Examples of novel approaches to the assessment of flow-limiting coronary artery disease (CAD) with cardiac computed tomography (CT). In the top panel,

Slides:



Advertisements
Similar presentations
Date of download: 5/28/2016 Copyright © The American College of Cardiology. All rights reserved. From: Comprehensive Assessment of Coronary Artery Stenoses:
Advertisements

Date of download: 5/31/2016 Copyright © 2016 McGraw-Hill Education. All rights reserved. Evaluation of the patient with known or suspected ischemic heart.
Date of download: 6/3/2016 Copyright © The American College of Cardiology. All rights reserved. From: Detection of Coronary Artery Stenoses by Low-Dose,
Date of download: 6/9/2016 Copyright © The American College of Cardiology. All rights reserved. From: Navigator-Gated 3D Blood Oxygen Level–Dependent CMR.
Date of download: 6/23/2016 Copyright © The American College of Cardiology. All rights reserved. From: ACCF/SCAI/AATS/AHA/ASE/ASNC/HFSA/HRS/SCCM/SCCT/SCMR/STS.
Date of download: 7/7/2016 Copyright © The American College of Cardiology. All rights reserved. From: Diagnostic Performance of Noninvasive Fractional.
13. Immunocompromising conditions Inactivated vaccines generally are acceptable (e.g., pneumococcal, meningococcal, influenza [inactivated influenza vaccine])
Paralysis of conjugate gaze to the opposite side: Frontal contraversive eye field or projecting fibers Source: Cerebrovascular Diseases, Harrison's Principles.
Life cycle of microsporidia
Paralysis or weakness of all extremities, plus all bulbar musculature: Corticobulbar and corticospinal tracts bilaterally Source: Cerebrovascular Diseases,
Urine sediment from a patient with calcium oxalate stones (left) and a patient with cystine stones (right). Calcium oxalate dihydrate crystals are bipyramidally.
Invasive Assessment of Coronary Artery Disease
E. Stress and rest myocardial perfusion PET images obtained with rubidium-82 in a patient with chest pain on exertion. The images demonstrate a large and.
Fractional Flow Reserve Evaluation in Patients Considered for Transfemoral Transcatheter Aortic Valve Implantation: A Case Series Cardiology 2012;123:234–239.
Copyright © 2012 American Medical Association. All rights reserved.
Comparison of Myocardial Transmural Perfusion Gradient by Magnetic Resonance Imaging to Fractional Flow Reserve in Patients With Suspected Coronary Artery.
Global deaths by cause, CMNN, communicable, maternal, neonatal, and nutritional disorders; CVD, cardiovascular diseases; INJ, injuries; ONC, other.
Multi Modality Approach to Diagnosis of Ischemia in Post CABG Cases
A monoplace chamber. (Prince of Wales Hospital, Sydney.)
Follicular lymphoma. The normal nodal architecture is effaced by nodular expansions of tumor cells. Nodules vary in size and contain predominantly small.
Source: Adapted from JE Manson with SS Bassuk: Hot Flashes, Hormones & Your Health. New York, McGraw-Hill, Source: Chapter 348. The Menopause Transition.
Ear anatomy. A. Drawing of modified coronal section through external ear and temporal bone, with structures of the middle and inner ear demonstrated. B.
Electrocardiogram (ECG) of a patient with prolonged QT and episodes of torsade de pointes ventricular tachycardia (VT). A. Twelve-lead ECG showing a heart.
Electron micrographs of hepatitis A virus particles and serum from a patient with hepatitis B. Left: 27-nm hepatitis A virus particles purified from stool.
A chamber designed to treat multiple patients
A. The algorithm of ventricular fibrillation or pulseless ventricular tachycardia begins with and initial defibrillate on attempt. If a single shock fails.
Kidney Disease Improving Global Outcome (KDIGO) classification of chronic kidney disease (CKD). Gradation of color from green to red corresponds to increasing.
Modification of the trade-off hypothesis of Slatopolsky and Bricker as it relates to the adaptation of the body to decreased functional renal mass in an.
A coronal magnetic resonance image was obtained using a half Fourier single-shot T2-weighted acquisition with fat saturation in a 27-year-old pregnant.
E. Stress and rest myocardial perfusion PET images obtained with rubidium-82 in a patient with chest pain on exertion. The images demonstrate a large and.
Evaluation of hypothyroidism
Evaluation of hypothyroidism
Acute left hemiparesis due to middle cerebral artery occlusion. A
Ochronotic pigmentation of the femur of a 56-year-old alkaptonuric patient. (Courtesy of Dr. H. W. Edmonds of the Washington Hospital Center, Washington,
Ochronotic pigmentation of the femur of a 56-year-old alkaptonuric patient. (Courtesy of Dr. H. W. Edmonds of the Washington Hospital Center, Washington,
Progressive myopathy in a patient with type IIIa glycogen storage disease. The patient has a debrancher deficiency in both liver and muscle (subtype IIIa).
Percentage changes in the annual amount of precipitation falling in very heavy events, defined as the heaviest 1% of all daily events from 1901 to 2012.
Schematic representation of the autonomic nervous system
The zone of necrosing myocardium is shown at the top of the figure, followed in the middle portion of the figure by a diagram of a cardiomyocyte that is.
Management strategy for patients with aortic stenosis
An example of balanced triple-vessel disease
Representative patterns of serum electrophoresis and immunofixation
Renal ultrasonogram and contrast-enhanced abdominal CT scan in a 56-year-old woman with autosomal dominant polycystic kidney disease. A. Sonogram of the.
Summary of potential mechanisms by which H
Scurvy (vitamin C deficiency)
Stress and rest rubidium-82 myocardial perfusion positron emission tomography (PET) images (left) and noncontrast gated computed tomography (CT) images.
Heart sounds. A. Normal. S1, first heart sound; S2, second heart sound; A2, aortic component of the second heart sound; P2, pulmonic component of the second.
Examples of non-contrast- and contrast-enhanced coronary imaging with computed tomography (CT). A. Calcified coronary plaques in the distal left main and.
Nomogram for determining body mass index
Relationship of glycemic control and diabetes duration to diabetic retinopathy. The progression of retinopathy in individuals in the Diabetes Control and.
Plaque rupture, thrombosis, and healing. A
Medical management of inflammatory bowel disease
Estimated number of AIDS cases and AIDS deaths, United States, 1985–2011. (From CDC.) Source: Human Immunodeficiency Virus Disease: AIDS and Related Disorders,
Population subsets, risk predictors, and distribution of sudden cardiac deaths (SCDs) according to clinical circumstances. A. The population subset with.
Cystic fibrosis with bronchiectasis, apical disease.
Hinchey classification of diverticulitis
Pattern of inheritance and laboratory findings in von Willebrand disease (VWD). The assays of platelet function include a coagulation assay of factor VIII.
Features of Graves’ disease. A
Coronary computed tomography angiography (CTA) obtained on a 35-year-old female presenting to an outpatient clinic with a history of unexplained syncope.
E. Stress and rest myocardial perfusion PET images obtained with rubidium-82 in a patient with chest pain on exertion. The images demonstrate a large and.
Figure 4 Imaging in patients with suspected acute coronary syndrome
Alexander Liu et al. JACC 2018;71:
Brian R. Weil et al. BTS 2017;2: Brief Myocardial Ischemia Produces Transient LV Dysfunction Consistent With Stunned Myocardium A 10-min total left.
Figure 1 Typical case example
Representative images of coronary angiography and fractional flow reserve (FFR) from a patient who showed no resting ECG abnormality. Representative images.
Bjarne L. Nørgaard et al. JIMG 2015;8:
Fig. 4. Case with discrepancy between myocardial perfusion imaging and fractional flow reserve. A. 72-year-old woman with stable angina who underwent myocardial.
James A. Goldstein et al. JIMG 2008;1:
Figure 1 Imaging assessments of luminal stenosis, haemodynamic
Detection of Hemodynamically Significant Coronary Stenosis: CT Myocardial Perfusion versus Machine Learning CT Fractional Flow Reserve Myocardial blood.
Presentation transcript:

Examples of novel approaches to the assessment of flow-limiting coronary artery disease (CAD) with cardiac computed tomography (CT). In the top panel, representative views of a coronary CT angiogram (CTA; left), coronary angiogram (middle), and stress myocardial perfusion CT (right) images in a patient with CAD and prior stenting of the left anterior descending coronary artery (LAD) are presented. On the CTA, the stent (arrows) is totally occluded as evidenced by the loss of contrast enhancement distal to the stent. The coronary angiogram demonstrates a concordant total occlusion of the LAD. On the perfusion CT images, there is a black rim (arrows) involving the anterior and anterolateral walls, indicating the lack of contrast opacification during stress consistent with myocardial ischemia. (Images courtesy of CORE 320 investigators.) The lower panel illustrates an example of fractional flow reserve (FFR) estimates with coronary CTA (left) compared to the reference standard of invasive FFR. The FFR reflects the pressure differential between a coronary segment distal to a stenosis and the aorta. In normal coronary arteries, there is no gradient, and FFR is 1. An FFR <0.80 is consistent with a hemodynamically significant stenosis. (Images courtesy of Dr. James Min, Cornell University, New York.) Source: Noninvasive Cardiac Imaging: Echocardiography, Nuclear Cardiology, and Magnetic Resonance/Computed Tomography Imaging, Harrison's Principles of Internal Medicine, 19e Citation: Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J. Harrison's Principles of Internal Medicine, 19e; 2015 Available at: https://accessmedicine.mhmedical.com/DownloadImage.aspx?image=/data/Books/1130/kas_ch270e_f013.png&sec=98721443&BookID=1130&ChapterSecID=79741825&imagename= Accessed: October 17, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved