…for atrial size and volume Women Men Normal range Mildly abnormal Moderately abnormal Severely abnormal Normal range Mildly abnormal Moderately abnormal Severely abnormal ATRIAL DIMENSIONS…

…Drugs and electrolyte imbalance ECG Definition and Pathophysiology Acquired long QT syndrome (LQTS) is characterised by an abnormal prolongation of the QT interval on the…

…focuses on practical diagnostic and therapeutic considerations, with recommendations aligned with current guidelines from both the American Heart Association (AHA) and American College of Cardiology…

…myocardial ischaemia caused by transient abnormal vasoconstriction of one or more coronary arteries. Epicardial spasm produces a reversible functional occlusion and usually causes transmural ischaemia…

…This is also a normal finding. Abnormal (pathological) causes of sinus bradycardia In all other situations, sinus bradycardia should be regarded as a pathological finding…

…Causes of ventricular rhythm and idioventricular rhythm The usual mechanisms are responsible for all ventricular rhythms. Increased automaticity (in His Purkinje fibers), abnormal automaticity (in…

…cause abnormal vasoconstriction of coronary arterioles. Structural and functional mechanisms may coexist. The formal diagnostic construct for MVA incorporates four components: Symptoms suggestive of myocardial…

…morbidity and mortality, despite often having a greater burden of cardiovascular and non cardiovascular comorbidity than patients with reduced EF. Pathophysiology Abnormal ventricular relaxation and…

…Lane DA, Lip GYH. Evaluation of the HAS BLED, ATRIA, and ORBIT bleeding risk scores in atrial fibrillation patients on warfarin. Am J Med . 2016…

…adults with elevated blood pressure (BP), in whom absolute cardiovascular risk varies considerably according to age and the presence of concomitant risk factors. In contrast…

…than 5% of otherwise normal angiograms demonstrate bridging. The wide range reflects differences in ascertainment and imaging technique. Coronary fistulae represent abnormal communications between a…

…CCTA) and functional imaging have higher diagnostic performance. Its most consistent contemporary role is therefore the assessment of functional capacity, symptoms, haemodynamic responses, arrhythmias and…

…systemic inflammation Insulin resistance Abnormal adipokine signalling Endothelial dysfunction Dyslipidaemia A prothrombotic state Albuminuria and declining estimated glomerular filtration rate Development of type 2 diabetes…

…ventricular hypertrophy, and to the left in left ventricular hypertrophy). ST T segment Significant hypertrophy may result in abnormal depolarization of the ventricular myocardium. This…

…Q waves and guidelines do not state any ECG criteria specific to R wave progression. Figure 1. Pathological R wave progression is indicative of previous…

…in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. In European heart journal cardiovascular Imaging 16 (3)…

…complementary domains: Indicators of acute PE severity , including clinical findings, RV dysfunction on imaging, and myocardial injury shown by laboratory testing. Comorbidity and aggravating conditions …

…and optical coherence tomography (OCT) can reveal lesions that are not apparent on conventional angiography. Coronary vasomotor disorders may involve epicardial spasm or abnormalities of…

…and certain disease entities can span both categories; for example, acute heart failure may occur in the context of acute myocardial ischaemia, though abnormal cardiac…

…The set up and the instructions decide whether the investigation will be usable. Ambulatory blood pressure monitoring (ABPM) Indications Confirmation of newly detected hypertension — recommended…

…Clinical Implications and Prognosis Mechanical and Diagnostic Impact LBBB causes extensive reorganization of left ventricular activation [2]. This leads to abnormal LV mechanical function [7…

…studies of pulmonary arterial hypertension (PAH). The threshold is not absolute: patient phenotype, risk factors for heart failure with preserved ejection fraction, echocardiographic findings, and…

…T waves are seen after periods of ischemia, after infarction and after successful reperfusion (PCI). Post ischemic T wave inversion is caused by abnormal repolarization…

…In STE ACS, on the other hand, the ST segment depressions are secondary findings and the primary findings are the ST segment elevations. As explained…

…ECG diagnosis and management Atrial fibrillation is the most common abnormal tachyarrhythmia (only sinus tachycardia is more common). The prevalence of atrial fibrillation correlates strongly…

…discussion. A premature ventricular complex is recognized on the ECG as an abnormal and wide QRS complex occurring earlier than expected in the cardiac cycle…

…factors include pulmonary disorders, particularly obstructive pulmonary disease, the use of theophylline, and elevated catecholamine states. EAT typically has an abrupt onset, although a brief…

…pulmonary oedema, or evidence of coronary ischaemia. These findings determine the urgency and type of intervention. The assessment should also clarify: Whether AF is pre…

…Definition and pathophysiology Atrial fibrillation (AF) is a major independent risk factor for thromboembolism, including ischaemic stroke. This risk applies across the clinical patterns of…

…hypernatremia) and decreased (hyponatremia) sodium levels do not have any effect on the ECG, nor cardiac rhythm, or impulse conduction. 2. Calcium Hypercalcemia Causes of…

…rise of cardiac imaging and invasive electrophysiological methods which allow for detailed in vivo studies of arrhythmias. However, this chapter focuses on clinical aspects of…

…situations, sinus arrest/pause should be considered abnormal, and the following differential diagnoses are at hand: Sinus node dysfunction. Side effects of drugs (diltiazem, verapamil…

…effect on impulse conduction because digoxin slows impulse conduction. It is important to note that the association between ECG changes and the risk of arrhythmia…

…changes. This is due to the fact that pre excitation leads to abnormal depolarization of the ventricles and this leads to abnormal repolarization as well…

…emphasis on ECG diagnosis, definitions, management, and clinical characteristics. Ventricular tachycardia is a highly nuanced arrhythmia that originates in the ventricles. A wide range of…

…of an acute MI remains a comprehensive clinical diagnosis based on patient symptoms, ECG changes, highly sensitive biochemical markers, and information gleaned from various imaging…

…Pulmonary valve morphology normal normal/abnormal abnormal Density CW Doppler weak, slow deceleration variable dense, steep deceleration, early termination of diastolic flow Jet width colour…

…the presence of an abnormal amount of fluid in the pericardial space. It can be caused by numerous local and systemic disorders. Accumulation of fluid…

…ECG interpretation The QRS complex (ventricular complex): normal and abnormal configurations and intervals A complete QRS complex consists of a Q , R and S wave…

…nature makes prior imaging particularly important when interpreting a current LVEF of 41–49%. Diagnostic phenotype Criterion HFmrEF Symptoms and/or signs of heart failure…

…Visualization on multiple imaging planes. Location adjacent to hyperkinetic myocardium. Large thrombus burden. Cardiac magnetic resonance (CMR) can further characterize thrombus morphology and may assist…

…pulse pressure, an elevated jugular venous pressure with a paradoxical rise on inspiration (Kussmaul sign), and a difficult to palpate apex beat [10]. Despite congestive…

…The ECG contour of the normal P wave, P mitrale (left atrial enlargement) and P pulmonale (right atrial enlargement) Abnormal P waves: atrial enlargement If…

…wave amplitude is on average 3 mm in V2–V3 in females and it rarely exceeds 8 mm. Note that the amplitude of the T…

…by elevated levels of cardiac proteins in the blood. Diagnostic criteria for acute myocardial infarction A diagnosis of myocardial infarction is based on the following…

…will typically cause abnormal ventricular activation (i.e. contraction). The significance of this will depend on the severity of the conduction defect and the affected…

…retrograde (inverted) P waves, which can be located anywhere between the J point and the terminal part of the T wave. PR interval 0,22…

…m² Abnormal urinalysis or renal imaging Risk of progression rises with proteinuria and depends on cause 2 60 mL/min/1.73 m² Abnormal urinalysis…

…Stroke and Bleeding Assessment The decision to initiate oral anticoagulation (OAC) hinges on a rigorous assessment of both thromboembolic and hemorrhagic risks. The diagnostic prerequisite…

…or become abnormal, in the presence of symptoms suggestive of ischaemia and presumed new ischaemic ECG changes. The distinction between myocardial injury and type 2…

…electrocardiographic findings, cardiac biomarkers, imaging, angiography, and, occasionally, pathological examination. Pathologically, infarction represents myocardial cell death caused by prolonged ischaemia. The first cellular abnormalities of…

…this chapter, you will learn the physiological basis of all ECG waves and how to determine whether the ECG is normal or abnormal. Although heart…

…facilitates precise reporting and ensures consistent communication of findings across clinicians. Perfusion defects are categorized by their size, encompassing: Small defects : <10% of the left…

…aortic and pulmonary regurgitation (native valve disease). In European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of…

…patient to recite the months of the year backwards. A normal result does not exclude delirium, however, and an abnormal result is not specific to…

…The tests that reflect the synthetic function of the liver are the prothrombin time (INR) , the albumin and the bilirubin — and they become abnormal late…

…retrograde (inverted) P waves, which can be located anywhere between the J point and the terminal part of the T wave. PR interval 0,22…

…function and perform troubleshooting should be considered a basic clinical skill. Pacing activity may be visible or invisible, depending on e.g the type of…

…2nd AV block, prolonged QT interval, and profound sinus bradycardia are typically considered abnormal or profound findings that may require further investigation. 2. What heart…

…and the neurological status assessed at 30 days was evaluated. The findings were as follows: The absence of a pupillary reflex demonstrated a sensitivity of…