834 APPENDIX Clinical trials MIST Migraine Intervention with Star \202 ex Technology trial Purpose: a multicentre double-blind sham-controlled trial to evaluate the effectiveness of percutaneous patent foramen ovale (PFO) closure to resolve refractory migraine. Follow-up: 180 days Results: there was no difference in resolution of migraine with PFO closure. However, those with PFO closed did report a reduction in the number of headache days experienced. Reference: Dowson AJ et al . ( 2008 ). Circulation 117 : 1397 \200\223 404 . OASIS 5 Fifth Organization to Assess Strategies in Ischemic Syndromes Purpose: to compare fondaparinux 2.5 mg daily vs. enoxaparin 1 mg/kg of body weight twice d aily in patients presenting with acute coronary syndromes. The primary end-point was death, MI, or refractory ischaemia at 9 days. Additionally, major bleeding and longer-term mortal ity and morbidity at 180 days were evaluated. Follow-up: 6 months Results: fondaparinux is non-inferior to enoxaparin in reducing the short-term risk of isch aemic events but it substantially reduced the risk of major bleeding (2.2 % vs. 4.1 % , P < 0.001) and improves long-term mortality and morbidity. Reference: Yusuf S et al . ( 2006 ) N Engl J Med 354 : 1464 \200\223 76 . PARTNER Placement of Aortic Transcatheter Valve trial Purpose: multicentre randomized clinical trial to evaluate the impact of transcatheter aort ic valve implantation (TAVI) in patients with severe aortic stenosis considered not to be s uitable candidates for conventional surgery. The primary end-point was all-cause mortality. Follow-up: mean 1.6 years Results: signi \201 cant reduction in all-cause mortality after 1 year. There was, however , an increase in the rate of major stroke and vascular complications at 30 days. Reference: Leon MB et al . ( 2010 ). Transcatheter aortic-valve implantation for aortic ste nosis in patients who cannot undergo surgery. N Engl J Med 363 : 1597 \200\223 607 . SPIRIT IV 835 PLATO Platelet inhibition and Patient Outcomes trial Purpose: to compare outcomes in patients presenting with acute coronary syndrome with or wi thout ST-segment elevation treated with ticagrelor 180 mg loading followed by 90 mg daily d ose, vs. clopidogrel 300 mg and 75 mg daily dose. Primary end-points included cardiovascula r death, MI, and stroke. Follow-up: 1 year Results: patients treated with ticagrelor had lower cardiovascular mortality compared with clopidogrel (9.8 % vs. 11.7 % , P <0.001) but a small, albeit non-signi \201 cant, increas e in major bleeding. Reference: Wallentin L et al . ( 2009 ). N Engl J Med 361 : 1045 \200\223 57 . SCD-HeFT Sudden Cardiac Death in Heart Failure Trial Purpose: to evaluate whether amiodarone or a single-lead implantable cardiac de \201 brill ator could reduce death in patients with NYHA class II or III heart failure. Follow-up: median 45.5 months Results: a single-lead implantable de \201 brillator reduced mortality by 23 % in patients with NYHA class II or III and left ventricular ejection fraction <35 % , whereas amiodaron e did not in \202 uence survival. Reference: Bardy G et al . ( 2005 ). N Engl J Med 352 : 225 \200\223 37 . SPIRIT IV Clinical evaluation of the XIENCE V everolimus eluting coronary stent system i n the treatment of subjects with de novo native coronary artery lesions Purpose: to compare the ef \201 cacy of everolimus-eluting (XIENCE) vs. paclitaxel-eluting (TAXUS) stents in patients undergoing PCI for de novo coronary artery lesions. Follow-up: 1 year Results: in patients without diabetes, everolimus-eluting stents reduced the primary end-po int of target lesion failure by 54 % ( P <0.0001) and major adverse cardiovascular events b y 52 % ( P <0.0001). However, in patients with diabetes, there were no statistically signi \201 cant differences at 1 year. Reference: Stone GW et al . ( 2010 ). N Engl J Med 362 : 1663 \200\223 74 . 836 APPENDIX Clinical trials TRITON-TIMI 38 Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet I nhibition with Prasugrel \200\224 Thrombolysis In Myocardial Infarction Purpose: to compare outcomes in patients with moderate \200\223high-risk acute coronary syn dromes scheduled to receive PCI, treated with prasugrel 60 mg loading followed by 10 mg dai ly dose vs. clopidogrel 300 mg loading and 75 mg daily dose. Follow-up: 15 months Results: prasugrel was associated with a signi \201 cantly lower incidence of ischaemic ev ents than clopidogrel. It was particularly effective in speci \201 c patient subgroups suc h as those with diabetes mellitus (30 % relative risk reduction). However, it was associate d with signi \201 cantly higher bleeding complications, resulting in no difference in all- cause mortality. Reference: Antman EM et al . ( 2008 ). J Am Coll Cardiol 51 : 2028 \200\223 33 . 837 Index AICDs see automatic angiography, aortic 768 angiography, coronary catheter types 318 complications 324 congenit al heart disease A Aase syndrome 698 abciximab 96 ABC in life support 710 ablation therapy implantable cardiac de \201 brillators albumin albuminuria 646 hypoproteinaemia 733 alcohol consumption 225 alcoholic cardiomyopathy 595 3D mapping 556 , 582 accessory pathways CT angiography 6 , 8 Fabry disease 438 grafts 322 interpretation 320 methods 318 \200\22319 574 , 579 446 alcohol septal ablation for LVOT obstruction 430 alcohol septal ablation 430 aldosterone antagonists 106 dilated cardiomyopathy arrhythmogenic RV angiography, pulmonary cardiomyopathy 442 422 \200\2233 745 \200\2236 atrial \201 brillation 562 , heart failure 388 , 398 renal disease and 108 , AngioGuard device 360 angioplasty see 568 , 570 atrial tachycardia 566 AV re-entrant 399 , 650 percutaneous coronary intervention (PCI) Angio-Seal device 316 \200\22317 angiotensin co nverting enzyme inhibitors (ACE-Is) 98 , 229 Al \201 di \200\231s syndrome 698 Allen test 784 ALL-HAT trial 228 ambulatory ECG monitori ng tachycardias 574 complications 560 , 563 , 570 energy sources 558 robotics 556 trans-septal puncture techniq ue 562 ventricular tachycardia 441 , 513 \200\22314 amiodarone 430 , 722 \200\2233 amlodipine 115 , 772 amoebic pericarditis 474 amyloidosis 71 , 434 , 436 anemia dilated cardiomyopathy 422 heart failure 98 , 390 myocardial infarction 98 , 582 abscesses 36 , 188 ABSORB trial 832 ACC/AHA classi \201 cation of 263 , 299 angiotensin receptor heart failure 412 , 416 pulmonary oedema 732 blockers (ARBs) 102 , 229 heart failure 375 accessory pathways 552 analgesia heart failure 102 \200\2233 , 392 NSTEMI/UA 298 pericarditis 776 pulmonary embolism 748 STEMI 262 ablation therapy 574 , 579 AVRT 498 , 528 , 572 , anion-exchange resins 127 \200\2238 , 237 anistreplase 266 ankle oedema 115 , 370 ankylosing spondylitis 634 anth racyclines 456 antiarrhythmic drugs 721 accessory pathways 574 , 721 localization 578 Mahaim pathways 579 pharmacological anatomical position 13 ANCA-positive vasculitis 632 treatments 579 , 721 WPW syndrome 576 , 708 Andersen syndrome 698 Anderson \200\223Fabry disease ACE-Is see angiotensin converting enzyme inhibitors 579 , 721 atrial \201 brillation 423 , 504 69 , 438 , 698 aneurysms aortic 662 atrial septum 34 in HIV-positive patients 658 see also pseudoaneurysms acne 606 action potentials 478 \200\2239 cardiomyopathies 423 , 430 in long QT syndrome 518 de \201 brillation and 588 interactions 113 , 116 in pregnancy 694 supraventricular ACUITY trial 832 acute coronary syndrome Anger gamma cameras 52 angina pectoris (ACS) 254 diagnosis 250 \200\2231 investigations 4 , 252 management 110 , 114 , 132 , 136 , 138 , 140 , 252 \200\2233 post-MI 276 Prinzmetal \200\231s angina 706 syphilitic 662 unstable see un stable see also NSTEMI; STEMI acute heart failure 370 , 401 adenosine stress testing tachycardia 723 ventricular tachycardia 510 , 722 54 , 74 antibiotics adrenaline (epinephrine) endocarditis 194 , 196 , 202 endocarditis prophylaxis causing myocarditis 456 treatment of shock 730 advanced life support 712 after depolarizati ons 546 age, CAD risk 220 206 , 607 , 696 interactions 123 , 141 myocarditis 456 rheumatic fever 147 angina angioedema 100 , 104 , 391 838 INDEX anticoagulants contraindications 86 , 403 hypertension 230 NSTEMI/UA 299 in pregnancy 689 rheumatic fever 147 antiphospholipid angioplasty 334 , 359 atrial \201 brillation 506 DC cardioversion 820 dilated cardiomyopa thy syndrome 624 bicuspid 28 , 164 , 611 cardiomyopathy 446 Doppler measurements asthma 394 , 729 asystole 716 423 DVT 740 heart failure 403 interactions 86 , 94 , 134 mitral stenosis 153 NSTEMI/UA 299 \200\223300 in pregnancy 688 prosthetic valve 16 rheumatic fever 146 rheumatoid arthritis 620 SLE 622 see also cardiac arrest atenolol 112 , 723 , 761 , 772 atherosclerosis aortic valve replacement and diabetes 240 in \202 ammation 224 , 618 pathophysiology 212 , ECHO 48 patient prosthesis mismatch 185 for regurgitation 174 Ross operation 600 for stenos is 168 , 834 214 , 246 thrombosis 184 plaque assessment 346 plaque development 214 plaque rupture 216 risk 218 , 220 , 232 pulmonary embolism 748 STEMI post-thrombolysis 270 apical window (in ECHO) 17 apolipoprotein E 306 ARBs see angiotensin receptor blockers antihypertensives athletes 69 atorvastatin 122 , 230 , 236 atrial \201 brillation in aortic dissection 771 \200\2232 choosing 110 , 228 \200\2239 combination therapy arrhythmias ablation therapy 562 , 230 \200\2231 in angiography 324 in cardiomyopathies 423 , 568 , 570 causes 500 classi \201 cation 500 diagnosis 501 \200\2232 emergency management for emergency treatment 760 430 , 439 antioxidants 225 antiphospholipid cocaine-induced 283 in congenital heart syndrome 448 , 624 antiplatelet drugs 82 , 84 , 88 , 90 , 94 , 96 , 836 angioplasty and ste nting 270 , 334 , 338 , 358 atrial \201 brillation 85 , 506 heart failure 403 NSTEMI/UA 2 99 \200\223300 STEMI 270 see also aspirin disease 528 , 607 emergency management 504 488 , 504 , 716 heart failure and 404 management see management algorithm 505 mechanism 564 pacemakers 505 pharmacological antiarrhythmic drugs; implantable cardiac de \201 brillators; pacemakers (permanent) management 85 , 423 , 504 , 506 , 721 , 820 post-MI 284 stroke risk 507 pediatric 528 post-MI 284 \200\2235 in pregnancy 528 , 694 see also individual conditions anti-TNF drugs 642 \200\2233 aortic aneurysm 662 aortic coarctation 598 , atrial \202 utter 496 , 564 , 566 atrial pacing wire insertion 810 605 , 611 atrial septal aneurysm 34 atrial septal defect aortic dissection 35 , 766 , arrhythmogenic 768 , 770 right ventricular cardiomyopathy (ARVC) 70 , 440 , 442 , 524 arterial blood gasses 604 , 610 aortic insuf \201 ciency, in atrial tachycardia 490 , 496 ablation therapy for 566 after ablation therapy 570 focal 564 , 566 mechanisms 564 post-MI 284 syphilis 662 aortic regurgitation 170 acute 734 causes 170 , 634 , 734 investigations 11 , 76 , pulmonary embolism 744 pulmonary oedema 725 sampling procedure 784 171 , 329 arterial lines 786 over-the-needle technique atrioventricular (AV) management 174 \200\2235 , 788 block 483 209 , 734 over-the-wire technique after ablation therapy 560 in autoimmune diseases in pregnancy 685 , 687 786 aortic root dilatation 18 , 170 arterial switch operation 623 , 625 congenital 625 familial 703 post-MI 285 in pregnancy 683 aortic stenosis 164 600 arteriovenous \201 stulas 416 arti \201 cial hearts 406 Aschoff bodies 146 ASCOT trial 2 30 aspirin 84 causes 28 , 164 , 611 classi \201 cation 28 , 165 Heyde \200\231s syndrome 702 investigati ons 28 , 165 , 329 management 168 , 208 , 604 in pregnancy 684 \200\2235 , 687 atrioventricular nodal re-entrant tachycardia (AVNRT) 498 , 572 , 574 , 721 angina 252 angioplasty 358 atrial \201 brillation 85 , 506 atrioventricular node, aortic valve function 478 , 550 , 552 anatomy 144 INDEX 839 atrioventricular re-entrant emergency management balloon pumps, intra-aortic tachycardia (AVRT) 498 , 528 , 572 , 574 , 721 atrioventricular septal 480 \200\2231 822 , 826 post-MI bradyarrhythmias balloon valvuloplasty 285 aortic valve 168 , 604 mitral valve 153 , 364 pulmonary valve 177 Barlow \200\231s syndrome 698 Barth syndrome 698 basic life support 710 bat \200\231s wing shadowing 380 BEAUTIFUL t rial 138 Becker \200\231s muscular dystrophy 450 defect 610 sinus bradycardia 482 temporary pacing 481 , atrioventricular sequential pacing 807 , 811 806 \200\2237 Branham sign 416 breathlessness 615 brucellosis 198 Brugada syndrome 526 , 69 9 B-type natriuretic peptide attenuation correction 53 ATTR cardiac amyloidosis 434 auscultation aortic regurgitation 171 aortic stenosis 165 congenital heart disease (BNP) 411 , 435 bundle branch block 484 Beck \200\231s triad 462 Beemer lethal malformation 593 constrictive pericarditis syndrome 698 benzylpenicillin 194 beri-beri 448 , 664 beta-blockers (beta- C CABG see coronary artery 464 in infective endocarditis 188 bypass grafting mitral regurgitation 159 mitral stenosis 151 pericardial rub 461 pulmonary regurgitation adrenoceptor blockers) 110 , 252 CAD see coronary artery disease aortic dissection 772 cardiomyopathies 422 , 430 heart failure 110 , 394 heart-rate control in CT 8 MI: cocaine use 283 MI: NSTEMI/UA 298 MI: STEMI 262 renal disease 650 bifasicular block 484 bifurcation lesions 352 bile acid sequestrants calci \201 c pericarditis 465 calcium-channel blockers 177 114 pulmonary stenosis 177 tricuspid regurgitation 176 cardiomyopathies 430 MI: cocaine use 282 MI: NSTEMI/UA 298 MI: STEMI 271 autoimmune disease heart block 623 , 625 myocarditis 620 , 622 pericarditis 473 , 620 , 622 valvular disease 6 20 , calcium ions (hypocalcaemia) 456 calcium scoring 6 Canadian Cardiovascular 622 , 624 (resins) 127 \200\2238 , 237 bioprosthetic valves 180 \200\2232 , automatic implantable Society (CCS) classi \201 cation of angina 250 cardiac de \201 brillators (AICDs) 584 \200\2236 , 588 185 , 46 biopsy arrhythmogenic RV candesartan 102 \200\2234 , 392 cannulation procedures amyloidosis 435 Fabry disease 439 bisoprolol 112 , 395 bivalirudin 359 biventricular pacing (cardiac cardiomyopathy 442 dilated cardiomyopathy arterial access points 784 arterial line insertion 423 heart failure 404 long QT syndrome 522 programmed ventricular stimulation 554 safety during CMR 66 786 , 788 central lines 790 , 796 , 798 internal jugular vein 792 pulmonary artery 800 , resynchronization therapy) 404 , 423 , 538 , 832 802 , 804 Blalock \200\223Taussig shunt 598 Bland \200\223Garland \200\223White automaticity 478 , 546 AVNRT see atrioventricular subclavian vein 794 see also vascular access, for catheterization nodal re-entrant tachycardia syndrome (ALCAPA) 699 CAPRIE trial 90 carbon monoxide poisoning AVRT see atrioventricular re-entrant tachycardia bleeding see hemorrhage blood pressure 227 456 see also hypertension; cardiac arrest hypotension Borrelia burgdorferi 454 Bouillaud \200\231s syndrome 699 see also rheumatic fe ver Bourneville \200\223Pringle disease advanced life support 712 basic life support 710 in pregnancy 696 pulmonary embolism 749 tr eatment of arrhythmias B bacterial myocarditis 454 , 657 bacterial pericarditis 699 488 , 716 cardiac biomarkers amyloidosis 435 cocaine-induced MI 282 NSTEMI 292 statin thera py 125 STEMI 258 \200\22360 468 , 471 brachial artery 784 Bradbury \200\223Egglseton syndrome 699 balloon angioplasty 332 \200\2233 cutting balloons 362 balloon atrial septostomy bradycardia 480 604 beta-blockers in heart balloon occlusion devices failure 395 360 \200\2231 840 INDEX cardiac catheterization see Chlamydia psittaci 198 cholesterol for physiological catheterization cardiac MRI (CMR) measurements 328 , 340 CAD risk 232 familial aortic dissection 768 cardiomyopathies 68 , 428 , plaque assessment 346 prosthetic valves 180 radiation safety 310 restrictive cardiomyopathy hypercholesterolaemia 304 , 307 441 , 445 congenital heart disease see also lipid-lowering 77 , 595 therapies vs constrictive pericarditis 475 infective endocarditis 193 iron status 73 ischaemia 74 masses 80 myocarditis 72 pericardial disease 78 pre-procedure 64 principles 62 safety issues 66 valvular disease 76 cholesterol-absorption inhibitors (ezetimibe) 127 , 237 right-heart 326 valvular regurgitation 159 , cholestipol 128 , 237 cholestyramine 128 , 237 chronic heart failure see 171 , 329 valvular stenosis 152 , 165 , 329 heart failure vascular access 312 , chronic kidney disease (CKD) 646 , 648 \200\22350 314 , 316 see also ablation chronic obstructive therapy; angiography, coronary; cannulation procedures; percutaneous coronary intervention cardiac output 328 pulmonary disease (COPD) 394 , 412 chronic total occlusion, angioplasty 348 , 352 Churg \200\223Strauss syndrome in pregnancy/postpartum 676 cardiac resynchronization therapy 404 , 423 , 538 , 832 central venous lines 790 , 632 792 , 794 cardiac tamponade see CIBIS III trial 394 CK see creatine kinase clips 316 clonidine 761 clopidogrel 90 , 94 ultrasound-guided tamponade insertion 796 , 798 central venous pressure cardiogenic pulmonary oedema 729 791 , 798 cardiogenic shock 286 , CHADS2 scoring system (stroke risk) 507 Chagas \200\231 disease 455 , 660 chamber evaluatio n (in ECHO) 17 CHARM trial 102 chest pain angioplasty 270 , 358 atrial \201 brillation 506 NSTEMI/UA 299 STEMI 270 288 , 730 cardiomyopathy classi \201 cation 418 in HIV-positive patients Clo-Sur device 316 CMR see cardiac MRI coarctation of the 658 see also individual conditions cardiovascular disease see angina pectoris; coronary artery disease; NSTEMI; STEMI CARE-HF trial 832 CARMEN trial 394 Carney syndrome 699 carnitine 456 carotid sinus massage 514 Carpentier \200\231s classi \201 cation aortic dissection 766 cocaine-induced MI 282 congenital heart disease 615 aorta 598 , 605 , 611 cocaine MI 282 myocarditis 456 differential diagnosis 251 , colchicine 776 colesevelam 128 collagen-based closure 255 , 618 , 767 mitral stenosis 150 pericarditis 461 STEMI 256 , 276 see also angina pector is devices 316 color Doppler imaging 15 , 24 chest pain clinics 253 chest X-rays COMMIT trial 90 compartment syndrome (mitral regurgitation) 158 carvedilol 112 , 395 catecholaminergic aortic dissection 768 aortic valve disease 325 computed tomography (CT) polymorphic ventricular tachycardia 526 165 , 171 6 , 8 cardiomyopathy 420 congenital heart disease aortic dissection 768 pulmonary angiography catecholamines causing myocarditis 456 treatment of heart failure 402 594 \200\2235 heart failure 378 infective endocarditis 192 mitral valve disease 745 conduction system treatment of shock 730 atrial arrhythmias 564 conduction blocks 544 long QT syndrome 518 physiological 478 , 544 s upraventricular catheterization 152 , 159 congenital heart disease pacemakers 531 , 535 pericardial disease 461 , 595 intravascular ultrasound 330 , 334 , 346 , 351 pericardial disease 463 \200\2234 , 463 \200\2234 tachycardia 575 tachycardia in general pulmonary embolism 744 pulmonary oedema 725 tamponade 780 544 , 546 475 INDEX 841 ventricular tachycardia see also angina pectoris; myocardial infarction; NSTEMI; STEMI corticosteroids 147 , 642 , digoxin 400 , 723 DIG trial 400 dilated cardiomyopathy 68 , 580 congenital heart block 625 congenital heart disease 591 420 , 422 alcoholic 446 de \201 ciency 456 peripartum 447 , 692 arrhythmias 528 , 607 assessment 77 , 592 , 776 cough, due to ACE-Is 594 , 596 100 , 391 complications 606 , 614 epidemiology 590 PCI 604 pregnancy 608 specialist care centers diltiazem 115 dimensionless obstructive COURAGE trial 833 COX-2 inhibitors 642 Coxiella burnetii (Q fever) index 28 diphtheria 454 , 657 dipyridamole 54 , 358 direct thrombin inhibitors 195 , 198 , 453 creatine kinase (CK) NSTEMI/UA 292 statin therapy 125 STEMI 259 590 \200\2231 surgery 598 , 600 see also individual conditions 359 , 506 discharge post-NSTEMI/UA 301 post-STEMI 274 see also follow-up procedures disease-modifying anti- creatine kinase-MB (CK-MB) congenitally corrected transposition of the great arteries 613 congestive heart failure see 260 , 292 cryoablation therapy 558 CURE trial 90 CURRENT-OASIS7 trial 90 cutting balloons 362 cyanoti c heart disease 591 complications 606 , 614 signs 596 see also congenital heart heart failure rheumatic drugs 642 \200\2233 constrictive pericarditis 78 , disopyramide 722 \200\2233 diuretics 106 464 , 469 compared with restrictive cardiomyopathy 475 in dilated cardiomyopathy 422 \200\2233 continuous wave (CW) disease in heart failure 106 , Doppler 15 contraception 608 contrast media cysts, pericardial 79 386 , 398 renal disease and 108 , 387 , 399 , 650 dobutamine 402 , 730 dobutamine stress testing D dabigatran 506 DC cardioversion 488 , 716 , complications 67 , 324 , 649 54 , 165 coronary injection 318 coronary angiography see angiography, coronary dopamine 402 , 730 Doppler imaging 14 LV function 23 \200\2234 818 , 821 D-dimer test 739 , 744 DeBakey classi \201 cation coronary artery bypass grafting (CABG) Doppler wire devices 340 Dressler syndrome 700 driving restrictions 517 drug-eluting stents 336 , (aortic dissection) 769 angiography of grafts 322 heart failure 406 STEMI 269 coronary artery deep vein thrombosis (DVT) 738 , 740 see also pulmonary embolism 832 \200\2233 , 835 Duchenne muscular calci \201 cation 6 coronary artery disease de \201 brillation dystrophy 450 , 700 Duke classi \201 cation (infective external 488 , 716 , 818 , 821 internal see automatic implantable cardiac de \201 brillato rs dentistry, infective (CAD) cardiomyopathy 446 diabetes and 240 dyslipidaemia and 232 , endocarditis) 190 DVT (deep vein thrombosis) 738 , 740 236 , 238 see also pulmonary embolism dyslipidaemia 232 endocarditis and 193 , 206 , 607 epidemiology 216 , 220 , 240 , 618 dermatomyositis 627 diabetes mellitus 240 , 412 genetics 302 , 304 , 306 \200\2237 hypertension and 226 , see also lipid-lowering therapies dyspnoea 615 antidiabetic drug 228 , 230 imaging 6 , 8 , 56 , 318 , 320 interactions 127 , 248 dialysis 469 diamorphine 262 , 298 diaphragmatic pacing 813 diastolic function 24 , 26 dias tolic heart failure 370 , E Ebstein \200\231s anomaly 613 , 700 ECG see metabolic syndrome and 244 , 248 pathophysiology 212 , 214 , 246 , 618 408 , 410 electrocardiography plaque 214 , 216 , 346 rheumatological disease diathermy, pacemakers echocardiography amyloidosis 435 aortic dissection 35 , 768 aortic valves 28 , 48 , and 536 and 618 , 621 dietary recommendations 118 , 225 , 228 , 238 , 382 DiGeorge syndrome 700 risk 218 , 220 , 232 , 240 , 245 , 304 , 306 165 , 171 842 INDEX echocardiography (cont.) atrial \201 brillation 502 cardiac masses 44 cardiac source of e mbolism 34 left ventricular non- compaction 444 MI: cocaine use 282 MI: NSTEMI 292 , 296 MI: STEMI 258 \200\2239 , 272 mitral valve disease equilibrium radionuclide ventriculography 58 erectile dysfunction 644 erythema marginatum 1 47 erythropoietin 651 esmolol 760 ethnicity, CAD risk 221 Ewart \200\231s sign 462 exercise testing cardiomyopathies 420 , 428 , 432 , 441 , 475 , 692 152 , 159 congenital heart disease pericardial disease 461 \200\2232 , 595 464 , 774 in pregnancy 678 pulmonary embolism 744 pulmonary oedema 724 syncope 514 tachycar dia 492 , 499 , 509 tamponade 780 torsades de pointes 521 tricuspid stenosis 176 see also i ntracardial electrograms electrolytes, myocarditis congenital heart disease Fabry disease 438 heart failure 378 infective endocarditis 36 , 594 ECG test 2 NSTEMI/UA risk 193 , 197 , 199 intraoperative 50 Kawasaki disease 630 left ventricular function 18 , 20 , 22 , 24 , 26 left ventricular non- contraction 445 mitral regurgitation 38 , 42 , 46 , 159 , 736 mitral stenosis 43 , 152 mitral valve prolapse strati \201 cation 296 sudden cardiac death risk 428 external cardiac pacing for bradycardia 481 external de \201 brillation (cardioversion) 488 , 716 , 818 , 821 eye, signs of disease 456 electrophysiology (EP) hypertensive retinopathy studies 548 227 , 754 , 762 \200\2233 infectious endocarditis 3D imaging 556 , 582 programmed ventricular stimulation 554 uses 274 , 515 , 550 see also a blation therapy 40 \200\2231 mitral valve prostheses 46 palpitations 513 pericardial disease 462 , 188 visual disturbance with ivabradine 139 ezetimibe 127 , 237 464 , 475 , 774 Ellis \200\223Van Creveld syndrome 700 pulmonary embolism 744 pulmonary valve 177 \200\2238 syncope 514 tamponade 780 transoesopha geal 30 transthoracic 10 tricuspid valve 176 ventricular septal defect 278 effusive-constri ctive embolic protection devices F Fabry disease 69 , 438 , 698 facioscapulohumeral 360 , 506 , 750 embolism cardiac sources 34 , 184 , 188 muscular dystrophy 450 fat 752 pulmonary 277 , 742 , Fallot \200\231s tetralogy 600 , 612 , 701 FAME trial 341 familial 744 , 748 pericarditis 465 , 469 Ehlers \200\223Danlos syndrome Emery \200\223Dreifuss muscular dystrophy 451 , 701 hypercholesterolaemia 304 , 307 640 enalapril 99 , 390 encephalopathy, Eisenmenger syndrome familial hyperlipidaemias 610 , 700 hypertensive 764 endless loop tachycardia 120 , 233 ejection fraction 22 , 58 electrocardiography (ECG) accessory pathways 576 amyloidosis 435 angina 252 atrial \201 brillation 502 beri-beri 665 bradycardia 480 Brugada syndrome 526 \200\2237 cardiomyopathies 420 , family history of CAD 221 , 535 302 , 304 , 306 \200\2237 endocarditis see infective fascicular tachycardia 508 fat embolism 752 felodipine 115 femoral artery endocarditis endomyocardial \201 brosis 667 \200\2238 endothelial dysfunction (atherogenesis) 212 , 214 as an access point for catheterization 312 , 316 , 324 , 326 sampling from 784 Enterococcus species 194 , 196 428 , 432 , 441 fever, post-MI 277 \201 brates 126 , 236 \201 broelastoma 44 \201 brosis, myocardial EPHESUS trial 106 epicardial wires for congenital heart disease 594 temporary pacing 806 epinephrine (adrenaline) diphtheria 657 exercise tests 2 , 296 Fabry disease 438 heart block 483 , 485 heart failure 378 infectious endocarditis 75 , 626 causing myocarditis 456 treatment of shock 730 eplerenone see aldosterone Fick principle 328 FilterWireEX device 360 \200\2231 \201 sh oils 237 \202 ecainide 722 \200\2233 antagonists epta \201 batide 96 192 , 197 INDEX 843 \202 ucloxacillin 194 \202 uid overload 732 \202 ushing 115 , 129 \202 uvastatin 12 2 follow-up procedures pathophysiology 368 \200\2239 , H HACEK species 194 hematology 408 renal disease and 387 , 391 , 399 , 412 side effects of drug classes 415 anemia 412 , 416 , 732 complications of cyanotic disease 606 , 614 implantable de \201 brillators 588 statins 403 surgery 406 worsening 414 see also pulmonary haematoma infective endocarditis 208 pacemakers 536 after ablation therapy 560 after angiography 324 after pacemaker insertion 534 Fontan operation 600 , 613 fractional \202 ow reserve oedema (FFR) 340 Friedreich \200\231s ataxia heart transplantation aortic 35 406 \200\2237 , 423 haemolysis, prosthetic 448 , 701 heparin valves 184 Friedreich \200\231s disease 701 fungal infections angioplasty 359 DVT 740 see also low molecular weight heparin; unfractionated heparin haemoptysis 150 , 615 hemorrhage endocarditis 198 myocarditis 455 pericarditis 474 after angiography 324 \200\2235 in congenital heart disease 614 gastrointestinal 85 \200 \2236 prevention (vascular hepatitis B 829 hepatitis C 829 Heyde \200\231s syndrome 702 hibernating myocardium G gadolinium contrast closure devices) 316 HDL (high density lipoprotein) 57 , 75 media 67 gallstones 606 gamma cameras 52 gastrointestinal bleeds (aspirin) 85 \200\2236 high density lipoprotein drugs affecting 119 , (HDL) 121 , 127 drugs affecting 119 , in dyslipidaemias 232 \200\2233 headaches, drug-induced 121 , 127 in dyslipidaemias 232 \200\2233 His \200\223Purkinje system 478 His synchronous ventricular premature beats 572 gated SPECT imaging 53 gem \201 brozil 236 gender, CAD risk 220 genetics 115 , 133 , 137 head-up tilt testing 515 health and safety see safety heart block see histology amyloidosis 434 CAD 302 , 304 , 306 \200\2237 cardiomyopathies 424 , atrioventricular (AV) block amyloidosis 435 Fabry disease 439 heart failure 368 , 370 HIV (human 429 , 440 ACE-Is 98 , 390 acute 370 , 401 anticoagulants/antiplatelet immunode \201 ciency virus) 658 left ventricular non- compaction 444 long QT syndrome 520 Marfan syndrome 636 hypertriglyceridaemia 126 myocarditis 453 , 658 pericardial disease 658 post-exposure drugs 403 ARBs 102 \200\2233 , 392 beta-blockers 110 , 394 causes 372 classi \201 cation/s everity gentamicin 194 \200\2235 Ghent criteria (Marfan syndrome) 637 giant cell arteritis 629 Glen n shunt 598 glitazones 248 glomerular \201 ltration prophylaxis 829 HMG-CoA reductase 374 \200\2235 inhibitors see statins Holt \200\223Oram syndrome 701 homocystinuria 224 , 305 HORIZONS-AMI trial 833 hormone replacement co-morbidities 412 de \201 brillators and pacemakers 404 , 538 diagnosis 373 \200\2234 , 378 , 410 diastolic 370 , 408 , 410 digoxin and other rate 646 glyceryl trinitrate 132 , 252 , therapy 220 262 , 298 Hurler \200\231s syndrome 702 hydralazine 401 , 760 \200\2231 , 772 hyperkalaemia glycoprotein IIb/IIIa inotropic agents 400 , 402 receptor inhibitors 96 angioplasty 270 , 359 NSTEMI/UA 299 \200\223300 diuretics 106 , 386 , 398 epidemiology 368 , 373 high-output 370 , 416 hydralazine and isos orbide ACE-Is and 391 diuretics and 107 \200\2238 , 399 gout hyperlipidaemias 120 , 233 in congenital heart disease 614 dinitrate 401 see also lipid-lowering therapies; statins in heart failure 386 , 412 in infective endocarditis granulomatous 195 hypersensitivity pericarditis 473 grapefruit juice 124 , 141 GUSTO trial 266 gynaecomastia 108 management overview cardiomyopathy 448 myocarditis 457 pericarditis 472 382 , 384 , 410 palliative care 414 844 INDEX hypertension 226 pericarditis 460 , 466 , 468 , J jaw lift/jaw thrust cardiomyopathy 446 heart failure 412 management 110 , 118 , 471 , 474 , 476 see also individual causes/ maneuvers 713 Jervell \200\223Lange \200\223Nielsen syndrome 702 Joint British Societies diseases 228 , 230 \200\2231 infective endocarditis pulmonary 626 \200\2237 , 658 , antibiotics 194 , 196 , 202 , 682 206 , 607 , 696 culture-negative 198 diagnosis 190 investigations 36 , 192 , 197 monitoring 197 outpatient review 208 presentation 170 , 188 prophylaxis 206 , 607 , 696 of prosthetic valves 184 , CAD risk assessment renal disease 647 , 650 see also hypertensive emergencies tables 219 guidelines on lipid levels 119 hypertensive emergencies Jones criteria (rheumatic de \201 nition 226 , 754 encephalopathy 764 management 756 , 760 , fever) 148 jugular vein cannulation 792 ultrasound-guided central 762 \200\2234 presentation 754 retinopathy 227 , 754 , 200 , 209 risk factors 189 stopping treatment 196 surgery 202 line placement 796 , 798 jugular venous pulse/ pressure (JVP) 762 \200\2233 stroke 763 hypertrophic inferior vena cava (IVC) congenital heart disease cardiomyopathy 424 investigations 11 , 68 , 428 management 430 in pregnancy 691 pulmonary o edema 732 \201 lters 750 596 in \202 ammation 224 , 618 inguinal canal 313 inotropes see individual tamponade 778 \200\2239 junctional tachycardia 498 drugs/classes insulin resistance 245 , 248 internal jugular vein cannulation 792 ultrasound-guided centra l hypocalcaemia 456 hypokalaemia 386 hypomagnesaemia 386 , 456 hyponatraemia 386 hypophosphat aemia 456 hypoproteinaemia 733 hypotension K Kartagener \200\231s syndrome 702 Kawasaki disease 630 , 702 Kearns \200\223Sayre syndrom e line placement 796 , 798 703 intra-aortic balloon pumps Kerley B lines 380 Keshan disease 667 kidney disease see renal 822 , 826 aortic dissection 766 , 771 drug-induced 100 , 104 , 133 , 391 , 395 , 399 intracardiac electrograms (ICegrams) 553 , 548 \200\2239 disease post-MI 286 , 288 pulmonary Kussmaul \200\231s sign 778 intravascular elastography embolism 749 346 intravascular L labetalol 282 , 760 \200\2231 , 772 lacidipine 115 laropiprant 129 \200\22330 LDL (low de nsity lipoprotein) in pulmonary oedema 730 in thrombolysis 265 ultrasonography (IVUS) 330 , 346 hypothyroidism 470 in angioplasty 334 , 351 IONA trial 136 irbesartan 104 iron I ICegrams (intracardiac drugs affecting 119 , de \201 ciency with electrograms) 548 \200\2239 , 553 121 , 127 polycythaemia 606 in dyslipidaemias 232 \200\2233 iron-overload immune complex LEADERS trial 833 Leber hereditary optic neuropathy 703 left atrial appendage occlusion 506 cardiomyopathy 73 deposition 188 implantable cardiac de \201 brillators see automatic implantable cardiac de \201 brillators ischaemia assessment of myocardial viability 57 , 60 , 74 , 296 peripheral, after left atrium implantable loop ECHO 18 , 24 mitral valve disease angiography 324 ischaemic cardiomyopathy recorders 67 , 513 , 515 infections 656 150 , 158 left bundle branch anatomy 478 446 after pacemaker insertion 534 in congenital heart ISIS-2 trial 84 isoprenaline 480 isosorbide mononitrate/ left bundle branch block disease 607 , 614 myocarditis 453 \200\2235 , 484 isosorbide dinitrate 132 , 252 , 401 ivabradine 138 left coronary artery 657 , 660 angiography 319 \200\22320 needlestick injuries 828 INDEX 845 angioplasty 354 , 356 SYNTAX score 355 lipid levels Marfan syndrome 636 , CAD risk 232 normal ranges 118 , 232 683 , 704 left heart failure 370 left parasternal window (in ECHO) 17 left ventricle assist devices 4 06 left ventricle (LV) angiography 319 assessment of myocardial viability 57 , 60 , 74 , 29 6 Medina classi \201 cation lipid-lowering (bifurcation lesions) 353 meningococcal myocarditis therapies 118 , 127 bile acid sequestrants 454 128 , 237 MERLIN-TIMI-36 trial 140 metabolic abnormalities in HIV-positive patients 659 ezetimibe 127 , 237 \201 brates 126 , 236 \201 sh oils 237 indications for use metabolic cardiomyopathy cardiac output 328 CMR 70 , 74 diastolic function 24 , 26 ECHO 18 , 20 , 22 , 24 , 119 , 238 438 , 447 interactions 123 , 127 , 129 nicotinic acid 129 , 237 statins see statins metabolic syndrome 244 , 248 metoprolol 112 , 395 MI see myocardial infarction 26 , 51 lisinopril 99 , 390 liver function tests hypertrophy see hypertrophic cardiomyopathy 123 I-MIBG imaging 58 microscopic polyangiitis 632 minoxidil 761 MIST trial 834 mitral regu rgitation 158 125 , 192 Loef \202 er endocarditis 667 , MIBG imaging 58 non-compaction 670 , 703 long QT syndrome (LQTS) 518 , 520 , 522 , 702 , 706 congenital 518 , 520 , 522 loop diureti cs 386 , 388 , 422 loop recorders 67 , 513 , 515 losartan 104 , 229 , 392 loss of conscious ness cardiomyopathy 70 , 444 acute 280 , 736 chronic 42 , 158 classi \201 cation 158 \200\2239 after infective endocard itis perfusion scintigraphy 57 PET 60 radionuclide ventriculography 58 208 (syncope) 324 , 514 , 517 arrhythmia 514 , 615 , 706 investigations 38 , 42 , 46 , 76 , 159 , 329 , 736 management 161 , 280 , systolic function 22 left ventricular out \202 ow tract (LVOT) obstruction low density lipoprotein (LDL) 406 , 736 assessment 69 , 426 congenital 611 in hypertrophic drugs affecting 119 , in pregnancy 685 , 687 121 , 127 mitral stenosis 150 classi \201 cation 153 after infective endocarditis in dyslipidaemias 232 \200\2233 cardiomyopathy 425 , 430 low molecular weight heparin 834 208 Lenegre \200\223Lev disease 703 leptospirosis 454 less-developed countries DVT 740 NSTEMI/UA 299 \200\223300 in pregnancy 689 pulmonary embolism 748 STEMI post-thromb olysis investigations 11 , 43 , 152 , 329 management 153 , 156 \200\2237 , cardiovascular disease 654 de \201 ciency diseases 664 , 364 667 in pregnancy 684 \200\2236 infectious diseases 660 , mitral valve 270 662 , 656 \200\2238 anatomy 144 antiphospholipid see also heparin restrictive cardiomyopathy Lown \200\223Ganong \200\223Levine syndrome 703 670 , 667 \200\2238 syndrome 624 cardiomyopathy 446 Doppler tetanus 666 Lutembacher \200\231s syndrome levosimendan 402 Libman \200\223Sacks syndrome 704 measurements 16 ECHO 11 , 24 , 26 , 39 infective endocarditis LV see left ventricle Lyme disease 454 704 lidocaine 722 lifestyle 203 , 208 M magnesium that increases CAD risk prosthetic 46 , 154 rheumatic fever 146 SLE 622 221 \200\2232 , 224 \200\2235 management of angina hypomagnesaemia 252 mitral valve prolapse 386 , 456 management of 162 , 698 therapeutic 270 , 722 dyslipidaemia 118 , 238 investigations 11 , 162 , magnetic resonance imaging (MRI) see cardiac MRI (CMR) 40 \200\2231 management of heart management 41 , 162 mixed connective tissue failure 382 management of Mahaim pathways 579 malignant hypertension 226 , disease 627 hypertension 228 M-mode limb girdle muscular dystrophy 450 754 , 762 echocardiography 10 malnutrition 448 , 664 846 INDEX Mobitz type I/II AV block neonates Ortner \200\231s syndrome 706 oxygen saturation 596 oxygen therapy 262 285 , 483 arrhythmias 528 lupus 625 Morquio \200\231s syndrome 704 Morrow procedure 430 MRSA (meticillin-resistant S. neoplastic disease see tumors P pacemakers (permanent) aureus ) 194 neuromuscular disorders murmurs see auscultation muscular dystrophies 450 , 448 nicorandil 136 nicotinic acid (niacin) 127 , 530 700 \200\2231 in atrial \201 brillation 505 biventricular 405 , 423 , Mustard/Senning operations 129 , 237 600 nifedipine 115 , 761 Niobe navigation system 556 nitrates 132 832 mycoplasmal myocarditis complications 534 , 708 follow-up 536 in heart failure 404 , 538 in hypertrophic 454 myocardial granuloma 620 myocardial infarction (MI) cocaine-induced 282 complications 276 , 278 , 280 \200\2231 , 472 , 700 post-MI arrhythmias aortic dissection 772 CAD 252 , 262 , 298 heart failure 401 hypertensive emergencies cardiomyopathy 431 implantation procedures 760 530 , 538 nitroprusside 760 , 772 Noonan \200\231s syndrome 706 noradrenaline indications 431 , 505 , 284 \200\2235 532 , 539 post-MI heart failure 102 , international codes 530 modality 533 safety issues 66 , 536 , 821 pacemaker syndrome 534 pa cing, temporary 106 (norepinephrine) 402 NSTEMI (non-ST-segment elevation myocardial infarction) post-MI hypotension/ shock 286 , 288 secondary prevention 84 , 90 , 98 , 110 , 120 , 236 see also NSTEMI; STEMI de \201 nition 254 , 290 diagnosis 292 discharge 301 management 91 , 254 , 290 , atrial 810 atrioventricular 807 , 811 in bradycardia 481 , 806 \200\2237 complications 812 in EP studies 548 , 552 indications 806 using AICDs 586 using an external myocardial perfusion scintigraphy 54 , 56 , 296 298 , 301 in pregnancy 690 presentation 290 risk strati \201 cation 294 , 296 myocarditis 452 bacterial 453 \200\2234 , 657 Chagas \200\231 disease 455 , 660 CMR 72 fungal 455 in HIV-po sitive patients nuclear medicine 52 de \201 brillator 481 123 I-MIBG imaging 58 perfusion scintigraphy 54 , ventricular 808 453 , 658 paclitaxel, in drug-eluting stents 336 , 833 , 835 non-infectious causes 56 , 296 PET 60 \200\2231 radionuclide 456 , 667 pediatrics in rheumatoid arthritis 620 in SLE 622 viral 453 arrhythmias 528 congenital heart disease 590 de \201 ciency diseases