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Harrison's Online > Chapter e20. Atlas of Noninvasive Cardiac Imaging > Atlas of Noninvasive Cardiac Imaging >


Video e20-1A | Requires Flash

Real-time echocardiographic images of a patient with a normal heart. Parasternal long axis view.

View in Context

Harrison's Online > Chapter e20. Atlas of Noninvasive Cardiac Imaging > Atlas of Noninvasive Cardiac Imaging >


Video e20-1B | Requires Flash

Real-time echocardiographic images of a patient with a normal heart. Parasternal short axis view.

View in Context

Harrison's Online > Chapter e20. Atlas of Noninvasive Cardiac Imaging > Atlas of Noninvasive Cardiac Imaging >


Video e20-1C | Requires Flash

Real-time echocardiographic images of a patient with a normal heart. Apical four-chamber view. There is symmetric contraction of the ventricles, evidenced by a decrease in cavity size and an increase in wall thickness during systole.

View in Context

Harrison's Online > Chapter e20. Atlas of Noninvasive Cardiac Imaging > Atlas of Noninvasive Cardiac Imaging >


Video e20-2A | Requires Flash

Real-time echocardiographic images of a patient with a severe decrease in left ventricular systolic function. The estimated ejection fraction is 20%. Parasternal long axis view.

View in Context

Harrison's Online > Chapter e20. Atlas of Noninvasive Cardiac Imaging > Atlas of Noninvasive Cardiac Imaging >


Video e20-2B | Requires Flash

Real-time echocardiographic images of a patient with a severe decrease in left ventricular systolic function. The estimated ejection fraction is 20%. Parasternal short axis view.

View in Context

Harrison's Online > Chapter e20. Atlas of Noninvasive Cardiac Imaging > Atlas of Noninvasive Cardiac Imaging >


Video e20-3A | Requires Flash

Real-time echocardiographic images of a patient with hypertrophic cardiomyopathy, demonstrating an increase in wall thickness during systole. Parasternal long axis view.

View in Context

Harrison's Online > Chapter e20. Atlas of Noninvasive Cardiac Imaging > Atlas of Noninvasive Cardiac Imaging >


Video e20-3B | Requires Flash

Real-time echocardiographic images of a patient with hypertrophic cardiomyopathy, demonstrating an increase in wall thickness during systole. Parasternal short axis view.

View in Context

Harrison's Online > Chapter e20. Atlas of Noninvasive Cardiac Imaging > Atlas of Noninvasive Cardiac Imaging >


Video e20-4A | Requires Flash

Real-time echocardiographic images of a patient with mitral stenosis. There is diastolic doming and restricted leaflet opening secondary to fusion of the commissures. Parasternal long axis.

View in Context

Harrison's Online > Chapter e20. Atlas of Noninvasive Cardiac Imaging > Atlas of Noninvasive Cardiac Imaging >


Video e20-4B | Requires Flash

Real-time echocardiographic images of a patient with mitral stenosis. There is diastolic doming and restricted leaflet opening secondary to fusion of the commissures. Parasternal short axis.

View in Context

Harrison's Online > Chapter e20. Atlas of Noninvasive Cardiac Imaging > Atlas of Noninvasive Cardiac Imaging >


Video e20-5A | Requires Flash

Real-time images with color-flow Doppler imaging of a patient with mitral regurgitation due to ruptured chordae tendinae. Gray scale image showing a thickened redundant posterior leaflet with loss of coaptation.

View in Context

Harrison's Online > Chapter e20. Atlas of Noninvasive Cardiac Imaging > Atlas of Noninvasive Cardiac Imaging >


Video e20-5B | Requires Flash

Real-time images with color-flow Doppler imaging of a patient with mitral regurgitation due to ruptured chordae tendinae. Color-flow imaging showing the regurgitation as a high-velocity turbulence (mosaic pattern) regurgitating into the left atrium during systole.

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Harrison's Online > Chapter e20. Atlas of Noninvasive Cardiac Imaging > Atlas of Noninvasive Cardiac Imaging >


Video e20-5C | Requires Flash

Real-time images with color-flow Doppler imaging of a patient with mitral regurgitation due to ruptured chordae tendinae. Color-flow imaging of a patient with a normal mitral valve showing no regurgitation into the left atrium.

View in Context

Harrison's Online > Chapter e20. Atlas of Noninvasive Cardiac Imaging > Atlas of Noninvasive Cardiac Imaging >


Video e20-6 | Requires Flash

Real-time transesophageal echocardiographic images of a patient with severe mitral regurgitation due to a flail posterior leaflet. The posterior mitral valve leaflet is completely unsupported and moves into the left atrium during systole.

View in Context

Harrison's Online > Chapter e20. Atlas of Noninvasive Cardiac Imaging > Atlas of Noninvasive Cardiac Imaging >


Video e20-7A | Requires Flash

Real-time echocardiographic images from the parasternal long axis view of a patient with mitral valve prolapse. Both leaflets prolapse into the left atrium during systole. Black and white images demonstrating leaflet morphology and motion.

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Harrison's Online > Chapter e20. Atlas of Noninvasive Cardiac Imaging > Atlas of Noninvasive Cardiac Imaging >


Video e20-7B | Requires Flash

Real-time echocardiographic images from the parasternal long axis view of a patient with mitral valve prolapse. Both leaflets prolapse into the left atrium during systole. Color-flow imaging demonstrating a late systolic blue-colored jet of mitral regurgitation.

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Harrison's Online > Chapter e20. Atlas of Noninvasive Cardiac Imaging > Atlas of Noninvasive Cardiac Imaging >


Video e20-8 | Requires Flash

Real-time two-dimensional echocardiographic images of a patient with a vegetation on the mitral valve. There is a mobile echo density attached directly to the mitral valve apparatus.

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Harrison's Online > Chapter e20. Atlas of Noninvasive Cardiac Imaging > Atlas of Noninvasive Cardiac Imaging >


Video e20-9 | Requires Flash

Real-time two-dimensional parasternal long axis echocardiographic images from a patient with aortic stenosis. The aortic valve is calcified with restricted opening.

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Harrison's Online > Chapter e20. Atlas of Noninvasive Cardiac Imaging > Atlas of Noninvasive Cardiac Imaging >


Video e20-10A | Requires Flash

Real-time echocardiographic images showing a close-up view of the atrial septum in a patient with a large secundum atrial septal defect. Gray scale image showing a questionable "drop-out" in the atrial septum.

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Harrison's Online > Chapter e20. Atlas of Noninvasive Cardiac Imaging > Atlas of Noninvasive Cardiac Imaging >


Video e20-10B | Requires Flash

Real-time echocardiographic images showing a close-up view of the atrial septum in a patient with a large secundum atrial septal defect. Color-flow imaging confirms flow across the atrial septum.

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Harrison's Online > Chapter e20. Atlas of Noninvasive Cardiac Imaging > Atlas of Noninvasive Cardiac Imaging >


Video e20-11 | Requires Flash

Real-time transesophageal echocardiographic images of a patient with a left atrial myxoma. There is a large echo-dense mass in the left atrium that is attached to the atrial septum. The mass moves across the mitral valve in diastole.

View in Context

Harrison's Online > Chapter e20. Atlas of Noninvasive Cardiac Imaging > Atlas of Noninvasive Cardiac Imaging >


Video e20-12 | Requires Flash

Real-time two-dimensional echocardiographic images of a patient with a pericardial effusion. The effusion is shown as black echo-free space surrounding the heart.

View in Context

Harrison's Online > Chapter e20. Atlas of Noninvasive Cardiac Imaging > Atlas of Noninvasive Cardiac Imaging >


Video e20-13 | Requires Flash

Real-time two-dimensional echocardiographic images from the parasternal long axis view of a patient with a large aneurysm of the ascending aorta.

View in Context

Harrison's Online > Chapter e20. Atlas of Noninvasive Cardiac Imaging > Atlas of Noninvasive Cardiac Imaging >


Video e20-14A | Requires Flash

Real-time two-dimensional stress echocardiogram in a normal subject. The studies at rest are shown on the left and the studies during peak exercise are on the right. Parasternal long axis (top) and short axis (bottom) views. At rest, there is contraction of all segments of the myocardium. During exercise, there are increases in contractility and in the thickening of all segments of the myocardium.

View in Context

Harrison's Online > Chapter e20. Atlas of Noninvasive Cardiac Imaging > Atlas of Noninvasive Cardiac Imaging >


Video e20-14B | Requires Flash

Real-time two-dimensional stress echocardiogram in a normal subject. The studies at rest are shown on the left and the studies during peak exercise are on the right. Apical four-chamber (top) and two-chamber (bottom) views. At rest, there is contraction of all segments of the myocardium. During exercise, there are increases in contractility and in the thickening of all segments of the myocardium.

View in Context

Harrison's Online > Chapter e20. Atlas of Noninvasive Cardiac Imaging > Atlas of Noninvasive Cardiac Imaging >


Video e20-15A | Requires Flash

Real-time two-dimensional stress echocardiogram of a patient with coronary artery disease. The studies at rest are shown on the left and the studies during peak exercise are on the right. Parasternal long axis (top) and short axis (bottom) views. The images during peak exercise show regional wall motion abnormalities in the anteroapical distribution indicative of myocardial ischemia.

View in Context

Harrison's Online > Chapter e20. Atlas of Noninvasive Cardiac Imaging > Atlas of Noninvasive Cardiac Imaging >


Video e20-15B | Requires Flash

Real-time two-dimensional stress echocardiogram of a patient with coronary artery disease. The studies at rest are shown on the left and the studies during peak exercise are on the right. Apical four-chamber (top) and two-chamber views (bottom). The images during peak exercise show regional wall motion abnormalities in the anteroapical distribution indicative of myocardial ischemia.

View in Context

Harrison's Online > Chapter e20. Atlas of Noninvasive Cardiac Imaging > Atlas of Noninvasive Cardiac Imaging >


Video e20-16 | Requires Flash

MRI scan in real-time of a patient with a large left ventricular apical aneurysm. The long axis view demonstrates a thin dyskinetic apical aneurysm with preserved systolic function of the basal anterior and basal inferior wall.

View in Context

Harrison's Online > Chapter e20. Atlas of Noninvasive Cardiac Imaging > Atlas of Noninvasive Cardiac Imaging >


Video e20-17 | Requires Flash

Three-dimensional reconstruction of an MR angiogram, showing a severe coarctation of the descending aorta. The large collateral vessels as a result of the coarctation are shown.

View in Context

Harrison's Online > Chapter e20. Atlas of Noninvasive Cardiac Imaging > Atlas of Noninvasive Cardiac Imaging >


Video e20-18 | Requires Flash

Cine MR scan of a patient with a dilated ascending aorta (annulo-aortic ectasia). There is a thin central jet of aortic regurgitation going into the left ventricular outflow tract.

View in Context

Harrison's Online > Chapter e20. Atlas of Noninvasive Cardiac Imaging > Atlas of Noninvasive Cardiac Imaging >


Video e20-19 | Requires Flash

CT coronary angiogram showing a normal right coronary artery. The movie highlights multiple thin slices through the right coronary artery.

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Harrison's Online > Chapter e22. Atlas of Atherosclerosis > Atlas of Atherosclerosis >


Video e22-1 | Requires Flash

Pulse pressure. Considerable evidence suggests that pulse pressure serves as an important risk factor for future cardiovascular events. This video clip explains the derivation of pulse pressure and some of the pathophysiology that determines this parameter. (With permission from the Academy for Health Care Education.)

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Harrison's Online > Chapter e22. Atlas of Atherosclerosis > Atlas of Atherosclerosis >


Video e22-2 | Requires Flash

Plaque instability. We currently understand that most coronary thromboses result from a physical disruption of the atherosclerotic plaque. This video animation explains some of the current concepts of the pathophysiology of atherosclerotic plaque disruption and how it triggers arterial thrombosis.

View in Context

Harrison's Online > Chapter e22. Atlas of Atherosclerosis > Atlas of Atherosclerosis >


Video e22-3 | Requires Flash

Lipoprotein menagerie. The lipid profile confers important information regarding cardiovascular risk and the effects of therapies; understanding lipoprotein metabolism provides insight into the pathophysiology of arterial disease. This video animation presents the rudiments of the metabolism of lipoproteins important in clinical medicine.

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Harrison's Online > Chapter e22. Atlas of Atherosclerosis > Atlas of Atherosclerosis >


Video e22-4 | Requires Flash

Formation and complication of atherosclerotic plaques. We now understand the generation of atherosclerotic plaques as a dynamic process involving an interchange between cells of the artery wall, inflammatory cells recruited from blood, and risk factors such as lipoproteins. This video animation reviews current thinking about how risk factors alter the biology of the artery...

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Harrison's Online > Chapter e22. Atlas of Atherosclerosis > Atlas of Atherosclerosis >


Video e22-5 | Requires Flash

Atherogenesis. This video clip highlights some of the current thinking about mechanisms of atherogenesis.

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Harrison's Online > Chapter e22. Atlas of Atherosclerosis > Atlas of Atherosclerosis >


Video e22-6 | Requires Flash

Metabolic syndrome. A number of important cardiovascular risk factors tend to cluster in a pattern described by some as the "metabolic syndrome." While controversy persists regarding whether cardiovascular risk due to these factors is additive or synergistic, their clinical importance is growing. This animation discusses some of the metabolic derangements that underlie the "metabolic syndrome."

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Harrison's Online > Chapter e23. Atlas of Percutaneous Revascularization > Case 1: Cardiogenic Shock with Left Main Coronary Artery Obstruction >


Video e23-1 | Requires Flash

Baseline left coronary angiogram shows severe ulcerated stenosis of the distal left main coronary artery.

View in Context

Harrison's Online > Chapter e23. Atlas of Percutaneous Revascularization > Case 1: Cardiogenic Shock with Left Main Coronary Artery Obstruction >


Video e23-2 | Requires Flash

Severe ulcerated stenosis of the distal left main coronary artery, as seen also in this right anterior oblique projection.

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Harrison's Online > Chapter e23. Atlas of Percutaneous Revascularization > Case 1: Cardiogenic Shock with Left Main Coronary Artery Obstruction >


Video e23-3 | Requires Flash

There is also significant stenosis in the midportion of the dominant right coronary artery.

View in Context

Harrison's Online > Chapter e23. Atlas of Percutaneous Revascularization > Case 1: Cardiogenic Shock with Left Main Coronary Artery Obstruction >


Video e23-4 | Requires Flash

Intraaortic balloon pump placed via contralateral groin. 8 Fr guiding catheter is used to place separate wires into the left anterior descending (LAD) and circumflex (CX) arteries.

View in Context

Harrison's Online > Chapter e23. Atlas of Percutaneous Revascularization > Case 1: Cardiogenic Shock with Left Main Coronary Artery Obstruction >


Video e23-5 | Requires Flash

Simultaneous inflation of two 3.0-mm adjacent "kissing" balloons.

View in Context

Harrison's Online > Chapter e23. Atlas of Percutaneous Revascularization > Case 1: Cardiogenic Shock with Left Main Coronary Artery Obstruction >


Video e23-6 | Requires Flash

Simultaneous kissing stent deployment in the LAD and Cx.

View in Context

Harrison's Online > Chapter e23. Atlas of Percutaneous Revascularization > Case 1: Cardiogenic Shock with Left Main Coronary Artery Obstruction >


Video e23-7 | Requires Flash

Cardiogenic shock with left main coronary artery obstruction: Post-stent result.

View in Context

Harrison's Online > Chapter e23. Atlas of Percutaneous Revascularization > Case 1: Cardiogenic Shock with Left Main Coronary Artery Obstruction >


Video e23-8 | Requires Flash

Cardiogenic shock with left main coronary artery obstruction: Post-stent result.

View in Context

Harrison's Online > Chapter e23. Atlas of Percutaneous Revascularization > Case 1: Cardiogenic Shock with Left Main Coronary Artery Obstruction >


Video e23-9 | Requires Flash

Shock persists, so the right coronary artery lesion was also stented.

View in Context

Harrison's Online > Chapter e23. Atlas of Percutaneous Revascularization > Case 1: Cardiogenic Shock with Left Main Coronary Artery Obstruction >


Video e23-10 | Requires Flash

Cardiogenic shock with left main coronary artery obstruction: Result of stent deployment.

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Harrison's Online > Chapter e23. Atlas of Percutaneous Revascularization > Case 2: Inferior MI with Cardiogenic Shock >


Video e23-11 | Requires Flash

Angiography of the non-infarct left coronary shows unexpected distal left main bifurcation stenosis with possible superimposed thrombus.

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Harrison's Online > Chapter e23. Atlas of Percutaneous Revascularization > Case 2: Inferior MI with Cardiogenic Shock >


Video e23-12 | Requires Flash

The right coronary artery is occluded proximally.

View in Context

Harrison's Online > Chapter e23. Atlas of Percutaneous Revascularization > Case 2: Inferior MI with Cardiogenic Shock >


Video e23-13 | Requires Flash

Guidewire passage restores antegrade flow, exposing extensive linear thrombus and stenosis in the mid-RCA. Elapsed time since arrival in the catheterization laboratory—10 min.

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Harrison's Online > Chapter e23. Atlas of Percutaneous Revascularization > Case 2: Inferior MI with Cardiogenic Shock >


Video e23-14 | Requires Flash

Some improvement in the filling defect after suction thrombectomy.

View in Context

Harrison's Online > Chapter e23. Atlas of Percutaneous Revascularization > Case 2: Inferior MI with Cardiogenic Shock >


Video e23-15 | Requires Flash

Positioning a 3.5 x 32 mm drug-eluting stent to cover the culprit lesion.

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Harrison's Online > Chapter e23. Atlas of Percutaneous Revascularization > Case 2: Inferior MI with Cardiogenic Shock >


Video e23-16 | Requires Flash

Stent deployment.

View in Context

Harrison's Online > Chapter e23. Atlas of Percutaneous Revascularization > Case 2: Inferior MI with Cardiogenic Shock >


Video e23-17 | Requires Flash

Inferior MI with cardiogenic shock: Post-stent.

View in Context

Harrison's Online > Chapter e23. Atlas of Percutaneous Revascularization > Case 2: Inferior MI with Cardiogenic Shock >


Video e23-18 | Requires Flash

Post-stent in shallow RAO cranial projection shows brisk flow in a very dominant right coronary artery. Elapsed time since catheterization laboratory arrival < 20 min.

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Harrison's Online > Chapter e23. Atlas of Percutaneous Revascularization > Case 2: Inferior MI with Cardiogenic Shock >


Video e23-19 | Requires Flash

Sheath injection shows entry into the common femoral artery just above a moderate lesion. An intraaortic balloon pump was placed to stabilize the patient for bypass surgery of the left coronary artery the following day. Peak CPK was 337 (upper limit of normal = 200), indicating an aborted myocardial infarction with this very early reperfusion.

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Harrison's Online > Chapter e23. Atlas of Percutaneous Revascularization > Case 3: Anterior MI Stent, with Stent Thrombosis >


Video e23-20A | Requires Flash

Baseline angiography showing bifurcation thrombus in the LAD.

View in Context

Harrison's Online > Chapter e23. Atlas of Percutaneous Revascularization > Case 3: Anterior MI Stent, with Stent Thrombosis >


Video e23-20B | Requires Flash

Baseline angiography showing bifurcation thrombus in the LAD.

View in Context

Harrison's Online > Chapter e23. Atlas of Percutaneous Revascularization > Case 3: Anterior MI Stent, with Stent Thrombosis >


Video e23-21A | Requires Flash

Rheolytic thrombectomy, with post-thrombectomy result.

View in Context

Harrison's Online > Chapter e23. Atlas of Percutaneous Revascularization > Case 3: Anterior MI Stent, with Stent Thrombosis >


Video e23-21B | Requires Flash

Rheolytic thrombectomy, with post-thrombectomy result.

View in Context

Harrison's Online > Chapter e23. Atlas of Percutaneous Revascularization > Case 3: Anterior MI Stent, with Stent Thrombosis >


Video e23-22A | Requires Flash

Simultaneous drug-eluting stenting of the LAD-diagonal bifurcation.

View in Context

Harrison's Online > Chapter e23. Atlas of Percutaneous Revascularization > Case 3: Anterior MI Stent, with Stent Thrombosis >


Video e23-22B | Requires Flash

After simultaneous drug-eluting stenting of the LAD-diagonal bifurcation: an excellent result.

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Harrison's Online > Chapter e23. Atlas of Percutaneous Revascularization > Case 3: Anterior MI Stent, with Stent Thrombosis >


Video e23-23 | Requires Flash

The patient self-discontinued clopidogrel at 2 months after stenting, and developed recurrent pain 10 days later. Emergency coronary angiography shows recurrent LAD occlusion due to subacute stent thrombosis.

View in Context

Harrison's Online > Chapter e23. Atlas of Percutaneous Revascularization > Case 3: Anterior MI Stent, with Stent Thrombosis >