What is Multivessel Disease?

The multivessel disease can be simply described as a >70% stenosis in two or more major coronary arteries of 2.5 mm diameter or greater.

Are Multivessel Disease and Coronary Artery Disease The Same?

Multivessel disease (MVD) is considered a form of coronary artery disease (CAD). MVD is a stage of CAD in which too much plaque builds up within two or more major arteries that can lead to major complications.

The multivessel coronary disease affects 40%to 50% of individuals with ST-elevation myocardial infarction (STEMI).

Etiology

The following are some of the most common risk factors for atherosclerosis and coronary artery disease:
●Hypertension
●Hyperlipidemia
●Diabetes
●Age
●Menopause
●Hyperhomocysteinemia
●Family history of heart diseases
●Endothelial nitric oxide synthase mutations
Coronary constriction, in addition to plaque rupture leading to platelet aggregation and thrombus development, plays a crucial role in myocardial infarction.

Epidemiology

Coronary artery disease led to the deaths of 607,000 patients in 2005, and the number is expected to rise to 23.4 million by 2030.
CAD is the main cause of death in developed countries. About 16.8 million Americans are affected by CAD, with 8 million of them having suffered a prior myocardial infarction.

Pathophysiology

The composition of atherosclerotic plaques in dead patients who had suffered a myocardial infarction has been studied. Smooth muscle cells, leukocytes, and foamy cells make up plaques, which have a thin fibrous cover, a big necrotic core, smooth muscle cells, leukocytes, and foamy cells. When a plaque ruptures and circulating thrombotic factors are exposed to exposed endothelial cells, a thrombus forms, which sticks to the artery’s luminal surface and causes an abrupt blockage. It’s made up of platelet aggregates, erythrocytes, and leukocytes, all of which are coated in a fibrin network.
Increased intraluminal pressure, coronary vasospasm, tachycardia, elevated systolic blood pressure, increased blood viscosity, increased sympathetic activity, hypercoagulability, and impaired fibrinolysis are all possible triggers for plaque rupture. Because of structural inflammation, atherosclerotic plaques are prone to rupture, resulting in the formation of a necrotic core with a thin fibrous cover for protection.

History and Physical

BThe severity of the underlying illness, the existence of concomitant disorders that may modify the typical presentation, and the sharpness of the disease all influence the presentation of multivessel disease.
Exertional chest discomfort or shortness of breath with radiation to the left arm and neck are common symptoms in patients with stable multivessel disease.
When three of the following symptoms are present, it is called “typical” chest pain, and when two of the following symptoms are present, it is called “atypical” chest pain: chest pain made worse by emotional or physical stress, chest pain relieved by rest and nitroglycerin, substernal chest pain, pressure, or discomfort.
Patients may experience nausea, diaphoresis, and lightheadedness as well. Patients in their latter years, particularly women and diabetics, may appear with unusual symptoms of epigastric pain.

Evaluation

The risk of a patient having CAD depends on some factors like their age, gender, and whether they have typical angina, atypical angina, or nonanginal chest pain at the time of the test.

A High pretest probability of CAD is defined as a likelihood of CAD that is more than or equal to 75% or 90%.

An intermediate pretest probability of CAD is described as a range of 10% to 25% to 75 percent and 90 percent, respectively, of CAD pretest probability.

A low pretest probability of CAD is defined as a likelihood of CAD that is less than 25% or 10%. There is no need for additional testing.

Differential Diagnosis

The following items help the differential diagnosis of typical and atypical chest pain:

Gastrointestinal
  • GERD
  • Dyspepsia
  • Dysphagia
  • Pancreatitis
Cardiac
  • Acute myocardial infarction (STEMI/NSTEMI)
  • Unstable angina
  • Stable angina
  • Acute pericarditis
  • Aortic dissection
  • Prinzmetal angina
  • Drug use (cocaine, amphetamines)
Musculoskeletal
  • Rib fracture
  • Chronic pain syndromes
  • Costochondritis
  • Trauma
Pulmonary
  • Pleurisy
  • Acute pulmonary embolism
  • Pneumonia
  • Pulmonary contusion
  • Pneumothorax

 

 

Treatment and Management

A healthcare professional will evaluate the severity of the condition and offer the best treatment option for the individual.
People with multivessel coronary artery disease should make major lifestyle changes and seek medical treatment, according to the international guidelines.
There are a lot of different treatment options for multivessel coronary artery disease.

Surgery

Doctors may consider stenting or surgery to allow more blood to reach specific organs in some cases. This is referred to as revascularization in the medical field.

Although revascularization surgery can be beneficial in some cases and may reduce mortality in many people, it is not suited for everyone. Importantly, revascularization surgery is most successful when combined with other medical treatments and lifestyle adjustments.

Lifestyle changes can include:
  • Exercise
  • Smoking cessation
  • Loss of weight or weight maintenance
  • A significant reduction in alcohol consumption
  • lowering salt consumption
Medical treatment may involve the following:
  • Aspirin and other antiplatelet medicines let blood flow more freely through the arteries.
  • Beta-blockers to treat angina symptoms.
  • Statin treatment to lower cholesterol levels and inflammation.

Complications

The multivessel disease has several side effects, including the following:
●Acute coronary syndrome (ACS)
●Acute coronary syndrome (ACS)
●In-stent restenosis
●In-stent thrombosis
●Stent embolization
●Side branch occlusion
●Stent fracture
●Graft failure
●Complications of surgery (bleeding, wound dehiscence, infection, pulmonary complication, stroke, myocardial infarction, arrhythmia, acute kidney injury, transfusion-related reactions)
●Complications of PCI (bleeding, pseudoaneurysm, retroperitoneal hematoma, infection, arterial dissection, distal arterial embolization, coronary perforation, stroke, acute kidney injury, reperfusion injury)

Resources

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Grants Submission

Please read carefully the below criteria to make sure that you are eligible for the GIS Valves 2024 Educational Grant

Please read carefully the below criteria to make sure that you are eligible for the GIS Valves 2024 Educational Grant

1- Subspecialty related to GIS Valves 2024

You can submit the Grant Request if you specialize in the following Subspecialties:

  • Cardiologists
  • Interventionists
  • Cardiovascular Surgeons
  • Chest Diseases Specialists
  • Cardiac Surgeons

2- Professional Approval

  • A recommendation letter must be signed, stamped and approved by the department head in the hospital/ university.
  • It should be directed to the Gulf Intervention Society “GIS”
  • Updated Resume “CV” is required

3- Attendance

To be eligible for reimbursement, 80% of the Program Hours must be attended.

4- Additional Requirements (Increase your opportunity by following these steps using the most active social media account(s))

  1. Follow our social media accounts (Instagram, Facebook, Twitter, LinkedIn).
  2. Engage with our content by liking, sharing our posts, and tagging us using the official hashtag #GIS2024.
  3. Ensure that your post is public.

5- What Grant offers

  • Full Free Registration
  • Reimbursement of Maximum specified amount as per your destination, which covers accommodation for two (2) nights and economy flight tickets. (Reimbursement form to be sent after the approval of your submission

 

GIS Educational Grant submission deadline: 15 April 2024

 



For Any Inquires please contact PCO In Charge
khaled.elsawy@icomgroup.org

 

Grants Submission

Please Read Carefully the Below Criteria to Make Sure that you are Eligible for the GIS Complications Cases Show 2024 Educational Grant

 

1. Subspecialty related to GIS Complications Cases Show 2024
You can submit the Grant Request if you specialize in the following specialties/subspecialties:
• Cardiology
• Interventional Cardiology
• Cardiovascular Surgery
• Chest Diseases

2. Professional Approval
Recommendation letter must be signed, stamped and approved by the department head in the hospital/ university/ institute

3. Attendance
80% of the Program Hours must be attended to be eligible to get the reimbursement

4. What Grant offers
• Full Free Registration
• Other covered elements to be determined based on the destination

5. Priority
• Submitting a case will be an added value for the grant selection.

 

GIS Educational Grant submission deadline: 1 February 2024

For Any Inquires please contact PCO In Charge
khaled.elsawy@icomgroup.org

 

Cases Submission

  • All Cases should be presented in a PowerPoint and to be written in clear English
  • All presenting authors should have proficiency in English, to be able to present and respond to questions.
  • Cases must be submitted via the online Cases submission site.
  • You must receive the approval of all co-authors before putting their names on the Presentation.
  • All Cases must be submitted to an appropriate category for review based on the scientific content of the Case.
  • Titles:
    • Case titles are limited to 10 words or less.
    • The title should be dynamic and conclusive, rather than descriptive.
    • In general, you should capitalize the first letter of each word unless it is a preposition or article.
    • Titles should not be bold.
  • Authors: One person must be identified as the presenting author. The order of the authors can be modified at any time prior to the case deadline.
  • Content of the case: The case should contain a brief statement of (but not as subheadings):

    Patients Name must be hide from the Presentation

Important dates

  • Submission deadline: 10, Feb 2024
  • Submissions received after this deadline will not be considered. Presenters are not permitted to modify their cases after this date for reviewing purposes.
  • Notification of cases acceptance: 15, Feb, 2024

Presenter agreement

All presenters must agree to the following conditions when submitting a Case:

  • Affirm that the work has not been published (in print or electronically) elsewhere prior to the meeting.
  • Agree that if the case is accepted, GIS has permission to publish the case in printed and/or electronic formats.

Presenter changes and withdrawal policy

If you are unable to attend the meeting and wish to name a substitute presenter, please use the following guidelines:

  • The Presenting Author is the only author that may request a presenter change.
  • Substitute presenter must NOT be presenting another case at the meeting.
  • Substitution requests must be made PRIOR to the meeting.
  • Substitution requests should be sent by the presenting author to the below email:
  • Withdrawal policy: If authors wish to withdraw their case/s, they are requested to send a letter via e-mail to the above-mentioned email

Financial assistance

  • Limited financial assistance is available for this conference in the form of Virtual / In Person Assistance
  • Availability will be indicated during the Cases submission process.

Fawaz Almutairi

Saudi Arabia

Fawaz Portrait GIS president

Title

President, Gulf Intervention Society

Interventional Cardiologists

National Guard Hospital

Riyadh, Saudi Arabia

Abdullah Shehab

United Arab Emirates

shehab portrait vice president GIS

Title

Vice President, Gulf Intervention Society

Professor of Cardiovascular Medicine

Chairman of Education, EMA 

Editor Chief New Emirates Medical Journal 

Alain, Abu Dhabi, UAE

Khalid Bin Thani

Bahrain

Title

Treasurer, Gulf Intervention Society

Head of Scientific Committee, GIS Conference

Consultant Interventional Cardiologist

Bahrain Specialist Hospital Manama, Bahrain
Khalid Bin Thani GIS

Mousa Akbar

Kuwait

Title

General Secretary, Gulf Intervention Society

Head of Cardiology Unit, Al Sabah Hospital

Kuwait City, Kuwait

mousa Akbar GIS