…ECG examples. Click to zoom. Overview of the normal electrocardiogram (ECG) ECG interpretation includes an assessment of the morphology (appearance) of the waves and intervals…

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

…the latter also known as idioventricular rhythm. Recognizing these arrhythmias on the electrocardiogram (ECG) is of clinical importance. Diagnosis and management of ventricular tachycardia will…

…adult Abnormal relaxation (grade 1 dysfunction) Pseudonormal (grade 2 dysfunction) Reversible restrictive filling (grade 3 dysfunction) Irreversible restrictive filling (grade 4 dysfunction) E/A ratio…

…11.029. Pulmonary valve Pulmonary valve regurgitation Mild regurgiation Moderate regurgitation Severe regurgitation Pulmonary valve morphology normal normal/abnormal abnormal Density CW Doppler weak, slow…

…size and volume Women Men Normal range Mildly abnormal Moderately abnormal Severely abnormal Normal range Mildly abnormal Moderately abnormal Severely abnormal ATRIAL DIMENSIONS LA diameter…

Pulmonary valve regurgitation Mild regurgiation Moderate regurgitation Severe regurgitation Pulmonary valve morphology normal normal/abnormal abnormal Density CW Doppler weak, slow deceleration variable dense, steep…

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

…formerly termed Prinzmetal or variant angina, is myocardial ischaemia caused by transient abnormal vasoconstriction of one or more coronary arteries. Epicardial spasm produces a reversible…

Arrhythmias and arrhythmology ECG Atrial fibrillation: definitions, causes, risk factors, ECG diagnosis and management Atrial fibrillation is the most common abnormal tachyarrhythmia (only sinus tachycardia…

…the liver are the prothrombin time (INR) , the albumin and the bilirubin — and they become abnormal late. A cirrhotic liver can have entirely normal transaminases…

…segment depression, reflecting an abnormal repolarization response to exercise induced myocardial oxygen supply–demand imbalance. The exercise response is not confined to the ECG. Ischaemia…

…and reduced LV systolic function. The principal mechanisms are the combination of an abnormal thrombogenic endocardial surface and blood stasis. During the acute infarction phase…

Arrhythmias and arrhythmology ECG Atrial rhythms: ectopic atrial rhythm, atrial tachycardia and multifocal atrial tachycardia Ectopic atrial tachycardia (EAT, or atrial tachycardia) arises when an…

…during ventricular contraction and relaxation. Pericardial effusion is the presence of an abnormal amount of fluid in the pericardial space. It can be caused by…

Conduction defects ECG Intraventricular conduction delay (defect): constellations of bundle branch blocks and fascicular blocks (hemiblocks) This chapter discusses intraventricular conduction delays (defects), which are…

ECG Myocardial ischemia and infarction Pathological R wave progression Normal R wave progression implies that the R wave amplitude increases gradually from V1 to V5…

…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…

…artery into the right ventricle during diastole. The most common cause of abnormal pulmonary regurgitation is pulmonary hypertension. Table 1 presents the causes of pulmonary…

…scores. Each incorporates various clinical parameters to stratify bleeding risk. HAS BLED: Incorporates factors such as hypertension, abnormal renal/liver function, stroke history, bleeding history…

…54 30–44 <30 2D, Two dimensional. Ejection fraction (EF) Normal Mildly abnormal Moderately abnormal Severely abnormal Ejection fraction (%), biplan, males 52 72 41 51…

…wave systolic flow reversal, Qualitative parameters Mild regurgiation Moderate regurgitation Severe regurgitation Mitral valve apparatus normal or mildly abnormal often abnormal abnormal, possibly flail CW…

…referred to as sinus node dysfunction (SND). If a person with ECG signs of SND is symptomatic, the condition is classified as sick sinus syndrome…

…either RV dysfunction or elevated biomarkers, or neither of these abnormalities in the presence of abnormal clinical risk assessment. Low risk PE is characterized by…

…inversion can occur without coronary artery disease. Proposed explanations in the source material include cardiac memory after abnormal ventricular activation, transient rate related conduction abnormalities…

…Moderate or severe chronic kidney disease (CKD) Hypertension mediated organ damage (HMOD) Probable or definite familial hypercholesterolaemia Other markedly abnormal single risk factors or genetic…

…in ascertainment and imaging technique. Coronary fistulae represent abnormal communications between a coronary artery and a cardiac chamber or vessel. Other congenital anomalies include anomalous…

…Evidence such as increased left atrial size, left ventricular hypertrophy or abnormal LV filling supports the diagnosis Unlike HFpEF, objective evidence of structural or functional…

…patients with reduced EF. Pathophysiology Abnormal ventricular relaxation and increased filling pressures The central hemodynamic abnormality in HFpEF is impaired diastolic function. The left ventricle…

Conduction defects ECG Lathundar Left Bundle Branch Block (LBBB) Electrocardiographic Criteria and Characteristics Left bundle branch block is characterized by a significant reorganization of the…

…coronary flow reserve (CFR), reduce microcirculatory conductance, or cause abnormal vasoconstriction of coronary arterioles. Structural and functional mechanisms may coexist. The formal diagnostic construct for…

…value is borderline or abnormal and the heart rate is less than 50 beats/min, it is recommended to repeat the ECG after mild aerobic…

…risk must be considered alongside thromboembolic risk. The HAS BLED score includes hypertension, abnormal renal or liver function, prior stroke, bleeding tendency or previous bleeding…

…8%. This implies that approximately one third of the patients who ultimately had a favorable neurological recovery exhibited an abnormal pupillary reflex upon initial examination…

Arrhythmias and arrhythmology ECG Diagnosis and management of narrow and wide complex tachycardia All clinically significant supraventricular and ventricular tachyarrhythmias have been reviewed in previous…

…imbalance. The ECG may be used to estimate the severity of electrolyte imbalances and to judge whether there is a risk of serious arrhythmias. This…

Arrhythmias and arrhythmology ECG Mechanisms of cardiac arrhythmias: from automaticity to re entry This section introduces the most common arrhythmias encountered in clinical practice, beginning…

…slow propagation leads to a delayed and abnormal activation sequence of the right ventricle, resulting in a prolonged and abnormal QRS complex on the ECG…

…than 50 beats per minute. ECG criteria follow: Regular rhythm with a ventricular rate slower than 50 beats per minute. P waves with constant morphology…

…the T wave is said to be discordant which is abnormal. Because most ECG leads have net positive QRS complexes (during normal circumstances) the T…

…Extreme dipper 20 % Also unfavourable, particularly in the elderly An abnormal 24 hour rhythm should prompt investigation for sleep apnoea, renal disease and secondary hypertension…

…with respiratory compensation, or a mixed metabolic and respiratory alkalosis if the pCO₂ is too low Normal Abnormal Abnormal A compensated simple disorder, or two…

…not exclude delirium, however, and an abnormal result is not specific to delirium. Symptoms are often worse in the evening and at night, but diurnal…

…supply of glucose to the brain can cause: difficulty concentrating irritability or abnormal behaviour slurred speech visual disturbance confusion focal neurological signs drowsiness or unconsciousness…

…11.029. Pulmonary valve Pulmonary valve regurgitation Mild regurgiation Moderate regurgitation Severe regurgitation Pulmonary valve morphology normal normal/abnormal abnormal Density CW Doppler weak, slow…

…amyloidosis [8, 15]. AL Amyloidosis: This is a plasma cell dyscrasia in which abnormal plasma cells produce misfolded immunoglobulin light chains [8, 19]. Light chains…

…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…

…Describes cardiac death in patients with symptoms suggestive of myocardial ischaemia and presumed new ischaemic ECG changes, occurring before cTn values become available or abnormal…

…impaired coronary flow reserve, reduced microcirculatory conductance, or abnormal arteriolar vasoconstriction. More than one mechanism may coexist. Supply–demand mismatch MINOCA may result from a…

…which death occurs before biomarkers can be obtained or become abnormal, in the presence of symptoms suggestive of ischaemia and presumed new ischaemic ECG changes…

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

…in healthy people older than 60 years. The abnormal slope does not itself distinguish precapillary from postcapillary disease. A PAWP/cardiac output slope greater than…

…myocardial ischaemia , demonstrated by at least one of the following: Symptoms of myocardial ischaemia. New ischaemic ECG changes. New pathological Q waves. Imaging evidence of…

…T wave changes. The term ST T segment changes (or simply ST T changes) is used to refer to such ECG changes. It must also…

…after infarction and after successful reperfusion (PCI). Post ischemic T wave inversion is caused by abnormal repolarization. These T wave inversions are symmetric with varying…

…myocardial ischaemia, though abnormal cardiac troponin (cTn) values in the setting of acute or chronic heart failure are often better categorised as myocardial injury. Clinical…

…anticoagulant therapies, balancing the imperative of stroke prevention against the inherent risks of iatrogenic hemorrhage. ECG recordings of atrial fibrillation. Click to enlarge. Risk Stratification…

ECG Hypertrophy and dilatation Principles of atrial and ventricular enlargement (hypertrophy and dilatation) Cardiac chamber enlargement refers to abnormally large atria or abnormally large ventricles…

…For laypeople, confirming absent or abnormal breathing is sufficient to alert the emergency service and commence CPR. Agonal breathing before apnea A cardiac arrest occurs…

ECG Myocardial ischemia and infarction Acute Myocardial Infarction: Definition & Criteria Acute myocardial infarction is the most severe complication of coronary artery disease. The most common…