…a large number of parameters have been introduced to assess left ventricular function. The majority of these parameters can be calculated or approximated using two…

…of both thromboembolic and hemorrhagic risks. The diagnostic prerequisite for clinical AF remains the documentation of the arrhythmia via a standard 12 lead ECG or…

…kg (maximum 6 mg), then 0.2 mg/kg (maximum 12 mg) Give into a large vein with a rapid flush. Warn the patient Amiodarone…

…prevent, or alleviate, the pressure increase in the left ventricle and left atrium. Chronic aortic regurgitation leads to dilatation and hypertrophy of the left ventricle…

…artery. Depending on the size and form of the thrombus, it will occlude the main pulmonary artery or its branches. The larger the thrombus, the…

…back to the right atrium and venous system, resulting in dilation of vena cava inferior ( 2.1 cm). Severe tricuspid regurgitation may lead to systolic…

…vector resulting from activation of the right ventricle does not come to expression , because it is drowned by the many times larger vector generated by…

…cannot distinguish whether large QRS amplitudes are due to dilatation or hypertrophy. Because the majority of the literature in the field of electrocardiology has focused…

…VT]). The VF waveform is initially coarse ( i.e fibrillatory waves have large amplitudes) but as the duration of VF is prolonged, the amplitude gradually…

…with PCI or without revascularization, although the exact antithrombotic strategy may differ when long term OAC is also indicated. Possible shortening of DAPT A duration…

…many times larger than the vector generated by the right ventricle, the QRS complex is actually a reflection of left ventricular depolarization. QRS duration is…

ECG Hypertrophy and dilatation Biventricular hypertrophy Simultaneous hypertrophy of the left and right ventricle is rather common. The ECG has low sensitivity with respect to…

…I and aVL displays smaller R waves than normal. Along with larger R waves in right sided leads, the R wave progression may be opposite…

…low risk of pneumothorax Uncomfortable for an awake patient, harder to keep the dressing clean with a tracheostomy or copious secretions Subclavian vein Most comfortable…

…a common cause (Figure 1). The duration of the P wave will exceed 120 milliseconds in lead II. Biatrial abnormality/enlargement Biatrial abnormality implies that…

…hypertrophy (RVH). The electrical vector of the left ventricle is enhanced in LVH, which results in large R waves in left sided leads (V5, V6…

…and always urgent. A large pericardial effusion with symptoms despite medical treatment. Diagnostic drainage in suspected purulent pericarditis, tuberculosis or malignancy. Tamponade is a clinical…

…heal with good function or cosmesis without apposition. A wound that bleeds because the edges are held apart. A wound through the full thickness of…

…decrease (e.g due to sinus pause or post VPC pause) results in augmentation of early afterdpolarization amplitude (typically seen with large T wave amplitude)…

…decrease (e.g due to sinus pause or post VPC pause) results in augmentation of early afterdpolarization amplitude (typically seen with large T wave amplitude)…

…Upon recognition of a cardiac arrest in a pregnant individual, either within or outside the hospital, prompt communication with an obstetrician and neonatologist is critical…

…and duration of exposure to cardiovascular risk factors. Primary prevention Primary prevention targets people without clinical CVD who nevertheless have established risk factors or an…

…and risk assessment The evaluation of a patient with AF who may require anticoagulation should establish: Whether AF is clinical or device detected subclinical AF…

…duration of 120 ms (0.12 s) or more is required to diagnose a complete left bundle branch block . In addition to prolonged QRS duration…

…inelastic and rigid, which limits the dilatation. It allows the pericardium to limit the filling of the chambers when the volumes become too large. Thus…

…women, respectively, should be considered abnormal. A common cause of abnormally large T waves is hyperkalemia, which results in high, pointed and asymmetric T waves…

…cardiomyopathy or hypertrophy. Prognosis of nonspecific intraventricular conduction delay Patients with nonspecific intraventricular conduction delays are at twice as great a risk of all cause…

…1 large box equals 200 ms). The hallmark of both RBBB and LBBB is the QRS duration which is by definition 120 ms or longer…

…of an X linked condition may develop a phenotype later and require delayed or individualized assessment. Disease specific genetic architecture HCM is predominantly associated with…

…associated with physical activity, a large meal, emotional upset, or cold exposure. The absence of chest pain does not exclude clinically important CCS. Silent or…

…for decades, and it has been regarded as a benign form of ST segment elevation with slurring or notching at the J point. A notch…

…delivers the electrical impulse to the posterior and inferior walls of the left ventricle. Anatomical or functional block in the anterior fascicle leads to left…

…Large U waves that are fused with the T wave should be included in the measurement. This may result in an overestimation of the QT…

…instability or a large area of myocardium at risk. Over 48 hours: urgent PCI is still indicated with continuing ischaemia, shock, serious arrhythmia or acute…

…marked renal failure. Duration of treatment: at least 3 months. Extended treatment in unprovoked pulmonary embolism, a persisting risk factor, or recurrence. Special situations Situation…

…the ventricles it will spread partly or entirely outside of the conduction system and thus produce a wide QRS complex (QRS duration ≥0.12 s)…

…is larger in unipolar pacing, as compared with bipolar pacing. The latter yields a discrete stimulation artifact, which may be visible in one or a…

…larger than the right ventricle, the QRS complex is actually a reflection of the electrical potentials generated by the left ventricle. QRS duration QRS duration…

…requires urgent surgical or transcatheter intervention, with temporary mechanical circulatory support (MCS) considered as a bridge. Clinical Presentation and Symptoms Symptoms of STEMI The usual…

…The larger the infarction, the higher the troponin level and the longer the duration of elevated troponin levels. Differences in absolute concentrations of troponin I…

…water soluble and short acting, not a depot preparation, and gives a shorter duration of effect. Lidocaine 10 mg/mL without adrenaline , 2–5 mL…

…of the Pupillary Reflex in Cardiac Arrest The pupillary light reflex is controlled by a simple neural circuit: light signals travel from the retina via…

…lead to ventricular dilation. However, the term dilated cardiomyopathy (DCM) refers to idiopathic or genetic dilation of the left ventricle . Patients with DCM typically develop…

…help determine expected normal values based on body surface area (BSA), aiding in the diagnosis of aortic root dilation. Key Formulas BSA Calculation (Mosteller formula): [ …

…with connective tissue disorders (Marfan syndrome, Ehlers Danlos syndrome), osteogenesis imperfecta typically causes prolapse of P2 (Figure 1). Myocardial ischemia affecting the papillary muscles or…

…with left ventricular dilation. This type of cardiomyopathy, referred to as tachycardia induced cardiomyopathy , can be caused by any tachyarrhythmia leading to prolonged periods of…

…are also estimated using continuous Doppler. A dense regurgitant jet with rapid deceleration (short PHT) is suggestive of severe regurgitation; the leakage usually ends early…

…the contraction of smooth muscle cells. As compared with nitroprusside, nicardipine induces relatively greater venodilation than arteriolar dilation. Effects Nicardipine causes dilation of the coronary…

…and P3 (posterior or lateral scallop). Figure 1. Anatomy of the mitral valve The leaflets are connected to the papillary muscles via chordae tendineae (Figure…

…pressure ≥180 mmHg and/or diastolic pressure ≥120 mmHg) with concurrent signs of acute organ damage or failure. Any of the drugs listed below may…

…pressure ≥180 mmHg and/or diastolic pressure ≥120 mmHg) with concurrent signs of acute organ damage or failure. Any of the drugs listed below may…

…hypertension and atherosclerotic coronary disease In patients with heavy alcohol use, left ventricular dilation may precede the development of increased left ventricular hypertrophy and mass…

…or other ECG changes (see below) should lead to a suspicion of ARVC. The gradual loss of myocardium leads to ventricular dilation and right heart…

…Valve replacement can be performed with biological or mechanical prostheses. The former is preferred due to the lower risk of thrombosis and evidence demonstrating long…

…if hypotension or bradycardia occurs. A defibrillator should be immediately available as a precaution. Dosage of vernakalant Vernakalant is dosed by body weight, with the…

…reference to the intravenous antihypertensive drugs used in a hypertensive emergency. It summarises the mechanism of action, the onset, the duration of effect, the dosing…

…10 mL with sodium chloride) before intravenous titration. Half of all opioid dosing errors arise at the dilution step, and an undiluted syringe of 10…

…QT dispersion. Increased QT dispersion is associated with increased morbidity and mortality. This is presumably explained by a higher incidence of malignant ventricular arrhythmias. It…

…flow across the mitral valve. The duration of diastasis is inversely related to heart rate (diastasis is shorter at higher heart rates and vice versa ).

…deceased — in the donation register, on a donor card, or through statements made to the next of kin. Active malignancy with a risk of transmission …