…PLR) The pupillary light reflex (PLR) – the constriction of the pupils in response to light – is a fundamental neurological examination finding that reflects brainstem (midbrain)…

…segment depression, reflecting an abnormal repolarization response to exercise induced myocardial oxygen supply–demand imbalance. The exercise response is not confined to the ECG. Ischaemia…

…in clinical practice, and these arrhythmias are commonly referred to simply as atrial tachycardia or atrial rhythm, depending on the ventricular response. The ECG in…

…include cardiac memory after abnormal ventricular activation, transient rate related conduction abnormalities, pacing related repolarization changes, and inadequate coronary flow relative to myocardial oxygen demand…

…min from rest to exercise. This response is age dependent and may rarely occur in healthy people older than 60 years. The abnormal slope does…

…vascular smooth muscle to vasoconstrictor stimuli, including adrenergic agonists, leukotrienes, and serotonin. In patients with CAD, endothelial disruption may convert normal vasodilator responses to vasoconstriction…

…to both microvascular and epicardial vasomotor disorders. Endothelial activation can promote the release of adhesion molecules, inflammatory cytokines, and vasoconstricting mediators, producing abnormal vascular responses…

…of cases Hypoactive Lethargy, slow responses, reduced speech, immobility, poor food intake, reduced eye contact Common and particularly easy to miss. May be misinterpreted as…

…is to determine if a cardiac arrest has occurred. A cardiac arrest is confirmed by the following four examinations: Responsiveness : Does the victim respond to…

…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…

…RVD 2), cm 2.7–3.3 3.4–3.7 3.8–4.1 4.2 Base to apex length (RVD 3), cm 7…

…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…

…small,, < 10 mm length, narrow origin variable large, wide origin Ratio pulmonic to aortic flow normal variable significantly increased References 1. Zoghbi, William A.…

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…

…LQTS) is characterised by an abnormal prolongation of the QT interval on the surface electrocardiogram (ECG), which predisposes the myocardium to a specific form of…

…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…

Echocardiography Myocardial ischemia and infarction Definition and pathophysiology Left ventricular (LV) thrombus is an intracavitary clot attached to the LV endocardium, typically overlying an akinetic…

…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)…

…V1 to V5 and then diminishes again in V6. Refer to Figure 1 . Abnormal R wave progression implies that the gradual increase from V1 to…

…lead to abnormal repolarization. This explains the secondary ST T changes seen on premature ventricular complexes; the ST T vector will be directed oppositely to…

…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…

…and ORBIT scores. Each incorporates various clinical parameters to stratify bleeding risk. HAS BLED: Incorporates factors such as hypertension, abnormal renal/liver function, stroke 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…

…blood flow increases RV pressure load and may impair RV filling and forward output. The resulting syndrome may progress to systemic congestion, reduced cardiac output…

…and SCORE2 Older Persons (SCORE2 OP) are European risk prediction models designed to estimate 10 year risk of both fatal and non fatal CVD events…

…the diagnostic method. Myocardial bridging has been identified in approximately 0.5–12% of angiographic series and up to 5–75% of CT series; other…

…Heart failure extends across the full range of LVEF, and echocardiographic measurement is subject to meaningful variability. HFmrEF may therefore represent several clinically distinct trajectories…

…failure (HF) is a clinical syndrome in which the heart cannot deliver blood at a rate appropriate to tissue requirements unless filling pressures are elevated…

…Implications and Prognosis Mechanical and Diagnostic Impact LBBB causes extensive reorganization of left ventricular activation [2]. This leads to abnormal LV mechanical function [7]. Furthermore…

…QTc value is borderline or abnormal and the heart rate is less than 50 beats/min? A: Proceed directly to an exercise ECG test without…

…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…

…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…

…lithium, thiazide diuretics, D vitamin and calcium overdose. ECG changes due to hypercalcemia Common ECG changes Shortened QT interval. Lengthened QRS duration. Bradycardia may occur…

…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…

…pacemaker under normal circumstances and the rhythm is referred to as sinus rhythm . An arrhythmia is defined as an abnormal heart rhythm or heart rate…

…abnormal, leading to secondary ST T changes, which appear on the ECG as discordant ST T segments. These ST T segments are directed opposite to…

…baroreceptor] stimulation). It is common to discover SB in healthy young individuals who are not well trained. This is also a normal finding. Abnormal (pathological…

…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…

…An abnormal 24 hour rhythm should prompt investigation for sleep apnoea, renal disease and secondary hypertension, and lead to one dose being moved to the…

…is too low Normal Abnormal Abnormal A compensated simple disorder, or two opposing primary disorders It is therefore not enough to ask which of the…

…Sampling and measurement error A capillary glucose is sufficient to start emergency treatment, but abnormal or unexpected values should be confirmed with a laboratory analysed…

…Pubmed Link Tricuspid valve stenosis Mean pressure gradient ≥ 5 mmHg Valve area according to the continuity equation (cm²) ≤ 1 cm² ZTime velocity integral of the…

…This is a plasma cell dyscrasia in which abnormal plasma cells produce misfolded immunoglobulin light chains [8, 19]. Light chains are directly toxic to cardiomyocytes…

…1.73 m², excess urinary albumin excretion—typically a spot urinary albumin to creatinine ratio (UACR) above 30 mg/g—or both. The eGFR is…

…or abnormal. Type 4a MI: Represents a periprocedural myocardial infarction associated with percutaneous coronary intervention (PCI). Type 4b MI: Denotes myocardial infarction related to stent…

…than MINOCA when identified as the final diagnosis. Reported prevalence varies according to the population and diagnostic criteria. MINOCA accounts for approximately 1–14% of…

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

…ectopic fat are particularly relevant to cardiovascular risk. Excess adipose tissue promotes: Chronic, low grade systemic inflammation Insulin resistance Abnormal adipokine signalling Endothelial dysfunction Dyslipidaemia…

…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…

…wise to subdivide ST T changes into primary and secondary. Primary and secondary ST T changes Primary ST T changes are caused by abnormal repolarization…

ECG Introduction to ECG interpretation The normal T wave Assessment of the T wave represents a difficult but fundamental part of ECG interpretation. The normal…

…myocardial injury occurring in the context of a mismatch between myocardial oxygen supply and demand, which is not related to acute coronary atherothrombosis. By definition…

…driver of global cardiovascular morbidity and mortality, primarily due to its association with ischemic stroke and systemic embolism. The contemporary understanding of AF has evolved…

…T segment Significant hypertrophy may result in abnormal depolarization of the ventricular myocardium. This is presumably due to a mismatch between the expansion of contractile…

…it is always possible to define an upper reference limit . Any value above the upper reference limit is considered elevated (abnormal) and thus indicates myocardial…