…ECG waves and how to determine whether the ECG is normal or abnormal. Although heart rhythm will be discussed in detail in the next chapters…

…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…

…is not mandatory for HFmrEF when the diagnosis of heart failure is clinically secure and the LVEF measurement is reliable. Nevertheless, these findings increase diagnostic…

…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 )…

…Digoxin effects on cardiac function and ECG Digoxin has a positive inotropic effect and a negative chronotropic effect, enhancing ventricular contractility while lowering heart rate…

…or heart rate, which is not physiologically justified . The latter criterion is important because rhythms that are physiologically justified should not be considered abnormal. For…

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

…Pulmonary embolism Recent coronary revascularization Infiltrative disease, such as amyloidosis or sarcoidosis Other cardiac procedures Chemotherapeutic agents Catheter ablation Critical illness Defibrillator shocks Strenuous exercise…

…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…

…The threshold is not absolute: patient phenotype, risk factors for heart failure with preserved ejection fraction, echocardiographic findings, and left atrial size must also be…

…a normal echocardiographic finding that requires no further investigation. Table 1. Causes of pulmonary regurgitation Pulmonary hypertension Endocarditis Myxoma Carcinoid heart disease Tetralogy of Fallot…

…causes & management Definition of sinus bradycardia Sinus bradycardia fulfills the criteria for sinus rhythm but the heart rate is slower than 50 beats per minute…

…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…

…hypertrophy, left ventricular dysfunction, valve disease, coronary artery disease, cardiomyopathy, congestive heart failure, congenital heart disease, diabetes mellitus (both type 1 and type 2), obesity…

…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…

…and cannot be diagnosed reliably by examination alone. Assessment should include evaluation for: Hemodynamic instability or cardiogenic shock. Clinical heart failure. Recurrent ischemia or reinfarction…

…or electrical heart disease. Less frequently, it may also present in individuals without identifiable cardiac disease. Contributing factors include pulmonary disorders, particularly obstructive pulmonary disease…

…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…

…transient ischaemic attack, and peripheral arterial disease. Heart failure is also considered established clinical CVD in the risk based approach to elevated BP. Risk categories…

…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…

…occur in primary valvular disease. Increasing severity of mitral regurgitation is associated with worse outcomes. Pulmonary hypertension secondary to left heart disease may occur because…

…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…

…factor Points Congestive heart failure 1 Hypertension 1 Age ≥75 years 2 Diabetes mellitus 1 Prior stroke or TIA 2 Vascular disease 1 Age 65…

…used interchangeably throughout this chapter. For sake of clarity, however, tachyarrhythmia is defined as an abnormal and rapid heart rate, whereas tachycardia is defined as…

…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…

…criteria for epidemiological purposes. With the advent of highly sensitive cardiac biomarkers, the European Society of Cardiology (ESC), American College of Cardiology (ACC), American Heart…

…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…