…circumferential shortening (Figure 1C). Left ventricular function depends on a complex interaction between the muscle fibers in these layers, which collectively produces a highly efficient…

…Troponin I is highly specific for myocardial injury. Interpretation of troponin T is more complex because injured skeletal muscle may express proteins detected by some…

…of congenital heart disease reach adulthood ( Mandalenakis et al ). The largest leap in survival has been observed among cases with the most complex malformations. Indeed…

…ventricular dilation. The left ventricle and the septum are generally spared. Regional wall motion abnormalities–i.e hypokinesia, dyskinesia and kinesia–may also be s

…L carnitine (limited evidence) Warfarin Vitamin K Fresh frozen plasma Prothrombin complex concentrate Actions in suspected poisoning and cardiac arrest Promptly contact the closest intensive…

Arrhythmias and arrhythmology ECG Genetic and miscellaneous conditions The early repolarization pattern and syndrome: from ECG criteria to management Although the early repolarization pattern has…

…will also be abnormal, resulting in discordant ST T segments (i.e the QRS complex and T wave display opposite directions). Below follows ECG tracings…

…Study Figure 7 carefully, as it illustrates how the P wave and QRS complex are generated by the electrical vectors. Note that the first vector…

ECG Video lecture: The QRS complex: Q wave, R wave & S wave

…to each respective ventricle) the QRS complex is normal (i.e QRS duration <0.12 s). However, the QRS complex can be wide (QRS duration…

Arrhythmias and arrhythmology ECG Premature ventricular contractions (premature ventricular complex, premature ventricular beats): ECG and clinical implications Premature ventricular complexes are also referred to as…

…system and thus the impulse originates in the atria (i.e the arrhythmia is supraventricular). WCT – Wide complex tachycardias (QRS duration ≥0,12 seconds) indicates…

…to give the reader firm knowledge of normal findings , normal variants (i.e less common variants of what is considered normal) and pathological variants . Thus…

ECG Troponin is a protein complex expressed in cardiac and skeletal muscle. The complex consists of troponin I (TnI) , troponin C (TnC) and troponin T…

Cardiology Introduction Ventricular tachycardia (VT) represents a complex and potentially lethal spectrum of cardiac arrhythmias that remains a formidable challenge in contemporary cardiovascular medicine. As…

[calc_syntax] SYNTAX Score: A Tool for Revascularization Strategy in Complex Coronary Artery Disease The SYNTAX Score is a semi quantitative scoring system designed to…

Cardiology Definition and terminology Heart failure (HF) is a complex clinical syndrome characterized by symptoms and signs resulting from structural or functional impairment of ventricular…

…progressive, and highly complex lipid driven inflammatory disease of the arterial intima that serves as the fundamental pathophysiological substrate for acute coronary syndromes (ACS), including…

Arrhythmias and arrhythmology Pharmacology & dosing Pharmacokinetic Considerations Relevant to Dosing Amiodarone exhibits highly variable and complex pharmacokinetics that profoundly influence its dosing strategies. The drug…

…sleep disordered breathing Hypoventilation Peripheral oedema or venous disease Reduced mobility Osteoarthritis and low back pain Symptoms of type 2 diabetes or metabolic syndrome Depression…

…and terminology Heart failure with preserved ejection fraction (HFpEF) is a complex clinical syndrome characterized by the cardinal symptoms and signs of heart failure (HF…

…R or Rs complex suggests VT. If the QRS complex in V1–V2 resembles a left bundle branch block (i.e negative QRS) V1 : The…

Cardiology Clinical medicine Introduction Cardiovascular disease becomes increasingly prevalent with advancing age, while its clinical expression and management become progressively more complex. Older adults, often…

…R wave, S wave, QRS complex, ST segment, T wave and QT interval This video is accompanied by the detailed article The normal electrocardiogram (ECG…

…ECG can never achieve, and makes it visible even when it lies buried in the QRS complex or the T wave. The whole value of…

…mean nothing. Capture is verified only when every pacing spike is followed by a wide QRS complex and a pulse that can be felt. The…

…PR interval <0,12 s : Pre excitation (WPW syndrome). Second degree AV block Mobitz type I (Wenckebach block) : repeated cycles of gradually increasing PR interval…

…discordant with the QRS complex [7]. Specifically, T waves are inverted and ST segments are depressed in leads with positive QRS waves (such as I…

…for depolarization and repolarization. It is measured from the beginning of the QRS complex to the end of the T wave. Prolonged QT duration predisposes…

…during ventricular tachycardia can precipitate ventricular fibrillation, whereas a synchronized shock (timed to the QRS complex) avoids this risk. Synchronized cardioversion is used for organized…

…it may be due to pre excited atrial fibrillation (i.e. atrial fibrillation with impulses conducted via an accessory pathway [see Wolff Parkinson White Syndrome])…

…evolved significantly; it is no longer viewed merely as an electrical anomaly but as a progressive, complex atrial myopathy. For the practicing cardiologist, mastering the…

…valvular function, and ventricular function. A large body of science has demonstrated that these parameters are highly interdependent and rather complex. Indeed, myocardial mechanics constitute…

…long QT syndrome (LQTS) & ventricular arrhythmias (torsade de pointes) due to prolonged QT interval The QT interval is the time interval from the beginning of…

…ventricular rate slower than 50 beats per minute. P waves with constant morphology preceding every QRS complex. P wave is positive in limb lead II…

…below. PR interval and PR segment The PR interval stretches from the onset of the P wave to the onset of the QRS complex. It…

…PR interval < 0.12 s: pre excitation (WPW syndrome). Second degree AV block, Mobitz I (Wenckebach): repeated episodes with progressive lengthening of the PR…

…Heart rate Heart rhythm The P wave The PR interval The QRS complex The ST segment The T wave The U wave The QT interval…

…trial. Limitations Requires detailed clinical and angiographic data. Calculation can be complex without dedicated software. May not account for all patient specific factors (e.g.…

Myocardial ischemia and infarction Definition and pathophysiology In acute coronary syndrome (ACS) with multivessel coronary artery disease (MVD), revascularization may be directed exclusively at the…

…stenoses. Higher scores indicate more diffuse or technically complex disease and are associated with a greater relative advantage for CABG over PCI in multivessel disease…

…first year after stenting, although the risk is higher after treatment of ST segment elevation myocardial infarction (STEMI) and following complex PCI. Stent thrombosis remains…

…in lead I). Situs inversus. Left posterior fascicular block is diagnosed when the axis is between 90° and 180° with rS complex in I and…

…in lead I). Situs inversus. Left posterior fascicular block is diagnosed when the axis is between 90° and 180° with rS complex in I and…

…lead V1 is common and normal. It is generally concordant with the QRS complex (which is negative in lead V1). Isolated T wave inversions also…

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

…of the ventricles. Note that the ECG rarely shows atrial recovery (repolarization) since it coincides with ventricular depolarization (i.e. QRS complex), which has much…

…function may become worse in patients with established SA node disease (sinus node dysfunction, sick sinus syndrome) P wave No effect. AV system (AV node…

…This chapter discusses first degree atrioventricular (AV) block, also referred to as 1st degree AV block, AV block I, or AV block 1. Before proceeding…

…PR interval <0,12 s : Pre excitation (WPW syndrome). Second degree AV block Mobitz type I (Wenckebach block) : repeated cycles of gradually increasing PR interval…

…However, a growing body of science suggests that essential hypertension is a multifactorial disease caused by a complex interplay between genes and environment. Industrialization and…

…normal interval. P wave with constant morphology preceding every QRS complex. The P wave is positive in lead II (and also I and aVF). Arrhythmias…

…cardiac death and ventricular arrhythmias. Figure 2. Fragmented QRS complex. These QRS configurations are also indicate of previous myocardial infarction. New conduction defect Myocardial infarction…

…stimulate both ventricles simultaneously). A tachycardia with Q wave or QS complex in lead I suggest that the tachycardia is caused by the CRT device.

…abnormal activation sequence of the right ventricle, resulting in a prolonged and abnormal QRS complex on the ECG. The hallmark of right bundle branch block…

…V1–V3. The ST T segment is usually discordant to the QRS complex. V5, V6, I and aVL displays smaller R waves than normal. Along…

…complex. Second degree AV block Mobitz type II is characterized by sporadically occurring blocks, without the Wenckebach phenomenon. Second degree AV block Mobitz type I…

…morphologically different from the sinus P wave, but the QRS complex is normal (provided that intraventricular conduction is normal). This rhythm may be referred to…

…ventricular rate between 50 and 100 beats/min. P wave with constant morphology preceding every QRS complex. The P wave is positive in lead II…

…in lead V1, which also has a net negative QRS complex (i.e the negative T wave is actually concordant with the QRS, which makes…