Ischemic heart disease is characterized by a decrease in myocardial blood flow, which reduces the relationship between oxygen supply and demand. The condition has attracted the attention of the scientific community due to its high incidence, elevated morbidity and mortality, and high therapeutic cost. The treatment primarily relies on myocardial revascularization. Paradoxically, reperfusion and restoration of blood flow can cause additional damage, called myocardial ischemia-reperfusion (IR) injury. Several mechanisms are involved in the IR injury, such as ionic homeostasis change, […]

The reasoning behind the often-difficult task of deciding whether, when and how to treat the patient with established Cardiovascular Disease (CVD) might be based on two simple questions: (1) Are we treating an acute event?, and (2) What is my patient at risk of in the future? Whilst the first question implies an expedite straightforward treatment, the second premise depends mostly on risk stratification and, thus, the capability of one to anticipate the likelihood of an event. Withal, the physician […]

Cardiovascular Diseases (CVD) have emerged as a global health concern responsible for more than 17 million deaths annually, representing the main cause of death since the 1960s. In particular, Ischemic Heart Diseases (IHD) constitute the most prevalent CVD, occupying the position of leading cause of death worldwide considering data until 2019, having been responsible for 8.9 million deaths in 2019 (16% of all causes of death) associated with an increase of more than 2 million deaths in the past two […]

Abstract Coronary artery fistula is a rare anatomic abnormality of the coronary arteries that affects 0.002% of the general population and represents 14% of all anomalies of coronary arteries. Its clinical relevance focuses mainly on the mechanism of the coronary steal phenomenon, causing myocardial functional ischemia, even in the absence of stenosis; therefore, angina and effort dyspnea are common symptoms. The suggested diagnostic approach is driven by patients’ symptoms, and it consists of a number of instrumental examinations like ECG, […]

According to the World Health Organization (WHO), ischemic heart disease is the leading cause of death worldwide, accounting for 16% of the world’s deaths in 2019. However, due to continuous evolution in medical treatment and revascularization techniques, a steady decline in death rates in acute coronary syndromes (ACS) has been observed in recent years. Currently, percutaneous coronary intervention (PCI) is the gold-standard treatment for ST-elevation myocardial infarction (STEMI) and a mainstay therapeutic option for non-STEMI ACS and stable coronary artery […]

Ischemic heart disease is the main cause of death worldwide, and its most severe presentation ST-elevation acute myocardial infarction (STEMI), which corresponds to approximately 1/3 of the presentations, and early reperfusion is the main strategy for reducing mortality. Despite broad historical knowledge of gender-related differences in treatment and prognosis of patients with an acute presentation of ischemic heart disease, male individuals, in addition to having earlier access to health systems, are even more likely to undergo a diagnostic coronary angiography […]

Cardiovascular diseases (CVD) are the main causes of death in women and men in Brazil. Since 1980, there has been a significant reduction in mortality from these diseases. From 1980 to 2012, the smallest reduction was 31% for ischemic heart diseases (IHD) in men, and the largest reduction was 54% for cerebrovascular diseases (CBVD) in women. Despite an important reduction in mortality due to IHD, the reduction in mortality due to CBVD was the one that most contributed to the […]

There is a growing recognition that disorders affecting the structure and function of the coronary microcirculation can act as key mediators of patient symptoms and prognosis.The subset of disorders affecting the microcirculation is termed coronary microvascular disease (CMD), which is expressed as either the inability of the coronary arteries to dilate appropriately to meet myocardial oxygen demand and/or as the abrupt reduction in coronary blood flow related to coronary spasm. For the past 2 decades, CMD has been actively investigated […]