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Acute coronary syndrome (ACS) embraces ST-segment-elevation myocardial infarction (STEMI) and non-ST-elevation MI (NSTEMI)-ACS (). The terms Q-wave and non-Q-wave MI are no longer used. Patients presenting with NSTEMIACS symptoms without biochemical markers of acute myocardial infarction (AMI) (particularly elevated troponin) are regarded as having unstable angina (Fig. 11).

Heart failure (HF), unlike coronary heart disease (CHD), has no territorial boundaries.

The prevalence of heart failure (HF) rises from 2% to 3% at age 65 to more than 50% in persons older than age 80. Many of these patients have HFPEF. The condition is not uncommon in elderly women, most of whom have hypertension, diabetes mellitus, or both and often coronary heart disease (CHD). However, CHD more commonly causes systolic heart failure (SHF). Atrial fibrillation is common in the elderly, and ventricular rates even when not very rapid (120-140) may precipitate HF with a preserved ejection fraction (EF).

The rational basis of antiarrhythmic therapy ideally requires a knowledge of

Approximately a quarter million individuals die suddenly from cardiac arrest (C A) in the United States each year before they reach a hospital (). It is relevant that approx 50% of patients with ventricular fibrillation (VF) survive cardiopulmonary resuscitation (CPR) versus amplt;10% for other rhythms, represented by asystole and pulseless electrical activity (PEA). The incidence of VF in most surveys of C A is approx 50%. Thus immediate defibrillation remains the mainstay of therapy for C A, and this concept is endorsed by the American Heart Association (AHA) 2005 guidelines (–).

Infective endocarditis (IE) most often results from bacterial infection, but infections caused by fungi, , or are not rare. Infection usually involves heart valves not always previously known to be abnormal, in particular a bicuspid aortic valve, mitral valve prolapse, or (rarely) a septal defect or ventricular aneurysm. Coarctation of the aorta, patent ductus arteriosus, aneurysms, or arteriovenous shunts may be the site of infective endarteritis. Prosthetic valves may be involved, and infection at the site of implantation of foreign material including devices poses a particularly difficult problem.

This chapter covers the following areas:

A Study to Evaluate the effect of Rosuvastatin On Intravascular ultrasound-Derived Coronary atheroma burden (ASTEROID) trial showed that very-high-intensity statin therapy resulted in significant regression of atherosclerosis for all three prespecified measures of disease burden ().

Antiplatelet agents are used in virtually all patients with coronary heart disease (CHD). Aspirin, the pioneer hallmark agent, is of proven value for the management of

Most cardiovascular agents (like all other drugs) must be avoided in the first trimester of pregnancy because they may produce congenital malformations, especially from the 3rd to the 1 lth week of pregnancy.