…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…

…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…

…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…

…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…

…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…

…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…

…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 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…

…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…

…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…

…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…

…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…

…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…

…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…

…TSH and coeliac serology , together with ultrasound of the liver and biliary tract . Go through the medication and any herbal preparations carefully — drug induced liver…

…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…

…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…

…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…

…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…

…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…

…factors such as hypertension, abnormal renal/liver function, stroke history, bleeding history, labile INR, age 65, and concomitant drug/alcohol use. Some studies suggest HAS…

…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…

…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…

…hypertrophy, or echocardiographic evidence of impaired filling, make the diagnosis more likely. HFpEF and HFmrEF together account for approximately half of patients with symptomatic HF…

…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…

…abnormal renal or liver function, prior stroke, bleeding tendency or previous bleeding, labile international normalized ratio (INR), older age, drugs predisposing to bleeding and alcohol…

…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…

…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…

…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…

…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…

…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…

…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…