…free ventricular wall. Neoplasms (particularly breast and lung cancer). Inflammatory conditions, such as rheumatoid arthritis, systemic lupus erythematosus, scleroderma, and rheumatic fever. Aortic dissection rupturing…

…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…

…et al. (2003): Recommendations for evaluation of the severity of native valvular regurgitation with two dimensional and Doppler echocardiography. In Journal of the American Society…

…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…

…et al. (2003): Recommendations for evaluation of the severity of native valvular regurgitation with two dimensional and Doppler echocardiography. In Journal of the American Society…

…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…

…on identifying factors that trigger ventricular arrhythmias (VA), such as electrolyte imbalances (e.g., hypokalaemia), bradycardia, ischaemia, coronary spasm, thrombosis, fever, acute starvation, and dieting…

…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…

…diagnosis and management Atrial fibrillation is the most common abnormal tachyarrhythmia (only sinus tachycardia is more common). The prevalence of atrial fibrillation correlates strongly with…

…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…

…haemodynamic responses, arrhythmias and prognosis, with diagnostic interpretation reserved for appropriately selected patients. Pathophysiological basis Exercise progressively increases myocardial oxygen demand through increases in heart…

…with extensive anterior or transmural infarction, apical dysfunction, LV aneurysm formation, and reduced LV systolic function. The principal mechanisms are the combination of an abnormal…

…response. The ECG in ectopic atrial rhythm and atrial tachycardia A regular rhythm with P waves that differ in contour from sinus P waves. If…

…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…

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

…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…

…Pressure gradient and pressure half time (PHT) are also estimated using continuous Doppler. A dense regurgitant jet with rapid deceleration (short PHT) is suggestive of…

…compared to ATRIA. ORBIT: Includes factors like older age, reduced hemoglobin/hematocrit, bleeding history, insufficient kidney function, and treatment with antiplatelet agents. Research indicates that…

…the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography…

…et al. (2003): Recommendations for evaluation of the severity of native valvular regurgitation with two dimensional and Doppler echocardiography. In Journal of the American Society…

…complexes become wide due to abnormal ventricular depolarization (e.g sinus tachycardia with simultaneous left bundle branch block). P wave and PR interval Checklist P…

…in the presence of abnormal clinical risk assessment. Low risk PE is characterized by clinical low risk features, negative cardiac biomarkers, and no imaging evidence…

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

…cardiovascular risk varies considerably according to age and the presence of concomitant risk factors. In contrast, patients with confirmed hypertension generally require BP lowering treatment…

…and location, as well as related biomechanical and fluid dynamic factors. Increased thickness and length, and a more proximal vessel location, are associated with greater…

…closely than HFpEF. Patients are more commonly male and younger than those with HFpEF and have a greater likelihood of coronary artery disease, which is…

…morbidity and mortality, despite often having a greater burden of cardiovascular and non cardiovascular comorbidity than patients with reduced EF. Pathophysiology Abnormal ventricular relaxation and…

…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…

…bridging; myocardial metabolic abnormalities; and abnormal pain perception in patients without demonstrable ischaemia. The absence of obstructive disease therefore does not establish a benign diagnosis…

…formula with heart rates between 60 and 90 beats/min. 3. What is the recommended action if a QTc value is borderline or abnormal and…

…to stroke in patients with AF. Stroke risk is heterogeneous and is determined principally by the patient’s underlying clinical risk factors rather than by…

…pupillary reflex. Importantly, pupillary size and reactivity are influenced by factors beyond neural activity. Systemic catecholamines released or administered during resuscitation can affect pupil to

…expeditious management is warranted. Initial management includes assessing the patient's clinical status (symptoms, hemodynamics), ECG and risk factors (age, previous disease, medications, laboratory results…

…of hyperkalaemia Severe hyperkalemia is usually the result of several interacting factors, such as renal failure, insufficient corticosteroid substitution, acidosis, hemolysis and massive muscle damage…

…V3, which is normal in men and women. ECG example 7. Sinus rhythm. Relatively large T waves in V2 V3, with ST segment elevations. Relative…

…and arrhythmology ECG Mechanisms of cardiac arrhythmias: from automaticity to re entry This section introduces the most common arrhythmias encountered in clinical practice, beginning with…

…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…

…the sinoatrial node. They may also induce conduction defects (e.g. AV block). Increased intracranial pressure (manifests with sinus bradycardia and hypertension). Hypothyroidism . Hypothermia . Hyperkalemia …

…s syndrome and de Winter's syndrome – will be discussed in detail. The normal T wave The normal T wave is concordant with the QRS…

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

…are no absolute contraindications. Refrain or adapt in atrial fibrillation with a rapid and irregular ventricular rate (oscillometric measurement becomes unreliable), lymphoedema or a dialysis…

…High Metabolic alkalosis with respiratory compensation, or a mixed metabolic and respiratory alkalosis if the pCO₂ is too low Normal Abnormal Abnormal A compensated simple…

…syndrome and a clinical diagnosis, often described as acute brain failure. It is precipitated by somatic illness, drugs, poisoning, withdrawal, surgery or several concurrent factors…

…or with continued glucose administration adapted to the cause. 8. Identify drugs, renal failure, alcohol, a missed meal, physical activity and any other precipitating factor…

…et al. (2003): Recommendations for evaluation of the severity of native valvular regurgitation with two dimensional and Doppler echocardiography. In Journal of the American Society…

…Caused by autosomal dominant single nucleotide polymorphisms resulting in amino acid substitutions that destabilize the normal tetrameric TTR protein, favoring dissociation, misfolding, and amyloidogenesis [9…

…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…

…Describes cardiac death in patients with symptoms suggestive of myocardial ischaemia and presumed new ischaemic ECG changes, occurring before cTn values become available or abnormal…

…causes, and extracardiac or systemic causes producing myocardial oxygen supply–demand imbalance. Coronary mechanisms Coronary mechanisms include: Plaque rupture or plaque erosion with thrombosis, despite…

…acute when serial measurements demonstrate a rise and/or fall. A stable elevation indicates chronic myocardial injury . Myocardial injury is not synonymous with myocardial infarction…

…factor clustering, disability and premature mortality. Cardiovascular conditions associated with obesity include hypertension, dyslipidaemia, coronary artery disease (CAD), atherosclerosis, heart failure (HF), atrial fibrillation and…

…molecular, and acquired factors may interact in its development. PAH may be idiopathic, heritable, drug associated, or associated with conditions such as systemic sclerosis, HIV…

…except in type 2 and type 3 MI. A diagnosis of MI should not be made solely from an abnormal cTn concentration in the absence…

…plateau phase. These two factors are the reason why the ST segment is flat and isoelectric (i.e in level with the baseline). Displacement of…

…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…

…though abnormal cardiac troponin (cTn) values in the setting of acute or chronic heart failure are often better categorised as myocardial injury. Clinical Presentation and…

…Willebrand factor, and increased thrombin generation. The clinical consequence of this triad is severe: cardioembolic strokes associated with AF are typically larger, present with more…

…result in abnormal depolarization of the ventricular myocardium. This is presumably due to a mismatch between the expansion of contractile cells as compared with conduction…

…For laypeople, confirming absent or abnormal breathing is sufficient to alert the emergency service and commence CPR. Agonal breathing before apnea A cardiac arrest occurs…

…an upper reference limit . Any value above the upper reference limit is considered elevated (abnormal) and thus indicates myocardial necrosis. The upper reference limit is…