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277 Tricuspid Valve Disease of right and left heart catheterization is rarely necessary but can also show prolapse of the posterior and sometimes of both mitral valve leaflets. TREATMENT Mitral Valve Prolapse Infective endocarditis prophylaxis is indicated for...

278 Pulmonic Valve Disease Patrick T. O’Gara, Joseph Loscalzo Pulmonic Valve Disease PULMONIC STENOSIS Pulmonic valve stenosis (PS) is essentially a congenital disorder (Table 278-1). With isolated PS, the valve is typically domed. Dys­ plastic pulmonic valves...

279 Multiple and Mixed Valvular Heart Disease Patrick T. O’Gara, Joseph Loscalzo Multiple and Mixed Valvular Heart Disease Many acquired and congenital cardiac lesions may result in stenosis and/or regurgitation of one or more heart valves. For example, rheu­ ...

280 Congenital Heart Disease in the Adult There is a paucity of evidence to inform practice guidelines for surgical and/or transcatheter valve intervention in patients with multiple or mixed valve disease. When there is a clear, dominant lesion, as for example...

281 Pericardial Disease ■ ■UNREPAIRED CYANOTIC CHD Eisenmenger Syndrome  ES is felt to be the consequence of a long-standing high-volume or pressurized left-to-right shunt in which excessive blood flow to the pulmonary vasculature leads to severely increased p...

282 Atrial Myxoma and Other Cardiac Tumors a normal or slightly enlarged heart. Pericardial calcification is most common in tuberculous pericarditis. Pericardial calcification may, however, occur in the absence of constriction, and constriction may occur witho...

283 Cardiac Trauma scattered reports of palliation with radiotherapy and/or chemother­ apy, the response of cardiac sarcomas to these therapies is generally poor. The one exception appears to be cardiac lymphosarcomas, which may respond to a combination of che...

SECTION 5 Coronary and Peripheral Vascular Disease PART 6 Disorders of the Cardiovascular System Ischemic Heart Disease Robert P. Giugliano, Elliott M. Antman, Joseph Loscalzo Ischemic heart disease (IHD) is a condition in which there is an inad­ equate supply...

284 Ischemic Heart Disease PART 6 Disorders of the Cardiovascular System Ischemic Heart Disease Robert P. Giugliano, Elliott M. Antman, Joseph Loscalzo Ischemic heart disease (IHD) is a condition in which there is an inad­ equate supply of blood and oxygen to ...

286 ST-Segment Elevation Myocardial Infarction Simultaneous with these important advances in the high-income countries, the low- and middle-income countries have moved in the opposite direction. Improvements in agriculture, nutrition, sanitation, prevention an...

288 Hypertension ■ ■FURTHER READING Bhatt DL: Cardiovascular Intervention: A Companion to Braunwald’s Heart Disease. Philadelphia, Elsevier, 2024. Kumar V et al: Transcatheter aortic valve replacement programs: Clin­ ical outcomes and developments. J Am Heart ...

289 Renovascular Disease Whelton P et al: 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: A report of the American College of Cardiology/American Heart...

290 Deep-Venous Thrombosis and Pulmonary Thromboembolism Antihypertensive therapy is the mainstay of therapy for malignant hypertension. With effective BP reduction, manifestations of vascular injury, including microangiopathic hemolysis and renal dysfunction,...

291 Diseases of the Aorta Bejjani A et al: When direct oral anticoagulants should not be stan­ dard treatment. JACC State-of-the-Art Review. J Am Coll Cardiol 83:444, 2024. Bikdeli B et al: COVID-19 and thrombotic or thromboembolic disease: Implications for pr...

292 Arterial Diseases of the Extremities Hensley SE, Upchurch GR Jr: Repair of abdominal aortic aneu­ rysms: JACC focus seminar, part 1. J Am Coll Cardiol 80:831, 2022. Isselbacher EM et al: 2022 ACC/AHA guideline for the diagnosis and management of aortic dis...

293 Chronic Venous Disease and Lymphedema ■ ■ERYTHROMELALGIA This disorder is characterized by burning pain and erythema of the extremities (Fig. 292-3E). The feet are involved more frequently than the hands, and males are affected more frequently than females...

294 Pulmonary Hypertension lymphedema. Other surgical interventions, including lymph node transfer, are rarely used and often not successful in ameliorat­ ing lymphedema. Microsurgical lymphaticovenous anastomotic procedures have been performed to rechannel ly...

SECTION 1 Diagnosis of Respiratory Disorders Section 1 Diagnosis of Respiratory Disorders Bruce D. Levy Approach to the Patient with Disease of the Respiratory System The majority of diseases of the respiratory system present with cough and/or dyspnea and fal...