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Decoding the Menace Within: Unraveling Myocardial Bridges and Exercise-Induced Ischemia

Cardiology Update

The perplexing landscape of angina with nonobstructive coronary arteries (ANOCA) encompasses diverse pathophysiological entities, including coronary microvascular disease (CMD), coronary artery spasm, and the enigmatic myocardial bridging (MB).

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Differentiating Between Cardiac and Non-Cardiac Chest Pain

All About Cardiovascular System and Disorders

The typical pain of cardiac origin is a central chest pain which occurs on walking or other forms of exercise, known as effort angina. Effort angina is commonly due to significant obstruction to a blood vessel (coronary artery) supplying a part of the heart muscle. Pain is likely to be more if you are walking after a heavy meal.

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ECG in LMCA Stenosis

All About Cardiovascular System and Disorders

This patient had reported with recent onset angina. In a case reported by Shinde RS et al, coronary angiography documented total occlusion of left coronary artery and the patient underwent emergency coronary artery bypass surgery. In that case there was ST depression in I, aVL, II, aVF and V2-V6. ST elevation was 2 mm in aVR and 1 mm in V1.

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Hypertrophic Cardiomyopathy

All About Cardiovascular System and Disorders

Angina is another common symptom due the hypertrophy which causes a coronary supply demand mismatch Symptoms of HCM include syncope/near syncope, which could be precipitated by exertion, hypovolemia, rapid standing, Valsalva manoeuvre, diuretics, vasodilators or arrhythmia.

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Important Normal Values for ECG

All About Cardiovascular System and Disorders

That is usually with angina and ventricular strain patterns. So in anterior leads, for diagnosis of ST elevation myocardial infarction, V1, the cutoff is usually 2 mm, while 1 mm is enought in other leads. When there is ST depression, even 0.5 mm is enough, to consider abormal ST.

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ORBITA 2: The power of PCI revealed for stable angina

Cardiology Update

The ORBITA-2 trial ( NCT03742050 ) investigated the efficacy of Percutaneous Coronary Intervention (PCI) compared to placebo in 301 patients with stable angina. At the 12-week mark, the PCI group exhibited a significantly lower mean angina score (2.9) compared to the placebo group (5.6; odds ratio, 2.21; 95% CI, 1.41-3.47;

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POST-PCI Surveillance Strategies for Multivessel or Left Main Coronary Artery Disease

Cardiology Update

The primary outcome was a composite of death from any cause, myocardial infarction, or hospitalization for unstable angina at 2 years. The analysis composed of participants with multivessel or left main CAD.