…to start emergency treatment, but abnormal or unexpected values should be confirmed with a laboratory analysed plasma glucose when the situation allows. Glucose meters are…

…hyperventilation), rhabdomyolysis, septicemia (sepsis), osteolytic cancer metastases, abnormal calcium absorption (gastrointestinal) and resorption (from primary urine), renal failure, small bowel syndrome, parathyroid gland surgery, use…

…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…

…stress Vascular dysfunction Promotion of vascular calcification Albuminuria and proteinuria Neurohormonal activation Plasma volume expansion Myocardial remodelling and fibrosis These processes form part of the…

…ventricles. This increases the automaticity in cells with natural automaticity but it may also provoke abnormal automaticity in cells that normally do not exhibit automaticity…

…peak plasma concentrations of that drug. The QT interval should be adjusted for heart rate. Long QT interval causes long QT syndrome An abnormally prolonged…

…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…

…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…

…risk factors, ECG diagnosis and management Atrial fibrillation is the most common abnormal tachyarrhythmia (only sinus tachycardia is more common). The prevalence of atrial fibrillation…

…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…

…when limiting symptoms, significant electrocardiographic changes, arrhythmias or an abnormal haemodynamic response occurs, or when a predefined target heart rate is reached. Its principal outputs…

…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…

…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…

…Because the conduction system is crucial for rapid and synchronized activation of the ventricles, conduction defects will typically cause abnormal ventricular activation (i.e. contraction)…

…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…

…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…

…actually originate from the atria but the QRS complexes become wide due to abnormal ventricular depolarization (e.g sinus tachycardia with simultaneous left bundle branch…

…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…

…leads [7]. These stricter parameters correlate more closely with abnormal LV mechanical function and the potential benefit of resynchronization pacemaker therapy [7]. R Wave Peak…

…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…

…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…

…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…

…clarity, however, tachyarrhythmia is defined as an abnormal and rapid heart rate, whereas tachycardia is defined as the subjective perception of a rapid heart rate…

…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…

…the rhythm is referred to as sinus rhythm . An arrhythmia is defined as an abnormal heart rhythm or heart rate, which is not physiologically justified …

…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…

…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…

…the QRS complex head in opposite directions, the T wave is said to be discordant which is abnormal. Because most ECG leads have net positive…

…rhythms. Increased automaticity (in His Purkinje fibers), abnormal automaticity (in contractile myocardium), re entry (anywhere) or triggered activity (anywhere) may all cause ventricular arrhythmias. Indeed…

…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…

…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…

…of myocardial ischaemia and presumed new ischaemic ECG changes, occurring before cTn values become available or abnormal. Type 4a MI: Represents a periprocedural myocardial infarction…

…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…

…acute coronary atherothrombosis. Type 3 myocardial infarction: presumed fatal myocardial infarction in which death occurs before biomarkers can be obtained or become abnormal, in the…

…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…

…3 MI. A diagnosis of MI should not be made solely from an abnormal cTn concentration in the absence of evidence of ischaemia. Classification of…

…changes into primary and secondary. Primary and secondary ST T changes Primary ST T changes are caused by abnormal repolarization . This is seen in ischemia…

…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…

…validated tools, with the HAS BLED score being the most widely recommended. It evaluates Hypertension, Abnormal renal/liver function, Stroke history, Bleeding history, Labile INRs…

…left in left ventricular hypertrophy). ST T segment Significant hypertrophy may result in abnormal depolarization of the ventricular myocardium. This is presumably due to a…