…on left ventricular ejection fraction (LVEF). Heart failure with reduced ejection fraction (HFrEF) is defined by the combination of symptoms, with or without physical signs…

…cGMP. It also inhibits the cellular reuptake of adenosine into endothelial cells. Further, it inhibits adenosine deaminase, which is responsible for breaking down adenosine. These…

…used interchangeably throughout this text. Wall motion abnormalities in ischemic heart disease In the setting of stable ischemic heart disease, an atherosclerotic plaque causes ischemia…

…interpretation in adults. The ECG must always be interpreted using a systematic approach in order to minimize the probability of missing significant abnormalities. The following…

…include depletion of glycogen, relaxation of myofibrils, and disruption of the sarcolemma. These changes may appear within 10–15 minutes of ischaemia. Mitochondrial abnormalities can…

…or other pathologies. The software allows for detailed regional analysis of myocardial perfusion, highlighting specific segments of the left ventricle that demonstrate abnormalities. These tools…

…the absence of persistent ST segment elevation. This does not imply low risk: patients with NSTE ACS may have substantial myocardial ischaemia, dynamic ECG abnormalities…

…25% Normal FS, 2D measurement 18% Advantages of fractional shortening If ventricular geometry is normal and there are no regional wall motion abnormalities, then fractional…

…syndrome is therefore both a clinical risk factor cluster and a marker of broader metabolic dysfunction. Associated abnormalities may include increased apoB and apoC III…

…Nephrology Definition and pathophysiology Chronic kidney disease (CKD) is defined by abnormalities of renal structure or function that persist for more than 3 months and…

…The ischemic cascade The ischemic cascade describes the sequence of events during myocardial ischemia, beginning with perfusion abnormalities and ultimately leading to chest pain (angina…

…in the same order every time, reduces the risk of missing abnormalities. The eight steps below go through the rhythm and then the waveforms one…

…Coronary anomalies are congenital abnormalities involving the origin, course, distribution, or termination of the coronary arteries. They include anomalous aortic origin of a coronary artery…

…The clinical consequences of extracellular volume expansion include elevated cardiac filling pressures, pulmonary congestion, systemic venous hypertension, and peripheral interstitial edema. These abnormalities produce breathlessness…

…diagnosed without proteinuria when clinical symptoms or laboratory abnormalities indicate end organ injury. Eclampsia is the occurrence of new onset seizures or coma in a…

…period clinical presentations arising from structural or functional abnormalities of the coronary arteries or coronary microcirculation. These abnormalities can produce a transient and reversible mismatch…

…the clinical manifestations of chronic structural and/or functional disease involving the epicardial coronary arteries and/or the coronary microcirculation. These abnormalities may produce a…

…significant reorganization of the activation and recovery patterns within the left ventricle, resulting in a widened QRS complex and secondary ST T wave abnormalities [7…

…indirectly as reciprocal abnormalities in the anterior precordial leads. Acute myocardial ischaemia alters the resting membrane potential and action potential duration of affected myocardial cells…

…The increasing prevalence of refractory angina reflects population ageing and improved survival among patients with CAD following advances in anti ischaemic treatment and coronary revascularization…

…abnormalities, diabetes and glycaemic status, body weight, smoking, diet, physical inactivity, and alcohol consumption. Additional considerations include psychosocial stress, obstructive sleep apnoea, social determinants of…

…functional cardiac abnormalities and/or elevated natriuretic peptides (NPs) [1] [2] . The evolution of HF terminology has been driven by a deeper understanding of myocardial…

…decision making. Structural Heart Disease (SHD): Accounting for approximately 90% of all VT presentations, SHD provides the macroscopic architectural abnormalities necessary for arrhythmogenesis. Ischemic heart…

…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…

…methodological ECG interpretation. We recommend this approach as it minimizes the risk of missing important abnormalities and also speeds up the ECG interpretation. Press the…

…great paper written by a dozen of merited scholars. In this paper the authors discuss normal variants and abnormalities which athletes may exhibit on the…

…in the setting of both modifiable and nonmodifiable risk factors. Modifiable risk factors include electrolyte abnormalities such as hypokalemia, the co administration of multiple QT…

…on the magnitude of the stressor, the presence of non cardiac comorbidities, and the extent of underlying coronary artery disease (CAD) and structural cardiac abnormalities…

…abnormal vasoconstriction of one or more coronary arteries. Epicardial spasm produces a reversible functional occlusion and usually causes transmural ischaemia. The resulting abnormalities in left…

…An ECG should be performed if there is suspicion of syncope due to an arrhythmia or underlying cardiac disease. Relevant abnormalities include bradyarrhythmias or tachyarrhythmias…

…including abnormalities of LV relaxation and filling. Hypertension and diabetes can contribute to the development of heart failure in the preserved and mildly reduced EF…

…been described in HFpEF, while nitrosative stress and abnormalities of cellular and molecular myocardial function may further impair contraction and relaxation. Structural and vascular consequences…

…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…

…drug induced arrhythmias in patients receiving agents known to alter the electrical properties of the heart (inducing QRS or QT prolongation) or causing electrolyte abnormalities…

…cardiometabolic abnormalities make LDL C an incomplete representation of atherogenic burden. Clinical Presentation and Symptoms ApoB elevation and increased non HDL C are laboratory abnormalities…

…newly detected for the first time, or newly developed during management of an acute illness. The clinical relationship between AF and acute deterioration is often…

…functional capacity, and health related quality of life substantially influence both cardiovascular risk and the balance between treatment benefit and harm. Prevention in the very…

…scope Familial and genetic screening in cardiovascular medicine is the systematic assessment of relatives and other individuals who may carry an inherited predisposition to cardiovascular…

…Coarctation of the aorta and renovascular disease are important non endocrine causes, particularly in patients with resistant hypertension. Dietary sodium and potassium abnormalities and commonly…

…by separation within the coronary arterial wall, usually through formation of an intramural haematoma that compresses the true lumen. The resulting reduction in coronary blood…

…The pre test likelihood of obstructive CAD is moderate or high, generally greater than 15% and less than 85% Baseline ECG abnormalities make exercise ECG…

…markers for structural and hemodynamic cardiac abnormalities. Right Axis Deviation (RAD) RAD holds significant diagnostic weight in the evaluation of pulmonary vascular and right heart…

…the broader spectrum of acute coronary syndromes, which may present with recent changes in symptoms or signs, with or without ECG abnormalities and with or…

…facilitated by using an algorithm, as it minimizes the risk of missing important abnormalities and also speeds up the interpretation. Note that this chapter is…

…in V1. V7–V9 should display a positive T wave. T wave abnormalities are common and occur in a wide range of conditions. Unfortunately, many…

…Coronary vasomotor disorders may involve epicardial spasm or abnormalities of the coronary microcirculation. Microvascular angina reflects myocardial ischaemia caused by structural or functional microvascular abnormalities…

…in the context of the clinical presentation and other findings. A reduced CFR may occur with angiographically insignificant epicardial disease because of abnormalities in the…

…Abnormalities in the QT interval can cause serious arrhythmias and sudden cardiac death. QT prolongation can precipitate torsades de pointes, a specific form of polymorphic…

…development of increased left ventricular hypertrophy and mass. Initially, myocardial abnormalities may be subclinical. Progressive dilation can subsequently impair left ventricular ejection fraction. Enlargement of…

…beds. Malignant hypertension represents an extreme form in which acute microvascular injury occurs, classically involving fibrinoid necrosis of small arteries in the kidneys, retina, and…

…The occurrence of neoatherosclerosis helps explain why ISR and other stent related events may arise well after the initial intervention. Mechanical mechanisms Mechanical abnormalities may…

…occurred The extent and degree of myocardial involvement The anatomical territory, including anterior, inferoposterolateral or right ventricular involvement Pre existing abnormalities such as prior infarction…

…structural cardiac abnormalities, HF and sudden cardiac death. The relationship between glycaemia and cardiovascular disease is complex. Glycaemic control is important for prevention of microvascular…

…genetic cardiomyopathy that predominantly affects the right ventricle. ARVC is defined by the gradual loss of myocardial cells, which are replaced by fat and fibrous…

…is considered a poor measure of systolic function; it is only reliable if the left ventricle has normal geometry and no significant wall motion abnormalities…

…secondary ST T abnormalities). Click to zoom. Atrioventricular reentrant (reentry) tachycardia (AVRT) Individuals with accessory pathways are at risk of developing atrioventricular reentrant tachycardia (AVRT…

…However, the significance of the ST segment depression differs markedly in NSTE ACS and STE ACS. In NSTE ACS the ST segment depressions are the…

…system to master. The 12 lead ECG offers outstanding possibilities to diagnose abnormalities. Importantly, the vast majority of recommended ECG criteria (e.g. criteria for…

…Atrial fibrillation and ventricular arrhythmias were observed in the fifth decade of life in several family members. Imaging studies did not reveal structural cardiac abnormalities…

…be considered anginal equivalents. The emergency evaluation of non traumatic chest discomfort is structured around three principal diagnostic categories: Myocardial ischaemia , particularly acute coronary syndrome…