…determine whether the ECG waves and intervals are normal. This chapter will focus on the ECG waves in terms of morphology (appearance), durations and intervals…

…in lead II. Common findings Sinus rhythm (which is the normal rhythm) has the following characteristics: (1) heart rate 50–100 beats per minute; (2…

…prognostic evaluation using two complementary domains: Indicators of acute PE severity , including clinical findings, RV dysfunction on imaging, and myocardial injury shown by laboratory testing…

…or abnormal LV filling supports the diagnosis Unlike HFpEF, objective evidence of structural or functional cardiac abnormality or raised natriuretic peptides is not mandatory for…

…is based on principles similar to those used in echocardiography. The 17 segment model of the left ventricle serves as a standardized framework for identifying…

…Characteristics of ischemic ST segment depressions on ECG. Current guideline criteria for ischemic ST segment depression: New horizontal or downsloping ST segment depressions ≥0,5…

…presents ECG findings during normal atrioventricular impulse transmission as well as ECG findings during pre excitation. Figure 1. Hallmarks of pre excitation on the ECG…

…A net positive QRS complex should be followed by a net positive T wave (refer to the previous discussion on concordance/discordance and Figure 1 )…

…also provoke abnormal automaticity in cells that normally do not exhibit automaticity. The effect on automaticity should be distinguished from the effect on impulse conduction…

…should not be considered abnormal. For example, sinus bradycardia (a slow rhythm directed by the sinoatrial node) is a common finding in athletes and during…

…considered abnormal or profound findings that may require further investigation. 2. What heart rate range is ideally recommended for measuring the QT interval corrected for…

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

…evaluated. The findings were as follows: The absence of a pupillary reflex demonstrated a sensitivity of 72.2% for predicting an unfavorable neurological outcome, indicating…

…Several mechanisms may account for apparent ischaemic electrocardiographic changes during rapid AF. ST segment depression or T wave inversion can occur without coronary artery disease…

…in lead II. Common findings Sinus rhythm (which is the normal rhythm) has the following characteristics: (1) heart rate 50–100 beats per minute; (2…

…High Obesity 35.0–39.9 II Very high Extreme obesity ≥40 III Extremely high BMI is useful for screening and population level risk estimation…

…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…

…cause of abnormal pulmonary regurgitation is pulmonary hypertension. Table 1 presents the causes of pulmonary regurgitation. Mild pulmonary regurgitation is a normal echocardiographic finding that…

…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…

…valve stenosis: EAE/ASE recommendations for clinical practice. In European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society…

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

…et al. (2010): European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 1: aortic and pulmonary regurgitation (native valve disease). In European…

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…

…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)…

…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…

…factor for developing atrial fibrillation is age. Other significant risk factors are as follows: male sex, hypertension, left ventricular hypertrophy, left ventricular dysfunction, valve disease…

…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…

…exercise duration, workload or metabolic equivalents, is among the strongest predictors of mortality in patients with cardiovascular disease after accounting for age. Chronotropic response, blood…

…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…

…of the sinoatrial (SA) node. This enhanced atrial activity is most commonly attributable to abnormal automaticity or re entry mechanisms; triggered activity is a less…

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

…V6. Refer to Figure 1 . Abnormal R wave progression implies that the gradual increase from V1 to V5 is absent. It may be broken, as…

…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…

…points based on five clinical factors: Anemia: Hemoglobin <13 g/dL in men or <12 g/dL in women (3 points) Severe Renal Disease: Estimated…

…Society for Echocardiography (J Am Soc Echocardiogr 18:1440 1463, 2005). Left ventricular mass and geometry Women Men Reference Mildy abnormal Moderately abnormal Severely abnormal…

…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…

…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…

…Coronary fistulae represent abnormal communications between a coronary artery and a cardiac chamber or vessel. Other congenital anomalies include anomalous origin of a coronary artery…

…make the diagnosis more likely. HFpEF and HFmrEF together account for approximately half of patients with symptomatic HF. The distinction is clinically useful but not…

…a defibrillator or a CRT D is indicated to prevent SCD [15]. Disease Progression : There is a notable rate of progression for those with i

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

…disease 1 Age 65–74 years 1 Female sex 1 Bleeding risk must be considered alongside thromboembolic risk. The HAS BLED score includes hypertension, abnormal…

…morbidity or mortality, underscoring the need for a structured and guideline directed approach. This chapter focuses on practical diagnostic and therapeutic considerations, with recommendations aligned…

…changes. Specific electrolyte disorders 1. Sodium Increased (hypernatremia) and decreased (hyponatremia) sodium levels do not have any effect on the ECG, nor cardiac rhythm, or…

…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…

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

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

…is on average slightly lower than arterial pH. Agreement is usually good for pH and reasonable for bicarbonate and base excess, but considerably poorer for…

Akutsjukvård Psykiatri Lathundar Delirium in older adults: quick reference A quick reference for ward and on call physicians: recognise hypoactive delirium, stabilise the patient, work…

…reflects interstitial glucose and lags behind the blood glucose during rapid changes. Pressure on the sensor, for example during sleep, can give falsely low values…

…valve stenosis: EAE/ASE recommendations for clinical practice. In European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society…

…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…

…used as a filtration marker. CKD is one of the strongest independent risk factors for cardiovascular disease (CVD) and cardiovascular mortality. Cardiovascular risk rises progressively…

…The Fourth Universal Definition classifies MI into five distinct subtypes based on pathophysiology and clinical context: Type 1 MI: Caused by atherothrombotic coronary artery disease…

…coronary artery. Non obstructive disease is generally defined as the absence of a stenosis of 50% or more in any potential infarct related artery. MINOCA…

…imbalance, direct myocardial injury, systemic illness, structural heart disease, or several mechanisms acting simultaneously. Acute myocardial infarction Acute myocardial infarction requires: Acute myocardial injury, demonstrated…

…millimeters) between the J point and the PR segment. Refer to Figure 13 for examples. Figure 14 below shows how to measure ST segment deviation…

…that the ischemia is ongoing). Then one might wonder why T wave inversions are included as criteria for myocardial infarction. This is explained by the…