…plasma potassium level and ECG changes, as well as the risk of arrhythmia. Therefore the ECG may be used to estimate the severity of hyperkalemia…

…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…

…pressure gradient ≥ 5 mmHg Valve area according to the continuity equation (cm²) ≤ 1 cm² ZTime velocity integral of the tricuspid inflow (cm) 60 cm Pressure…

…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…

…early termination of diastolic flow Jet width colour Doppler small,, < 10 mm length, narrow origin variable large, wide origin Ratio pulmonic to aortic flow…

…referred to as Q wave. If the first wave is not negative, then the QRS complex does not possess a Q wave, regardless of the…

…receiving agents known to alter the electrical properties of the heart (inducing QRS or QT prolongation) or causing electrolyte abnormalities, such as thiazide and loop…

…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…

…highly effective in reducing stroke risk. Wrfarin and novel oral anticoagulants can reduce the risk of stroke by 70%, as compared with placebo. Besides anticoagulation…

…The tests that reflect the synthetic function of the liver are the prothrombin time (INR) , the albumin and the bilirubin — and they become abnormal late…

…of flow limiting disease, myocardial ischaemia may develop. The electrical manifestation may be horizontal or downsloping ST segment depression, reflecting an abnormal repolarization response to…

…mural thrombi to develop over infarcted myocardium in either ventricle. With contemporary imaging, LV thrombus has been reported in as many as 15% of patients…

…at a rate exceeding that of the sinoatrial (SA) node. This enhanced atrial activity is most commonly attributable to abnormal automaticity or re entry mechanisms…

…which acts as a lubricant that prevents friction during ventricular contraction and relaxation. Pericardial effusion is the presence of an abnormal amount of fluid in…

…in the left bundle branch is simply referred to as left bundle branch block. The consequence of left bundle branch block is that the left…

…the gradual increase from V1 to V5 is absent. It may be broken, as in Figure 1 . Any type of infarction may cause pathological R…

…Classification of premature ventricular contractions When every other beat on the ECG is a premature ventricular complex (PVC), the rhythm is referred to as PVC…

…ventricle during diastole. The most common cause of abnormal pulmonary regurgitation is pulmonary hypertension. Table 1 presents the causes of pulmonary regurgitation. Mild pulmonary regurgitation…

…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…

…assessment of regional wall motion (left ventricle) TYPE OF MOTION DEFINITION WALL MOTION SCORE Normal Normal thickening (typically 30% thickening from end diastole to end…

…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…

…Note that 10% of wide complex tachycardias actually originate from the atria but the QRS complexes become wide due to abnormal ventricular depolarization (e.g…

…obstruction of pulmonary blood flow increases RV pressure load and may impair RV filling and forward output. The resulting syndrome may progress to systemic congestion…

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

…year risk as follows: Risk category 10 year risk of fatal or non fatal CVD Low <2% Moderate ≥2% to <10% High ≥10% to <20…

…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…

…diabetes can contribute to the development of heart failure in the preserved and mildly reduced EF ranges, and obesity is increasingly recognised as a potential…

…Increasing severity of mitral regurgitation is associated with worse outcomes. Pulmonary hypertension secondary to left heart disease may occur because elevated left sided filling pressures…

…infarction [4]. Myocardial Necrosis : The occurrence of LBBB (as a form of bifascicular block) is linked to extensive myocardial necrosis [4]. Clinical Implications and Prognosis…

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

ECG Introduction to ECG interpretation 1. Which of the following ECG findings is typically considered a normal variant in asymptomatic athletes with no significant family…

…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…

…recovery exhibited an abnormal pupillary reflex upon initial examination. Notably, 31.2% of patients discharged with intact neurological function were observed to lack a pupillary…

…is often used to refer to tachycardias originating in the atria. The significance of QRS duration in judging arrhythmias can be summarised as follows: NCT…

…the time interval from the onset to the end of the QRS complex. A short QRS complex is desirable as it proves that the ventricles…

…of the impulse is the same. The sinoatrial (SA) node is the heart’s pacemaker under normal circumstances and the rhythm is referred to as…

…slowly as they travel partially or entirely outside the specialized conduction system. This slow propagation leads to a delayed and abnormal activation sequence of the…

…a normal finding. Abnormal (pathological) causes of sinus bradycardia In all other situations, sinus bradycardia should be regarded as a pathological finding. Numerous pathological conditions…

…direction as the net direction of the QRS complex. A net positive QRS complex should be followed by a net positive T wave (refer to…

…ventricular rhythm; idioventricular rhythm is primarily seen after reperfusion in an occluded coronary artery. It also occurs as side effect of drugs, hypoxia, myocarditis and…

…lowered at each measurement, and not to talk. Otherwise ordinary activities, including work. No showering or bathing. A diary of going to bed, getting up…

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

…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…

…pallor paraesthesiae Neuroglycopenic symptoms An inadequate supply of glucose to the brain can cause: difficulty concentrating irritability or abnormal behaviour slurred speech visual disturbance confusion…

…early termination of diastolic flow Jet width colour Doppler small,, < 10 mm length, narrow origin variable large, wide origin Ratio pulmonic to aortic flow…

…which abnormal plasma cells produce misfolded immunoglobulin light chains [8, 19]. Light chains are directly toxic to cardiomyocytes, inducing the elaboration of high levels of…

…may be as much as three times higher than in individuals without comparable renal impairment. The cardiovascular burden of CKD extends beyond CAD to peripheral…

…proportion of deceased patients. Historically referred to as coronary thrombosis, the term myocardial infarction ultimately prevailed. The need for a standardized global definition led to…

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

…motion abnormality in an ischaemic distribution Identification of a coronary thrombus by angiography or autopsy, where applicable to the relevant infarction category Myocardial infarction results…

…practice, obesity is conventionally defined by a body mass index (BMI) of ≥30 kg/m2. Severe obesity is generally defined as BMI ≥35 kg/m2…

…cause of increased flow are appropriate. Exercise PH is defined by an mPAP/cardiac output slope greater than 3 mmHg/L/min from rest to…

…of myocardial infarction The Fourth Universal Definition separates MI into five principal types. Type Mechanism or setting Type 1 Acute atherothrombotic MI, usually related to…

…The magnitude of ST segment deviation is measured as the height difference (in millimeters) between the J point and the PR segment. Refer to Figure…

…ischemic episode, and these T wave inversions are referred to as post ischemic T waves . Such T waves are seen after periods of ischemia, after…

…defined as an ischaemic myocardial injury occurring in the context of a mismatch between myocardial oxygen supply and demand, which is not related to acute…

…due to its association with ischemic stroke and systemic embolism. The contemporary understanding of AF has evolved significantly; it is no longer viewed merely as…

…or abnormally large ventricles. These conditions are referred to as atrial enlargement and ventricular enlargement . From a hemodynamic standpoint, there are two types of enlargement…

…including laypeople. As shown in Table 1, BLS is an exceptionally effective treatment, with a very low number needed to treat (NNT), indicating high effectiveness…

…unexplained weakness, or a combination of these symptoms. The diagnosis requires elevated levels of cardiac troponins. In addition to elevated troponins, the patient must display…