing’s syndrome/hypercortisolism, complications J 379, 380 embolization, 471 James fbers, 316 pheochromocytoma/paraganglioma, 378, heart failure, 471 Jatene procedure, 406 379 echocardiography, 468 Jugular (central) venous pressure waveforms, primary aldosteronism, 379 epidemiology and risk factors, 467 15, 16 sequelae of microbiology, 468 measurement, 17 morbid and mortal events, 96 modifed Duke criteria, 469 respirophasic variation, 17 target organ damage, 95, 96 outcomes and follow-up, 472 Juvenile T waves, 622 Stage 1, 94 pathology, 468 Stage 2, 94 surgical intervention, 472, 473 K therapy for, 94 treatment, 469 Kartagener’s syndrome, 412 treatment Infltrative diseases Kawasaki disease (KD), 371, 372 differing patient subsets, 97, 99, 100 amyloidosis, 376, 377 , 14 frst and second line oral cardiac sarcoidosis, 374, 375 antihypertensive drugs, 100 hemochromatosis, 376 non-pharmacologic strategies, 97 Infammatory arthropathies L resistant hypertension, 100 ankylosing spondylitis, 368 Labetalol, 100 severe/malignant hypertension and psoriatic arthritis, 368, 369 Large area of ischemia (IIa), 212 hypertensive crises, 100 rheumatoid arthritis, 366, 367 Late gadolinium enhancement, 54 Hypertensive nephropathy, 96 SLE, 367, 368 Latent autoimmune diabetes (LAD), 207 Hypertensive retinopathy, 96 Inherited thrombophilia, 242 Latent autoimmune diabetes in adults (LADA), Hypertensive urgency, 101 Inotropes, 525 103 Hyperthyroidism, 377, 378 Inotropic agents, 184 Lecithin cholesterolacyl transferase (LCAT) Hypertriglyceridemia, management of, 140 Inotropic/chronotropic stimulatory stress Defciency, 119 Hypertrophic cardiomyopathy (HCM), 24, 49, testing, 186 Left anterior descending artery, 204, 611, 615 519 Inotropic therapy, 508 Left anterior oblique (LAO), 194, 204 defnition, 542–543 dobutamine, 509 Left atrial (LA) anatomy, 51 diagnostic evaluation, 543–545 dopamine, 509 Left atrial appendage (LAA) closure, 211 etiology, 543 milrinone, 509 Left atrial appendage (LAA) thrombus, 43 history/physical examination, 543–545 Inspection, 20 Left atrial enlargement, 34 with midwall delay gadolinium Instantaneous fow ratio (iFR), 128, 137, 210 Left atrium to aorta assist device, 212 enhancement, 50 Insulin, 107 Left bundle branch block (LBBB), 133 treatment and prognosis, 545–548 Intensive care unit (ICU) Care, 251 Left circumfex (LCx), 204, 207 Hypoalphalipoprotenemia, 119 Intensive glucose, 105 Left circumfex coronary artery, 610 Hysteresis, 333 Intermediate/borderline risk, CVD, 84 Left heart catheterization, 193 Intermediate pretest probability patients, 179 complications, 196 Interventional catheter directed therapy, 251 cerebrovascular accident, 196 I Intestinal pathway, 112 pseudoaneurysm, 196 Idiopathic dilated cardiomyopathy, 465 Intra and extra cardiac structures, 42, 44 retroperitoneal bleed, 196 Idiopathic pericarditis, 227, 239 Intraaortic balloon counterpulsation (IABP), risk factors for, 196 Immunoglobulin G4-related disease (IgG4-RD), 212, 510 vascular, 196 303, 374 Intra-aortic balloon pump (IABP), 560 coronary angiography, 193 Implantable cardioverter-defbrillator (ICD), 28, Intramuralhematoma (IMH), 301 left ventriculography, 193–195 74, 161, 345–346, 525 Intravascular ultrasound (IVUS), 137, 210 pressure assessment in, 195 Impulse generation disorders Intraventricular block, 329, 330 transseptal catheterization sinus arrhythmia, 324 Investigations of Pregnancy Associated complications, 195 sinus , 324, 325 Cardiomyopathy (IPAC) Study, 169 indications, 195 SND, 325, 326 Iodinated contrast, side-effects related to, 45 Left heart disease, PH due to, 264–266 Impulse propagation disorders, 326–332 Ionizing radiation Left main coronary arterystenosis (LMCA), 204 668 Index

Left main (LM) disease, 126 Mammary souffé, 27 diagnosis and follow-up, 444 Left-to-right shunt lesions Marfan’s syndrome, 54, 170, 293 echocardiographic features, 442 ASD, 388–391 Massive iliofemoral thrombosis, 252 etiology, 441 PDA, 393, 394 Massive pulmonary embolism, 251, 252, 283 history, 442 VSD, 391, 393 Mechanical circulatory support management Left ventricle to aorta assist device, 212 complications, 511 interventions, 446, 447 Left ventricular assist devices (LVADs), 527, contraindications, 212 medical therapy, 446 560 indications, 212 physical examination, 442 Left ventricular ejection fraction (LVEF), 126 intraaortic balloon counterpulsation (IABP), physiology, 441 Left ventricular systolic dysfunction, 19 212 quantifcation, 442–444 Left ventriculography, 193–195 left atrium to aorta assist device, 212 Mitral valve, 38 LIMA graft, 207 left ventricle to aorta assist device, 212 Mitral valve area (MVA), 200 Linagliptin, 106 Mechanical circulatory support (MCS), 161, Mitral valve disease Lipid-lowering therapy, 138–140 479, 509–511 anatomy, 440 Lipid management, 73 Mechanical valves, 166 mitral regurgitation (see Mitral Lipoprotein disorders Mediastinal enlargement, 33 regurgitation) and CAD risk, 113 Medically refractory angina, 212 mitral stenosis diagnosis and screening, 113 Medication induced valvular heart disease, 382, calcifc, 448, 449 genetic dyslipidemias, management of 383 classifcation, 444 familial chylomicronemia syndrome, 119 Mesenteric , 279 diagnosis and follow-up, 444 familial defective apolipoprotein B Metabolic equivalents (METS), 176 echocardiographic features, 442 (FDB), 119 Metabolic gas exchange measurement, 187 etiology, 441 familial hypercholesterolemia (FH), 118, ACC/AHA indications for, 188 history, 442 119 breathing reserve, 187 interventions, 446, 447 genetic disorders affecting HDL, 119 oxygen pulse, 188 medical therapy, 446

lipoprotein metabolism, 111–113 peak VCO2, 187 physical examination, 442 management peak VO2, 187 physiology, 441 2018 ACC/AHA guidelines, core respiratory exchange ratio, 187, 188 quantifcation, 442–444 concepts from, 117 ventilatory effciency, 188 Mitral valve prolapse (MVP), 25, 29, 450 bile acid sequestrants, 115 ventilatory threshold, 188 Mitral valve stenosis, 29 cholesterol absorption inhibitors Metabolic syndrome Mobitz Type 1 (Wenkebach) AV block, 327 (Ezetimibe), 115 criteria, 104 Mobitz Type 2, 327 fbrates, 114, 115 defnition of, 104 Modality selection, 177 hydroxymethylglutaryl-coenzyme A Metastatic pericardial tumors, 235 Moderate/high-intensity statin therapy, 117 reductase inhibitors, 114 Metformin, 105 Moderate-intensity statin, 108 niacin, 115 Methotrexate, 572 Modifed Bruce and Naughton Protocols, 177 proprotein convertase subtilsin-kexin Methyldopa, 100 MR venography, VTA, 243 type 9 (PCSK9) Inhibitors, 115, 116 MI with non-obstructive coronary arteries Multi-detector computed tomography (MDCT), very high-risk ASCVD, 117, 118 (MINOCA), 158 135 Lipoprotein lipase (LPL), 112 Minoxidil, 100 Multifocal atrial tachycardia (MAT), 310, 643, Lipoprotein(a) (Lp(a)), 112 Mirror image dextrocardia, 412 644 Liraglutide, 106, 108 MitraClip, 162 Multi-vessel disease, 184 Loeys-Dietz syndrome, 54, 293 Mitral regurgitation (MR), 25 Murmurs, 20, 24 Loop diuretics, 169 cutoffs, 453 Muscular dystrophy (MD), 383, 384 Lovastatin, 114 history, 448 Myocardial bridge, 609 Low density lipoprotein (LDL), 113 indications, 456, 457 Myocardial infarction, 62, 109 Low density lipoprotein (LDL) cholesterol, MitraClip, outcomes after, 162 beta-blockers, 142 112–115, 157 outcomes after surgical management, 162 risk factors, 76 Low density lipoprotein receptor (LDL-R), 113, physical examination, 449 Myocardial injury, 63 115 presentation, 162 Myocardial ischemia, 130, 329, 630 Lower cardiovascular mortality, 106, 107 primary MR Myocarditis, 47, 367 Low molecular weight heparin, 168 diagnosis and follow-up, 451–453 classifcation, 554, 556 Low pressure cardiac tamponade, 229 fail posterior leafet, 451 clinical follow-up, 560 Lown-Ganong-Levine (LGL) syndrome, 317 management, 453–454 clinical presentation, 557 Lumbar spinal stenosis, 28 other causes, 451 diagnosis, 557, 559 Lung disease/hypoxia, PH due to, 266, 267 pathology, 450 incidence, 552 Lyme disease, 380, 381 posterior mitral valve leafet prolapse, natural history, 552 Lyme myocarditis, 556 450 treatment, 559 quantitative assessment, 453 Myxedema, 657 stages, 451 Myxomas, 580 M secondary MR Magnetic resonance angiography (MRA), 93, diagnosis and follow-up, 456 N 100 management, 456 Narrow complex (NCT), 318 Magnetic resonance (MR) imaging, aorta stages, 455–456 Negative arterial remodeling, 127 diseases, 290 Mitral stenosis (MS), 27, 28 Nephrogenic systemic fbrosis, 52, 53 Mahaim fbers, 317 calcifc, 448, 449 Neurally-mediated syncope, 346 Maintenance of Certifcation (MOC) program, 7 classifcation, 444 Index 669

Neurogenic claudication, 14 Penetrating atherosclerotic ulcer for the aorta Permanent pacing, 332 Niacin, 115 (PAU), 301 ACC/AHA/HRS Class I Recommendations Nifedipine, 100 Percussion wave, 19 for, 329 Nitrates, 65, 143 Percutaneous coronary intervention (PCI), 41, ACC/AHA/HRS Recommendations for, 334 Nitroglycerin, 56 145, 146, 192 additional indications, 333 Non-cardiac chest pain, 129 Percutaneous mitral balloon commissurotomy coding/nomenclature, 332, 333 Non-compaction cardiomyopathy, 49 (PMBC), 447 Pharmacologic stress testing, 184 Non-contrast coronary calcium score (CCS), Percutaneous stent placement, 140, 141 indications for, 186, 187 40–44 Percutaneous valvular procedures, 42 inotropic/chronotropic stimulatory stress Non-dihydropyridine CCBs, 143 Percutaneous ventricular assist devices (VAD), testing, 186 Non-high density lipoprotein cholesterol, 113 510–511 vasodilators, 184–186 Non-invasive positive pressure ventilation, 507 Pericardial anatomy, evaluation of, 44 Pharmacologic therapy, 140 Nonionic low-osmolar contrast agents, 196 Pericardial calcifcation, 35, 36 Pheochromocytoma, 93, 101, 378, 379 Nonischemic cardiomyopathy (NICM), 161, Pericardial constriction, 52 Phlegmasia, 252 518 Pericardial cysts, 36, 235 Phlegmasia Dolens, 282 Non-paroxysmal junctional tachycardia (NPJT), Pericardial diverticula, 236 Phosphodiesterase 5 inhibitors, 264 317 , 12, 13, 35, 164, 225 Phospholipids (PL), 111 Non-stochastic/deterministic effects, 45 with tamponade, 230 Physical examination Non-ST segment elevation myocardial without tamponade, 231 cardiac examination infarction (NSTEMI), 61, 64, 66, 76, , 224 inspection, 20 158 Pericardial masses palpation, 20 Nonsustained ventricular arrhythmia, 492 pericardial cysts, 235 general examination Normal aortic wave form, 18 pericardial diverticula, 236 abdomen, 18 Normal blood pressure, 94 pericardial tumors, 235 extremities, 18 Normal carotid (aortic) tracing, 18 Pericardial sac, 223 head and neck, 15–17 Normal chest X-ray (CXR), 32 Pericardial tumors, 235 skin, 14 Normal electrocardiogram, 60 Pericardiocentesis, 227 vascular examination, 18–20 Normal jugular venous waveform, 17 Pericarditis, 11, 13, 367 vital signs, 14, 15 NSAIDs, 93 Pericardium Pioglitazone, 109 Nuclear myocardial perfusion imaging (MPI) anatomy, 223 Plaque rupture, 157 agents, 182 physiology, 223 Plasma lipoproteins, 113 Perioperative cardiovascular management Pleuritic CP plus right-sided heart failure signs/ O arrhythmia, 491 symptoms, 12 Obesity, 157 coronary revascularization, 491 Point of maximal impulse (PMI), 20 Obstructive lesions functional capacity, 485 Polypharmacy, 90 , 396, 397 general approach, 484 Pooled Cohort Equation (PCE), 83, 117 discrete subaortic membrane, 395, 396 heart failure and cardiomyopathy, 492 Positive arterial remodeling, 126 LVOT obstruction, 394, 395 history, 484–485 Positron emission tomography (PET), 578 Obstructive sleep apnea (OSA), 93 ICD and pacemakers, 492 Positron emission tomography (PET) stress Occlusion of aortic branch vessels, 12 integrated approach, 485, 487 imaging, 182 Oligemia, 34 liver and kidney transplantation, 493 Post-procedural hypotension, 196, 238 Optical coherence tomography (OCT), 137, 210 medications Post-thrombotic syndrome (PTS), 252, 282 Optimal medical treatment (OMT), 136, 144 ACE inhibtors/angiotensin II receptor Post-transplant mortality, 161 Oral contraceptive pills, 93 blockers, 491 Post revascularization, 41 Orthostatic blood pressure, 14 anticoagulation, 490 Potent P2Y12 inhibitors, 159 Orthostatic hypotension, 90 antiplatelet agents, 489, 491 Prasugrel, 68 Orthostatic syncope, 349 beta-blockers, 488 Prediabetes, 104, 110 Ortner’s syndrome, 442 statins, 491 Pre-eclampsia, 166 Oxygen, 65 nonsustained ventricular arrhythmia, 492 Pregnancy-associated myocardial infarction, Oxygen pulse perioperative risk estimation, 485, 486 168 clinical utility, 188 physical examination, 485 Pressure-volume loops defnition of, 188 postoperative management, 493, 494 in heart failure, 237 preoperative cardivascular testing pressure-volume loop in heart failure, 237 pressure-volume loop response, 237 P electrocardiography, 486 response, 237 Palpation, 20 noninvasive (stress) testing, 488 standard Pressure-volume (PV) loop, 236, Palpitations, 12 transthoracic echocardiography, 488 237 Paradoxical low-fow, low-gradient aortic rationale, 484 Pretest probability of disease, 178, 180 stenosis, 425 valvular heart disease, 492 Pricardial disease, 51 Paraganglioma, 378, 379 Peripartum and postpartum status, 158 Primary aldosteronism (PA), 91, 93, 379 Patent ductus arteriosus (PDA), 27, 42, 393 Peri-partum cardiomyopathy (PPCM), 168, 169 Primary hypertension, 88 PCSK-9 inhibitors, 138 Peripheral artery disease (PAD) Primary lipid-modifying drug classes, 117 Peak exercise capacity, 181 diagnostic tests, 274 interventional therapy, 274, 275 Primary percutaneous coronary intervention, Peak VCO , 176 2 medical management, 274 158 clinical utility, 187 presentation, 272, 273 Primary pericardial tumors, 235 defnition, 187 prevalence, 272 Proprotein convertase subtilsin-kexin type 9 Peak volitional exercise intensity, 177 testing, 273 (PCSK9) Inhibitors, 115, 116 670 Index

Prostacyclins–vasodilation, 264 Corrigan pulse, 20 Retrograde approach, 212 Prosthetic valve endocarditis (PVE), 473 dicrotic pulse, 19 Rheumatoid arthritis (RA), 366, 367 Prosthetic valves, 166–168 to examination, 18 Right anterior oblique (RAO), 194, 195, 204 Pseudoaneurysm, 196 normal carotid (aortic) tracing, 18 Right bundle branch block (RBBB), 61 Pseudoclaudication, 28 pulsus alternans, 19 Right coronary artery (RCA), 204, 611, 612 Pseudoresistance, 100 , 19 Right heart catheterization (RHC) Psoriatic arthritis (PsA), 368, 369 , 19 cardiac output, 198, 199 Pulmonary arterial hypertension (PAH), 256 pulsus parvus et tardus, 20 complications, 197 epidemiology, natural survival, and Pulsus alternans, 19 indications for, 197 prognosis, 261 Pulsus bisferiens, 19 PH, 259, 260 treatment, 261–263 Pulsus paradoxus, 19, 229 pressure measurement, 197–199 Pulmonary arterial/pre-capillary hypertension, Pulsus parvus et tardus, 20 shunts, 199, 200 260 Purulent pericarditis, 226, 231 stenotic valve area, calculation of, 200, 201 Pulmonary artery pressure monitor P2Y12 receptor antagonists, 72 Right-sided aortic arch, 38 (CardioMEMS™), 525 P2Y12 Receptor Blockers, 67 Right ventricular (RV) failure, 519 Pulmonary embolism (PE), 34, 44, 282, 283 Right ventricular hypertrophy, 35 complications of, 252 Q Right ventricular outfow tract (RVOT) defnitions, 244 QRS complex tachycardias, 340, 341 obstruction diagnosis, 245 QTc prolongation, 572 Ebstein anomaly, 404 massive, 251, 252 Quadricuspid aortic valve, 395 pulmonic stenosis, 399 Revised Geneva Score, 246 Quincke’s pulse, 26 TOF, 400, 403 special patient populations, 247, 250 Riociguat, 265 submassive, 251 Rivaroxaban, 313 Wells’ Score, 246, 283 R Rosiglitazone, 109 Pulmonary hypertension (PH), 25, 34, 35, 256 Radial artery, 193 acute vasodilator testing, 261 Radiation-induced heart disease, 569 chronic thromboembolic pulmonary Radionuclide imaging, 135 S hypertension, 267, 268 Ranolazine, 143, 144 SA nodal reentrant tachycardia (SNRT), 309 diagnostic work up Rastelli, 418 Saphenous vein grafts (SVG), 207 diagnostic studies, 259 Rate-modulation, 333 Sarcoidosis, 47 history, 257 Rate-related aberration, 651 Saxagliptin, 106 physical exam, 257 Raynaud’s phenomenon, 373 Scimitar syndrome, 35 right heart catheterization, 259, 260 Recurrent effusions, 231 Scleroderma, 373 echocardiographic probability, 261 Reduced pulmonary blood fow, 35 Scoring tools, 181 endothelin receptor antagonists, 264 Refex tachycardia, 100 Secondary hypertension epidemiology synopsis, 265 Regadenason, 185 acute kidney disease, 90 left heart disease, due to, 264–266 Regurgitant orifce area (ROA), 431 aortic coarctation, 93 lung disease/hypoxia, due to, 266, 267 Relief of congestive symptoms, 235 causes of, 92 medical history, 257 Renal artery stenosis, 90, 514 chronic kidney disease, 90 pathology, 256 Renal denervation, 100 Cushing’s syndrome, 93 phosphodiesterase 5 inhibitors and Renovascular disease drug-induced hypertension, 93 guanylate cyclase stimulators, 264 ARAS obstructive sleep apnea, 93 prostacyclins–vasodilation with anti- imaging studies, 276 pheochromocytomas, 93 proliferative effects, 264 physical exam, 276 primary aldosteronism, 91, 93 risk stratifcation of WHO group, 264 presentation, 276 renovascular hypertension, 90 signs of, 261 prevalence, 275 thyroid disease, 93 WHO group classifcation of, 257 treatment, 276, 277 Seizure, 350, 351

Pulmonary oxygen uptake (VO2), 176 FMD, 277 cardiac vs non-cardiac causes of, 353 clinical utility, 187 Renovascular hypertension, 90, 514 Sellar’s criteria, 195 defnition, 187 Rentrop classifcation, 209 Semaglutide, 106, 108 Pulmonary vein, evaluation of, 51 Rescue percutaneous coronary intervention, 72 Severe aortic regurgitation, 20 Pulmonary venous anatomy, 43 Resistant hypertension, 91 Severe aortic stenosis, 20 Pulmonary venous/passive/post-capillary antihypertensive classes, 100 Severe hypercholesterolemia, 117 hypertension, 260 clinical evidence, 100 Severe/malignant hypertension and hypertensive Pulmonic regurgitation (PR), 26 defnition, 100 crises, 100 assessment, 434, 435 risk factors, 100 Severe mitral stenosis, 27 etiology, 434 Respiratory exchange ratio (RER) Severe preeclampsia, 101 management, 435 clinical utility, 188 Severe pulmonic stenosis, 25 pathophysiology, 434 defnition of, 187 Severe stenosis, 40 Pulmonic stenosis (PS), 25, 399 Respirophasic variation, 17 Severe vasodilator side effects, 186 assessment, 433, 434 Restrictive cardiomyopathy, 519 SGLT2-inhibitors, 108, 109 etiology, 433 defnition, 539 Sick sinus syndrome (SSS), 308 management, 434 diagnostic evaluation, 540–542 Sildenafl, 265 pathophysiology, 433 endomyocardial, 540 Simplifed Hakki formula, 200 Pulse pressure (PP), 14 history / physical examination, 540–542 Simvastatin, 114 Pulseless disease, 303 myocardial, 539 Single-photon emission computed tomography treatment and prognosis, 542 (SPECT), 134, 182 Index 671

Sinoatrial conduction time (SACT), 326 ST-elevation myocardial infarction (STEMI), Surgical embolectomy, 251 Sinoatrial exit block, 326, 327 61, 77, 557 Sympathomimetic decongestant agents, 93 Sinoatrial node recovery time (SNRT), 326 algorithm for, 71 Syncope Sinus arrhythmia, 324 anticoagulants approach, 346 Sinus bradycardia, 324, 325 bivalirudin, 73 cardiac vs. non-cardiac causes of, 353 Sinus node dysfunction (SND), 325, 326, 349 enoxaparin, 73 cardiac rhythm monitoring, 355, 356 Sinus of valsalva fstula, 394 glycoprotein IIb/IIIa inhibitors, 73 causes of, 350 Sinus tachycardia (ST), 308–309 antiplatelet drugs defnition, 346 Sinusoidal response, 14 aspirin, 72 ECG, 353, 354 Sitagliptin, 106 glycoprotein IIb/IIIa inhibitors, 72 echocardiogram, 354, 355 Snoopy sign, 36 P2Y12 receptor antagonists, 72 etiologies, 346, 347, 349 Sodium-glucose co-transporter-2 inhibitors reperfusion factors, 358 (SGLT-2i), 138 CABG, 72 history, 352 Sodium-glucose transport protein 2 (SGLT 2), fbrinolysis, 70, 72 initial evaluation of, 351 107 primary PCI, 70 mimics, 351 Sodium reduction, 97 rescue PCI, 72 physical Examination, 353 Spike and dome, 19 Stenosis severity, assessment of, 426 treatment, 356, 357 Spontaneous coronary artery dissection Stimulants, 93 Systemic disorders, 366 (SCAD), 76, 158 Stochastic effects, 45, 54, 192 autoimmune diseases Spontaneous respirations, 197 Stress testing modality, clinical scenarios, 189 adult onset Still’s disease, 373, 374 Stable coronary artery disease, 200 Stroke, 96, 209 IgG4-RD, 374 Stable ischemic heart disease (SIHD) Stroke volume (SV), 176, 236 systemic sclerosis, 373 anti-anginal therapy, 142 Stroke work, 236 cirrhosis, 383 beta-blockers, 143 Structural cardiac disease, 350 endocrinopathies calcium channel blockers (CCBs), 143 Structural heart intervention amiodarone-induced thyroid disease, 378 chelation therapy, 144 left atrial appendage (LAA) closure, 211 hyperthyroidism, 377, 378 enhanced external counterpulsation transcatheter aortic valve replacement hypertension, secondary causes of (EECP), 144 (TAVR), 211 acromegaly, 380 nitrates, 143 ST-segment interpretation considerations, Cushing’s syndrome/hypercortisolism, ranolazine, 143, 144 exercise stress testing, 179 379, 380 epidemiology, 126 dynamic ST-segment, 179 pheochromocytoma/paraganglioma, 378, invasive diagnostic testing, coronary dynamic ST-segment elevation, 179 379 angiography, 136, 137 ST-segment depression in lead V5, 179 primary aldosteronism, 379 laboratory testing, 130, 131 up-sloping ST-segment depression, 179 infections/toxins natural history, 128, 129 Subaortic membrane, 395 alcohol use disorder, 382 non-invasive diagnostic testing Subclavian artery disease, 278 cocaine use disorder, 381, 382 coronary calcifcation and coronary Subclavian steal, 351 HIV, 381 anatomy, 135 Sublingual/transdermal nitroglycerin, 44 Lyme disease, 380, 381 echocardiography, 132 Submassive pulmonary embolism, 251, 283 medication induced valvular heart exercise ECG testing, 133 Substernal chest discomfort, 60 disease, 382, 383 imaging stress testing, 133–135 Subvalvular aortic stenosis, 24 infltrative diseases non-invasive risk stratifcation in, 135 Sudden cardiac death (SCD), 317 amyloidosis, 376, 377 resting electrocardiogram, 131 Sudden death, 352 cardiac sarcoidosis, 374, 375 stress testing and advanced imaging, 132 Sulfonylureas, 105 hemochromatosis, 376 pathophysiology, 126, 127 Supraaortic stenosis, 396 infammatory arthropathies revascularization for, 144 Supravalvular aortic stenosis, 24, 396 ankylosing spondylitis, 368 coronary artery bypass grafting (CABG), Supraventricular arrhythmias, 307 psoriatic arthritis, 368, 369 144, 145 catheter ablation, 319, 320 rheumatoid arthritis, 366, 367 percutaneous coronary intervention, 145, electrical cardioversion, 318, 319 SLE, 367, 368 146 SSS, 308 muscular dystrophy, 383, 384 secondary prevention, 138 tachyarrhythmias, 308 prevalence and cardiac manifestations, 366 aldosterone antagonists, 142 AFL, 314, 315 systemic vasculitides angiotensin converting enzyme AT, 309 EGPA, 372, 373 (ACE)-inhibitors, 142 atrial fbrillation, 310–313 GCA, 369, 370 angiotensin receptor blockers (ARBs), AVNRT, 315–317 Kawasaki disease, 371, 372 142 IST, 309 Takayasu’s arteritis, 370, 371 antiplatelet agents, 140, 141 MAT, 310 Systemic embolism, 160 beta-blockers, 142 NCT, 318 Systemic lupus erythematosus (SLE), 367, 368 lipid-lowering therapy, 138–140 NPJT, 317 Systemic sclerosis, 373 signs and symptoms, 129, 130 sinus tachycardia, 308, 309 Systemic vasculitides treatment, 137 SNRT, 309 EGPA, 372, 373 Standard pressure-volume (PV) loop, 236, 237 WCT, 318 GCA, 369, 370 Statins, 108, 114, 119, 138, 139, 159 Supraventricular tachycardia (SVT), 169, 341, Kawasaki disease, 371, 372 of high-intensity, 114 349 Takayasu’s arteritis, 370, 371 of low-intensity, 114 management of, 319 Systolic blood pressure (SBP), 88, 89, 95 of moderate-intensity, 114 Surgical aortic valve replacement, Systolic blood PRessure Intervention Trial contraindications to, 211 (SPRINT), 94 672 Index

Systolic dysfunction, 336 Tissue extravasation, 45 Type 1 diabetes (T1D), 103 Systolic Hypertension in the Elderly Program Tissue mapping mesurement, 46 Type 2 diabetes (T2D), 101, 103 (SHEP), 97 Tobacco use, 157 diagnosis of, 104 Systolic murmurs, 20–26 TOF, Tetralogy of Fallot (TOF), see insulin therapy for, 108 Systolic pulsations, 26 Torsades de pointes, 651 medical therapy for, 105 Total cholesterol (TC), 157 Typical angina, 11 T Transcatheter aortic valve replacement (TAVR), Tachyarrhythmias, 308, 349 162 U AFL, 314, 315 indications, 211 Ulnar access, 193 AT, 309 Transesophageal echocardiography (TEE), 319 Ultrafltration, 506–507 atrial fbrillation, 310–313 aorta diseases, 289 Unequal hilar densities, 34 AVNRT, 315–317 Transposition of the great arteries (TGA), 407 Unfractionated heparin (UFH), 69, 73 IST, 309 CC-TGA, 406, 410 Unicuspid aortic valve, 395 MAT, 310 D-TGA, 405, 407 Univentricular heart, 409–411 NCT, 318 Transseptal catheterization Unstable angina/NSTEMI NPJT, 317 complications, 195 anticoagulants, 69, 70 sinus tachycardia, 308, 309 indications, 195 antiplatelet drugs, 67–69 SNRT, 309 Transthoracic echocardiography (TTE), 182 initial angiography strategy, 65, 66, 70 WCT, 318 amyloidosis, 540 Untreated hypothyroidism, 120 Tachy-Brady syndrome, 308 aorta diseases, 289 Upper-extremity hypertension, 93 Tadalaf, 265 septal predominant HOCM, 544 Urgent/immediate angiography, 65 Takayasu’s arteritis (TA), 303, 370, 371 Trastuzumab, 568 Tamponade, 12 Treadmill protocols, 177 V Tamponade without pulsus paradoxus, 229 Tricuspid regurgitation (TR), 25 Vagal maneuvers, 12 Tangier’s disease, 119 clinical assessment, 462 Vaginal delivery, 169 Technicium labeled myocardial perfusion diagnosis and follow-up, 462–463 Valsalva aneurysm, 28 imaging (MPI), 182 etiology, 459–462 Valsalva response, 14, 15 Tension pneumothorax, 12 impact, 459 Valvular aortic stenosis (AS), 24 Teratogenic effects, 114 indications, 464 Valvular diseases and murmurs Tetralogy of Fallot (TOF), 33, 399–401, 403 stages, 459 continuous murmurs, 28 TGA, Transposition of the great arteries Tricuspid stenosis (TS), 27 diastolic murmurs, 26 (TGA), see causes, 457 systolic murmurs, 20–26 Thallium-201, 182 clinical assessment, 458 Valvular heart disease, 51, 166–171, 519 The American Society of Regional Anaesthesia, diagnosis and follow-up, 458 aortic regurgitation 166 echocardiographic appearance, 458 assessment, 430, 431 Thermodilution, 198 etiology, 457–458 etiology, 428 Thiazide diuretics, 102 hemodynamics, 458 management, 432, 433 Thiazide-type diuretics, 97 management, 458–459 natural history, 432 Thiazolidinediones, 105, 109 Tricuspid valve, 38 pathophysiology and hemodynamics, Third-degree AV block, 327 Tricuspid valve disease 428, 429 Thoracic aorta dilatation, 36 anatomy, 456 aortic stenosis Thoracic aortic aneurysm (TAA), 28 tricuspid regurgitation assessment, 423–426 anatomic location, 293 clinical assessment, 462 etiology, 422 epidemiology, 293 etiology, 459–462 management of severe AS, 427, 428 etiology, 293 impact, 459 natural history, 426, 427 history and examination, 294 indications, 464 pathophysiology and hemodynamics, medical management, 295 stages, 459 422, 423 prognosis, 294 tricuspid stenosis in pregnancy, management, 168 repair, 295, 296 causes, 457 pulmonic regurgitation screening and diagnosis, 294 clinical assessment, 458 assessment, 434, 435 space-occupying symptoms of, 296 diagnosis and follow-up, 458 etiology, 434 surveillance imaging, 295 echocardiographic appearance, 458 management, 435 TAA repair, 295, 296 etiology, 457–458 pathophysiology, 434 Thoracic aortic dissection, 12 hemodynamics, 458 pulmonic stenosis Thoracic endovascular aortic repair (TEVAR), management, 458–459 assessment, 433, 434 296 Trifascicular block, 330 etiology, 433 Thoracoabdominal aortic aneurysms (TAAA), Triglycerides (TG), 111, 140, 157 management, 434 296 Triple therapy, 141 pathophysiology, 433 Thrombolysis, 158 Tuberculosis (TB), 224 Valvular heart disease in women Thrombolytic therapy, 251 Tuberculous pericarditis, 226 aortic stenosis Thymomas, 583 Tumors of heart outcomes after surgical AVR, 162 Thyroid disease, 93 classfcation, 575, 576 outcomes after surgical TAVR, 162 Ticagrelor, 68 clinical manifestation, 576 presentation, 162 Tidal wave, 19 diagnosis, 578 mitral regurgitation (MR) Tilt table testing, syncope, 355–356 incidence, 575 MitraClip, outcomes after, 162 TIMI criteria, 207 management, 579 outcomes after surgical management, TIMI risk score, 65 tumor characteristics, 579 162 Index 673

presentation, 162 PAD Ventricular tachycardia (VT), 341, 349, 350 Valvular regurgitation, 195 interventional therapy, 274, 275 Verapamil, 317 Valvulitis, 367 medical management, 274 Very high risk atherosclerotic cardiovascular Vardenafl, 265 presentation, 272, 273 disease, 84, 115, 117, 139 Vascular claudication, 14 prevalence, 272 VOO, asynchronous pacing modes, 333 Vascular closure devices, 197 testing, 273 VTE, see Venous thromboembolism (VTE) Vascular disease presentation, 242, 243 VVI pacing, 332 mesenteric, 279 risk factors, 242 PAD treatment of, 247–252 W interventional therapy, 274, 275 Ventilatory effciency (VE) Warfarin, 160, 167 medical management, 274 clinical utility, 188 Water hammer pulse, 20 presentation, 272, 273 defnition of, 188 Weight loss, 97 prevalence, 272 Ventilatory threshold Westermark sign, 34, 242 testing, 273 clinical utility, 188 Wide complex tachycardias (WCT), 318 Vasculitides, 302, 303 defnition of, 188 Widened pulse pressure, 26 Vasodilator therapy, 184–186 Ventricular arrhythmias, 341 Wolff–Parkinson–White (WPW) pattern, 640 nesiritide, 507 classifcation of, 341–345 Wolff–Parkinson–White (WPW) syndrome, nitroglycerin, 507 Ventricular assist device (VAD) infections, 133, 638 nitroprusside, 507 478–480 Venous duplex ultrasonography, VTE, 243 Ventricular fbrillation (VF), 349, 350 X Venous thromboembolism (VTE), 243 Ventricular interdependence, 231, 234 Xanthelasma, 130 complications of, 252 Ventricular morphology and function, 42 Xanthomas, 130 epidemiology, 242 Ventricular septal defects (VSD), 25, 391–393