…a complex interaction between the muscle fibers in these layers, which collectively produces a highly efficient pumping mechanism. Figure 1A 2C. The orientation of myocardial…

…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…

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

…rare (Naxos disease, Carvajal syndrome). The prevalence of ARVC is between 0.02 and 0.05% in Europe (Corrado et al). ARVC is more malignant…

…However, refrain from rescue breaths to mitigate the risk of potential contaminants endangering the rescuer. Contact expertise Contact your national or regional poison control centre…

…and syndrome: from ECG criteria to management Although the early repolarization pattern has been recognized for almost 50 years, it is still one of the…

…to the QRS morphology during LBBB. Stimulation in other regions of the ventricle may result in a different QRS morphology. If the lead tip is…

…Regardless of which waves are visible, the wave(s) that reflect ventricular depolarization is always referred to as the QRS complex . Naming of the waves…

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

…the bundle of His (which means that both bundle branches will conduct the impulse to each respective ventricle) the QRS complex is normal (i.e…

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

Arrhythmias and arrhythmology ECG Diagnosis and management of narrow and wide complex tachycardia All clinically significant supraventricular and ventricular tachyarrhythmias have been reviewed in previous…

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

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…

…Torsades de Pointes in Long QT Syndrome) [1] . Underlying Etiologies The etiology of VT is broadly dichotomized into structural heart disease (SHD) and structurally normal…

…could enhance the score's predictive accuracy. The SYNTAX Score remains a cornerstone in the management of complex CAD, providing a structured approach to revascularization…

…failure (HF) is a complex clinical syndrome characterized by symptoms and signs resulting from structural or functional impairment of ventricular filling or ejection of blood…

…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…

…low back pain Symptoms of type 2 diabetes or metabolic syndrome Depression, low self esteem or body image disturbance The number and severity of obesity…

…complex clinical syndrome characterized by the cardinal symptoms and signs of heart failure (HF) in the presence of a left ventricular ejection fraction (LVEF) of…

…the QRS complex in V1–V2 resembles a left bundle branch block (i.e negative QRS) V1 : The initial portion of the QRS complex is…

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…

…QRS complex, ST segment, T wave and QT interval This video is accompanied by the detailed article The normal electrocardiogram (ECG). A brief summary of…

…it is asked of a patient who is haemodynamically stable enough for there to be time to ask it. Indications Wide complex tachycardia where ventricular…

…cuts cause burning pain. 2. Position the pads, preferably anteroposteriorly : one anteriorly over the praecordium to the left of the sternum, the other on the…

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

…pathology) [3] Absence of Q waves in I, V5, and V6 [3] ST T Waves Usually opposite in direction to the QRS complex [3] Not…

…ischemia Cardiomyopathy Bradycardia Hypothyroidism Hypothermia A separate chapter discusses Long QT syndrome (LQTS). A complete list of drugs causing QT prolongation can be found here…

Arrhythmias and arrhythmology Procedurer Lathundar Electrical cardioversion is the delivery of a precisely regulated electrical shock to terminate a tachyarrhythmia, and it encompasses both synchronized…

…contraindication) . Irregular wide complex tachycardia is most often due to atrial fibrillation with wide QRS complexes due to bundle branch blocks or other conduction defects…

…risk factor [2] . This change reflects robust evidence that female sex alone, in the absence of other comorbidities, does not significantly increase stroke risk. Conversely…

…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…

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

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

…220 msec. The PR segment is the flat line between the end of the P wave and the start of the QRS complex. The PR…

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

…Method of interpretation Heart rate Heart rhythm The P wave The PR interval The QRS complex The ST segment The T wave The U wave…

…II Anatomical SYNTAX Score : Derived from the original SYNTAX Score, which evaluates the complexity of coronary lesions. Clinical Variables : Age : Older patients have a higher…

…infarction rates. Clinical presentation and symptoms The clinical presentation is determined primarily by the ACS syndrome and the haemodynamic consequences of the culprit lesion. Patients…

…left ventricular dysfunction, peripheral vascular disease and other manifestations of diffuse atherosclerosis. Percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are revascularization procedures…

…of the stent, stent diameter less than 3 mm, long stent length Large thrombotic burdens increase procedural risk because thrombus can fragment, embolize to other…

…complex in I and aVL as well as qR complex in III and aVF (with QRS duration <0.12 seconds), provided that other causes of…

…complex in I and aVL as well as qR complex in III and aVF (with QRS duration <0.12 seconds), provided that other causes of…

…positive QRS complex should be followed by a positive T wave, and vice versa ( Figure 17 ). Otherwise there is discordance (opposite directions of QRS and…

…all cause mortality. The excess risk is mediated by the combined effects of hyperglycaemia, hypertension, dyslipidaemia, obesity, smoking and other conventional risk factors, together with…

…with ventricular depolarization (i.e. QRS complex), which has much stronger electrical potentials. Cell types in electrocardiology For the purpose of this discussion it is…

…of atrial fibrillation in patients without structural heart disease (reduced left ventricular function is considered a structural heart disease). AVNRT, AVRT (WPW syndrome) and other…

…AV block I, or AV block 1. Before proceeding, it is recommended to review the basic concepts of AV blocks (refer to Introduction to AV…

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

…often necessary to normalize blood pressure. Management of hypertension requires careful consideration of other cardiovascular risk factors and coexisting conditions. Therapy must be tailored to…

…P wave PR interval QRS complex ST segment T wave U wave QT (QTc) interval Pediatric and neonatal electrocardiograms differ markedly – in terms of rhythm…

…ischemia. Inverted U waves are even more typical of ischemia (but the sensitivity is low). U wave changes always accompany other ischemic ST T changes…

…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.

…part of the QRS complex as an R’ wave (pronounced "R prime"), which is directed anteriorly and rightward. Due to the abnormal depolarization sequence of…

…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…

…the most common cause of sinus arrest/pause. It commonly affects younger individuals who endure intense emotional stress, acute pain or other stimuli that increases…

…every QRS complex. The P wave is positive in lead II. Figure 1 (below) shows normal sinus rhythm at a paper speed of 25 mm…

…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…