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

…the sinoatrial node) is a common finding in athletes and during sleep; in these scenarios, it should not be considered abnormal. On the other hand…

…learn the physiological basis of all ECG waves and how to determine whether the ECG is normal or abnormal. Although heart rhythm will be discussed…

…circulatory compromise or collapse. Causes of tachycardia (tachyarrhythmia) with wide QRS complexes (QRS duration ≥0,12 s) : ventricular tachycardia is the most common cause and…

…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 …

…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…

…ECG finding is the ST segment depressions. In STE ACS, on the other hand, the ST segment depressions are secondary findings and the primary findings…

…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…

…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…

…sinoatrial node (which lowers heart rate) and also slows conduction over the atrioventricular (AV) node. The most classical ECG finding is generalized ST segment depressions…

…and profound sinus bradycardia are typically considered abnormal or profound findings that may require further investigation. 2. What heart rate range is ideally recommended for…

…and pathophysiology Myocardial infarction (MI) is a clinical diagnosis that integrates myocardial injury, evidence of acute myocardial ischaemia, electrocardiographic findings, cardiac biomarkers, imaging, angiography, and…

…fundamental neurological examination finding that reflects brainstem (midbrain) function. In the context of cardiac arrest and the post resuscitation period, assessment of the PLR has…

…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…

…circulatory compromise or collapse. Causes of tachycardia (tachyarrhythmia) with wide QRS complexes (QRS duration ≥0,12 s) : ventricular tachycardia is the most common cause and…

…heart failure (HF), atrial fibrillation and cardiovascular events. In clinical practice, obesity is conventionally defined by a body mass index (BMI) of ≥30 kg/m2…

…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…

…normal finding. The regurgitation results in blood flowing back from the pulmonary artery into the right ventricle during diastole. The most common cause of abnormal…

…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…

…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…

…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…

…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…

…assessment of valvular regurgitation. Part 1: aortic and pulmonary regurgitation (native valve disease). In European journal of echocardiography : the journal of the Working Group on…

…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…

…alter the electrical properties of the heart (inducing QRS or QT prolongation) or causing electrolyte abnormalities, such as thiazide and loop diuretics. Diagnostics Electrocardiogram (ECG…

…Definition and pathophysiology Vasospastic angina (VA), formerly termed Prinzmetal or variant angina, is myocardial ischaemia caused by transient abnormal vasoconstriction of one or more coronary…

…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…

…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…

…because coronary computed tomography angiography (CCTA) and functional imaging have higher diagnostic performance. Its most consistent contemporary role is therefore the assessment of functional capacity…

…be excluded. Diagnostics Echocardiography TTE is the principal initial imaging method for detecting LV thrombus and assessing the substrate on which it develops. The thrombus…

…Causes of ectopic atrial tachycardia and ectopic atrial rhythm Side effect of digoxin. Heart failure. Lung disease (COPD, pulmonary hypertension, etc). Ischemic heart disease (coronary…

…due to the swinging back and forth of the heart in the pericardial space. Note that tachycardia, pulmonary embolism and ischemia may also cause electrical…

…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…

…type of infarction may cause pathological R wave progression. However, the specificity for pathological R wave progression is considerably lower than pathological Q waves and…

…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…

…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…

…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)…

…Gonzalo; Baumgartner, Helmut et al. (2012): Guidelines on the management of valvular heart disease (version 2012). In European heart journal 33 (19), pp. 2451–2496…

…Established ASCVD includes previous acute coronary syndrome, chronic coronary syndromes, coronary revascularization, stroke, transient ischaemic attack, and peripheral arterial disease. Heart failure is also considered…

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

…is therefore defined by symptoms and signs of congestion or impaired cardiac performance rather than by ejection fraction alone. Heart failure with preserved ejection fraction…

…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…

…Demonstration of reduced CFR and/or inducible microvascular spasm. The microvascular circulation cannot be directly visualized in vivo in humans. Consequently, diagnosis depends on functional…

…presence of mitral stenosis, a mechanical heart valve or hypertrophic cardiomyopathy. Heart failure, hypertension, diabetes and vascular disease. Age and sex category. Renal and hepatic…

…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…

…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…

…a delayed and abnormal activation sequence of the right ventricle, resulting in a prolonged and abnormal QRS complex on the ECG. The hallmark of right…

…rhythm. Recognizing these arrhythmias on the electrocardiogram (ECG) is of clinical importance. Diagnosis and management of ventricular tachycardia will be addressed in a separate chapter…

…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…

…assessment of pH and the metabolic component, but it should not be regarded as fully interchangeable with an arterial sample [3]. Venous pH is on…

…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…

…delay treatment of a neurologically compromised patient. Continuous glucose monitoring reflects interstitial glucose and lags behind the blood glucose during rapid changes. Pressure on the…

…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…

…A history of increasing frequency of hospitalizations and visits for heart failure without disease recognition in the 3 years preceding diagnosis is also a notable…

…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…

…associated with coronary artery bypass grafting (CABG). Clinical Presentation and Symptoms The diagnosis of an acute MI remains a comprehensive clinical diagnosis based on patient…

…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…

…waves Imaging evidence of new loss of viable myocardium or a new regional wall motion abnormality in an ischaemic distribution Identification of a coronary thrombus…

…Elsevier 2010 ). At the time of J 60 and J 80, there is minimal chance that there are any electrical potential differences in the myocardium…

…based, high and symmetric. Their duration is short; they typically disappear within minutes after a total occlusion in a coronary artery occurs (then of course…