…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…

Right ventricle and pulmonary artery Normal interval Mildly abnormal Moderately abnormal Severely abnormal RV DIMENSIONS Basal RV diameter (RVD 1), cm 2.0–2.8…

…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…

Arrhythmias and arrhythmology ECG Atrial fibrillation: definitions, causes, risk factors, ECG diagnosis and management Atrial fibrillation is the most common abnormal tachyarrhythmia (only sinus tachycardia…

…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…

…an abnormal haemodynamic response occurs, or when a predefined target heart rate is reached. Its principal outputs are: Functional capacity and exercise tolerance Reproduction and…

…of embolic events in patients with LV thrombus than in matched patients without thrombus. Factors associated with embolization Echocardiographic features suggesting increased embolic potential include:…

…also present in individuals without identifiable cardiac disease. Contributing factors include pulmonary disorders, particularly obstructive pulmonary disease, the use of theophylline, and elevated catecholamine states…

…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…

…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…

…risk. HAS BLED: Incorporates factors such as hypertension, abnormal renal/liver function, stroke history, bleeding history, labile INR, age 65, and concomitant drug/alcohol use…

…Left ventricular mass and geometry Women Men Reference Mildy abnormal Moderately abnormal Severely abnormal Reference Mildly abnormal Moderately abnormal Severely abnormal LINEAR METHOD LV mass…

…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…

…according to age and the presence of concomitant risk factors. In contrast, patients with confirmed hypertension generally require BP lowering treatment without additional risk stratification…

…The wide range reflects differences in ascertainment and imaging technique. Coronary fistulae represent abnormal communications between a coronary artery and a cardiac chamber or vessel…

…ejection fraction (HFrEF), defined by an LVEF ≤40%, and heart failure with preserved ejection fraction (HFpEF), defined by an LVEF ≥50%. The ejection fraction classification…

…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…

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

…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…

…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…

…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…

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

…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…

Arrhythmias and arrhythmology ECG Sinus bradycardia: ECG, causes & management Definition of sinus bradycardia Sinus bradycardia fulfills the criteria for sinus rhythm but the heart rate…

…1 ). If the T wave and the QRS complex head in opposite directions, the T wave is said to be discordant which is abnormal. Because…

…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…

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

…Normal Abnormal Abnormal A compensated simple disorder, or two opposing primary disorders It is therefore not enough to ask which of the pCO₂ and the…

…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…

…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…

…regurgitation Jet size < 5cm² 5 10 cm² 10 cm² size vena cava inferior < 2,1 cm and compressible in between 2,1 cm…

…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…

…of the strongest independent risk factors for cardiovascular disease (CVD) and cardiovascular mortality. Cardiovascular risk rises progressively as kidney function declines and as albuminuria increases…

…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…

…or abnormal arteriolar vasoconstriction. More than one mechanism may coexist. Supply–demand mismatch MINOCA may result from a mismatch between myocardial oxygen supply and demand…

…injury and type 2 infarction is particularly important. Type 2 infarction requires clinical evidence of ischaemia; an elevated and dynamically changing troponin concentration without evidence…

…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…

…absolute: patient phenotype, risk factors for heart failure with preserved ejection fraction, echocardiographic findings, and left atrial size must also be considered. Patients with mPAP…

…is a rise and/or fall in cTn values. An elevated cTn alone does not establish MI, because myocardial injury may occur without myocardial ischaemia…

…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 periods of ischemia, after infarction and after successful reperfusion (PCI). Post ischemic T wave inversion is caused by abnormal repolarization. These T wave inversions…

…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…

…characterized by elevated biomarkers such as D dimer, von Willebrand factor, and increased thrombin generation. The clinical consequence of this triad is severe: cardioembolic strokes…

…ventricular hypertrophy, and to the left in left ventricular hypertrophy). ST T segment Significant hypertrophy may result in abnormal depolarization of the ventricular myocardium. This…

…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…