The coronaries are the first branches of the ascending aorta. They arise from their respective sinuses of Valsalva, and gradually branch distally to the myocardium. Abnormalities of the coronary arteries, either congenital or acquired, can be characterized as a lack of origin, abnormal origin, anomalous course, lack of patency, abnormal connections, and/or abnormal drainage of the coronary vessels. Interruptions to or lack of flow can cause significant morbidity and mortality due to ischemia, infarction and fistulous connections, which can lead to cardiac failure, endocarditis and ischemia. Coronary artery anomalies are rare in general populations. Although they can be benign and asymptomatic, they can also be malignant due to their origin and course and can cause sudden cardiac death. As such, an understanding of how to analyze, diagnose and treat them is vital. This book presents the latest advances in congenital anomalies of coronary arteries. It offers a comprehensive overview of the field, including illustrative angiograms and diagrams that demonstrate all possible anomalies and clarify what is abnormal, and also provides practical insights to guide practitioners in their everyday practice.

This new case-based book fills a gap in the literature by guiding the reader through the challenging clinical problems encountered in daily practice. Each case presents the clinician with a complete patient work-up that includes clinical history, radiological and clinical findings, treatment summary and suggested readings. Ideal for radiology and cardiology residents, as well as experienced physicians, this text helps the reader arrive at a diagnosis for each clinical problem presented.

This atlas presents over 160 illustrations, with 116 in color, and illustrates the capacity of multidetector CT for the analysis of the anatomy of the coronary arteries. The multidetector CT scanner speeds diagnosis and treatment of patients. One of its many uses is to perform CT coronary angiography. Multidetector CT provides clear pictures and takes less time than other non-invasive techniques. The book is written by cardiologists and radiologists.

2 Diagnostic Use of Radiographic Methods in Coronary Disease. . . . . . . . . . . . . . . . . . . . . . . . . . 56 3 Material. . . . . . . . . . . . . . . . . . . . . . . . . 58 4 Mode of Operation . . . . . . . . . . . . . 62 5 Radiological Projections. . . . . . . . . . . . . . . . . 63 6 Monitoring of Cardiac Parameters . . . . . . . . . . . . 64 7 Pharmacological Tests . . . . . . . . . . . . . . . . 66 7. 1 Coronary Arteries . . . . . . . . . . . . . . . . . . . . . 66 7. 2 Left Ventricle. . . . . . . . . . . . . . . . . . . . . . . . 67 8 Accidents and Risks of Coronary Arteriography . . . . . 67 References . . . . . . . . . . . . . . . . . . . . . . . . . 68 III Angiographic Explorations: Normal Results . . . 71 1 Left Ventricle and Left Ventricular Function 71 1. 1 Radiological Anatomy. . . . . . . . . . . . 71 1. 2 Normal Kinetics. . . . . . . . . . . . . . . 77 1. 3 Analysis of Wall Contraction . . . . . . 78 1. 4 Volumes and Function Indexes. . . . . . . 81 2 Coronary Arteries and Veins . . . . . . . . 84 2. 1 Origin, Calibre and Preponderance of the Coronary Arteries . . . . . . . . . . . . . . . . . . . . . . . . 84 2. 2 Nomenclature and Segmentation of the Coronary Arteries . . . . . . . . . . . . . . . . . . . . . . 87 2. 3 A Reminder About the Physiology of Coronary Circulation . . . . . . . . . . . 93 2. 4 Angiographic Anatomy . . . . . . . . . . 94 2. 4. 1 Left Coronary Artery . . . . . . . . . . . 94 2. 4. 2 Right Coronary Artery. . . . . . . . . . . . . 95 2. 4. 3 Vascularization of Nodes and the Conduction System . . 96 2. 4. 4 Interconnecting Anastomoses . . . . . . . . . . . . . . . 97 2. 5 Coronary Veins . . . . . . . . . . . . . . . . . . . 97 References . . . . . . . . . . . . . . . . . . . . . . . . . 98 IV Angiographic Explorations: Congenital Anomalies of the Coronary Arteries. . . . . . . . . . . . . . . . . . . . . . . . 100 1 Anomalies of the Origin, Course and Distribution of Coronary Arteries Arising from the Aorta . . . . . . . . 100 2 Abnormal Origin of a Coronary Artery from the Pulmonary Artery . . . . . . . . . . . . . . . . . . . . . 101 3 Anomalies in the Diameter of Coronary Arteries . . . . . 104 4 Coronary Fistulae . . . . . . . . . . . 109 References . . . . . . . . . . . . . . . . . . . . . . . . . 113 VII V Angiographic Explorations: Coronary Atheroma. . . . . . . . 114 1 Left Ventricle . . . . . . . . . . . . . . . . . . . . . . . . 114 1. 1 Morphological Anomalies: Bulging and Lacuna-Like Aspects . . . . . . . . . . . . . . . . . . . . . . . . . . .

The new edition of the acclaimed reference text on the most critical tool in pediatric cardiology practice Echocardiography in Pediatric and Congenital Heart Disease provides comprehensive guidance on the use of non-invasive ultrasound imaging in the diagnosis and treatment of pediatric cardiac conditions. Written by a team of experts from the world’s leading pediatric cardiology centers, this highly-illustrated, full-color reference covers anatomy, pathophysiology, ultrasound physics, laboratory setup, patient preparation and safety, pediatric echocardiogram protocols, quantitative methods of echocardiographic evaluation, and more. Offering a wealth of additional material on state-of-the-art techniques and technologies in echocardiography, the thoroughly revised third edition features entirely new chapters on examination guidelines and standards, quality improvement in the laboratory, perioperative echocardiography, hemodynamic assessment of the neonate, early fetal echocardiography, and multimodality imaging. This edition offers updated and expanded discussion of the latest advances in echocardiography, particularly those related to speckle tracking and 3D echocardiography. An essential resource for all practitioners, instructors, and trainees in the field, Echocardiography in Pediatric and Congenital Heart Disease: Provides up-to-date reference to ultrasound imaging of the hearts of fetuses, children, and adults with both acquired and congenital heart disease Covers the echocardiographic examination of congenital cardiovascular abnormalities before, during, and after treatment Describes quantitative methods of echocardiographic evaluation, including assessment of diastolic function, right ventricular function and assessment of the post-Fontan patient Discusses intraoperative echocardiography, heart disease in pregnancy, and other special techniques and topics Includes more than 1200 high-quality color images as well as a companion website with over 600 video clips Echocardiography in Pediatric and Congenital Heart Disease, Third Edition, remains an essential textbook for cardiac sonographers, pediatric and adult cardiologists, echocardiography nurses and technicians, and adult cardiologists with interest in congenital heart disease.

Ischemic heart disease is the leading cause of morbidity and mortality in the developed world. The high metabolism and oxygen demand of the cardiac myocardium depends on both a high blood flow and a rich capillary density. For this reason, the growth of the coronary vasculature is vital, not only in early development, but also in the adult faced with various stresses. Novel technologies have enabled the discovery of the molecular mechanisms underlying the growth and assembly coronary vessels, and this volume covers the hierarchy of the coronary vasculature from its embryonic origins through its postnatal growth, adulthood, and senescence. Chapters address normal coronary development, coronary anomalies and their possible underlying developmental errors, coronary vessel adaptations to exercise training, aging, hypoxia, myocardial ischemia, and cardiac hypertrophy. This comprehensive overview of current research in coronary vessels and myocardial perfusion was written by Dr. Robert J. Tomanek, Emeritus Professor of Anatomy and Cell Biology at the University of Iowa. The book reviews, discusses, and integrates findings from various areas of coronary vasculature research, and as a result, will be a valuable reference source for cardiovascular scientists and physicians for many years to come.

The aims and scope of this atlas include a complete review of the embryology of the normal heart, the normal cardiac anatomy along with a complete discussion of the terms and definitions used to identify and clarify both normal and abnormal anatomy. In addition, techniques of cardiac CT angiography as it pertains to imaging congenital abnormalities are discussed including radiation concepts and radiation saving techniques. The bulk of this book then goes on to completely review the field of adult congenital heart disease using text and more importantly a multitude of pictorial examples (in color and grey scale) to demonstrate the abnormalities. Drawings accompany each picture to better explain the example. Furthermore, difficult and complex anatomical examples are supplemented with digital images and movies to aid in illustrating and understanding the anatomy. Each general set of anomalies as well as each specific abnormality or set of abnormalities includes a concise and simple review of the embryology and epidemiology of the abnormality as well as a concise explanation of the anatomy of the abnormality. In addition, the methods to identify and recognize the abnormality by computed tomography is discussed. Finally, the prognosis and common treatment options for the anomaly are addressed within this comprehensive book.

Written by the world’s foremost authorities, this volume provides comprehensive coverage of current approaches to the prevention, diagnosis, and management of atherothrombosis and its coronary and noncoronary complications. This edition has been thoroughly updated, sharply focused on clinical information, and trimmed to one manageable volume. Coverage begins with a review of risk factors and prevention, emphasizing lipid abnormalities, hypertension, smoking, diabetes, and obesity. Subsequent sections examine the pathogenesis of atherosclerosis, markers and imaging, acute coronary syndromes, chronic stable angina, and noncoronary atherothrombosis. Clinical presentations, medical management, and the latest interventional strategies are included.

Features comprehensive updates throughout the text, including indications, techniques, potential complications in perioperative management of patients, and surgical techniques for congenital heart disease. Covers recent advances in the treatment of pulmonary hypertension, developments in mechanical assist devices, heart and lung transplantation, and interventional cardiac catheterization. Features an all-new, full-color format that speeds navigation and helps clarify complex concepts. Contains 27 new chapters with an emphasis on the team approach to patient care in the ICU including creating multidisciplinary teams, quality and performance improvement, training , and challenges and solutions to developing a cohesive team environment. Includes a detailed chapter on bedside ultrasound, walking you through the techniques you’re most likely to encounter in the ICU. Employs well-documented tables, text boxes, and algorithms to make clinical information easy to access, and to provide a more complete understanding of echocardiography, imaging modalities, pulmonary hypertension, and more. Describes the basic pharmacology and clinical applications of new pharmacologic agents. Examines issues affecting adults with congenital heart disease.