…may also lead to left ventricular dilation, which is referred to as ischemic cardiomyopathy (Dilated Cardiomyopathy). Ventricular dilation leads to dilation of the mitral annulus…

…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…

…is the most common sustained cardiac arrhythmia and a profound driver of global cardiovascular morbidity and mortality, primarily due to its association with ischemic stroke…

…either LCX or the right coronary artery (RCA). For details, refer to chapter The Coronary Arteries. Mitral valve disease A wide range of conditions may…

…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…

…ventricle. Dilatation of the right atrium. Pulmonary hypertension. Left to right shunt. Right ventricular dysfunction due to pressure/volume overload is the most common cause…

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

…functionally and morphologically normal on echocardiography and cardiac MRI during the first two decades of life. The most common initial presentation is palpitations or syncope…

…prolonged duration of effect, and significant individual variations in its effect. Drug Enalaprilat Brand names Vasotec IV ® Indications Hypertension and hypertensive emergency. Acute left…

…prolonged duration of effect, and significant individual variations in its effect. Drug Enalaprilat Brand names Vasotec IV ® Indications Hypertension and hypertensive emergency. Acute left…

…may be more common than heart failure with reduced ejection fraction (HFREF, Redfield et al). Echocardiography is the principal modality for investigating left ventricular systolic…

…combination with new or progressive acute target organ damage. Common manifestations are hypertensive encephalopathy, intracerebral haemorrhage, acute coronary syndrome, acute left ventricular failure with pulmonary…

…a patient on digoxin treatment 1 ECG signs of left atrial enlargement 3 Left axis deviation 2 QRS duration ≥90 milliseconds 1 Prolonged R wave…

…mitrale, because mitral valve disease is a common cause (Figure 1). The duration of the P wave will exceed 120 milliseconds in lead II. Biatrial…

…dilatation. The most common cause is valvular regurgitation (insufficiency). For example, aortic regurgitation causes the flow of blood from the aorta back into the left…

…duration exceeding 140 msec in males and 130 msec in females , along with slurring or notching of the mid QRS in at least two left…

…who are otherwise healthy. The majority of those with LAFB, however, have significant heart disease. Myocardial infarction, coronary artery disease, left ventricular hypertrophy, dilated cardiomyopathy…

…Overview of the normal electrocardiogram (ECG / EKG) Figure 1. The classical ECG curve with its most common waveforms. Important intervals and points of measurement are…

…complex is actually a reflection of left ventricular depolarization. QRS duration is the time interval from the onset to the end of the QRS complex…

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…

…very common. Figure 2. Two ECGs showing left and right ventricular hypertrophy. Next chapter Biventricular Hypertrophy Related chapters Overview of Hypertrophy and Dilatation Left Ventricular…

…technically more difficult with ultrasound Femoral vein Fastest, and does not interfere with ongoing CPR or airway management, no risk of pneumothorax Highest risk of…

…Conventional thoracic X ray sometimes reveals calcification of the pericardium. With MRI or CT, the thickness of the pericardium can be measured and in most…

…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…

…with tamponade, and less common causes such as severe pre existing valvular disease or excessive beta blocker or calcium channel blocker exposure. The incidence of…

…left ventricular systolic function is depressed or preserved Whether hypotension is present Whether an accessory pathway is suspected, particularly before administration of digoxin The duration…

…depolarization of the right ventricle relies on electrical impulses originating from the left ventricle. However, these impulses propagate slowly as they travel partially or entirely…

…circulatory compromise or collapse. Causes of tachycardia (tachyarrhythmia) with wide QRS complexes (QRS duration ≥0,12 s) : ventricular tachycardia is the most common cause and…

…However, in cases of rapid AVNRT or in patients with underlying structural heart disease, the arrhythmia may result in symptoms indicative of reduced cardiac output…

…at the top. Refer to Figure 1 . Patients with left ventricular hypertrophy may instead display normalization of secondary T wave inversions (lead V5, V6, aVL…

…or more frequently, as individually appropriate. 3 Important study: Milrinone as Compared with Dobutamine in the Treatment of Cardiogenic Shock (N Engl J Med 2021…

…left ventricular hypertrophy, or echocardiographic evidence of impaired filling, make the diagnosis more likely. HFpEF and HFmrEF together account for approximately half of patients with…

…circulatory compromise or collapse. Causes of tachycardia (tachyarrhythmia) with wide QRS complexes (QRS duration ≥0,12 s) : ventricular tachycardia is the most common cause and…

…is caused by a complete coronary artery occlusion, which results in the complete stop of blood flow and thus more extensive myocardial ischemia (referred to…

…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…

…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…

…third vector: the ventricular free wall The vectors resulting from activation of the ventricular free walls is directed to the left and downwards ( Figure 7 )…

…a delayed equalization of the pressure gradient. Conversely, the deceleration time is shortened if left ventricular compliance is reduced, or if left atrial pressure is…

…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…

…system (His Purkinje network), which results in rapid impulse transmission and thus shorter QRS duration (as compared with apical pacing). Because ventricular pacing results in…

…aVF (with QRS duration <0.12 seconds), provided that other causes of right axis deviation have been excluded. Causes of left axis deviation Left bundle…

…aVF (with QRS duration <0.12 seconds), provided that other causes of right axis deviation have been excluded. Causes of left axis deviation Left bundle…

…of increasing coronary blood flow. In circumstances with non shockable rhythm or with prolonged periods of VF (fine VF resistant to defibrillations), the purpose of…

…prolonged duration of effect, and significant individual variations in its effect. Drug Enalaprilat Brand names Vasotec IV ® Indications Hypertension and hypertensive emergency. Acute left…

…lead V1 and qRS pattern in V6 with QRS duration <120 ms) D: Profound sinus bradycardia (<30 beats/min or sinus pauses ≥3 s) Explanation…

…therapies have failed. Patients with structural heart disease or reduced left ventricular function are not eligible. Effects of propafenone and flecainide on ECG, heart rhythm…

…and Pathophysiology Posterior myocardial infarction is myocardial necrosis involving the posterior region of the left ventricle, usually as part of an inferoposterior or posterolateral infarction…

…may impair left ventricular filling and reduce systemic output. In this setting, venous congestion is generally treated initially with diuretics, whereas norepinephrine and/or inotropes…

…the ventricle is empty or nearly empty). In patients with an initial shockable rhythm, compressions and ventilation can extend the duration of the shockable rhythm…

…in the AV node is high grade. Causes of tachyarrhythmia with narrow QRS complexes (QRS duration < 0.12 s): sinus tachycardia, inappropriate sinus tachycardia…

…or the needle from a pericardiocentesis set), 10 mL and 20 mL syringes, a three way tap. A Seldinger set with a guidewire, a dilator…

…20 th week of pregnancy, or when the fundal height surpasses the umbilicus, the uterus should be manually displaced to the woman's left side …

…collectively dictate the urgency and modality of intervention [3] . By Duration: Non sustained VT (NSVT): Defined as three or more consecutive ventricular beats at a…

…safe in patients with coronary artery disease since it does not increase heart rate, and reduces myocardial oxygen consumption. Time to onset of action: 5…

…in patients with suspected or established coronary artery disease (CAD). It combines echocardiographic assessment of left ventricular (LV) structure and function with exercise or pharmacological…

…clinical patterns of AF—paroxysmal, persistent, long standing persistent and permanent—and is not determined solely by the apparent frequency or duration of documented episodes…

…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…

…escalation of beta blocker or CCB therapy. Nicorandil and trimetazidine are additional options in selected patients. Treatment choices should be integrated with management of precipitating…

…the stroke risk is high or the time of onset uncertain, choose the more cautious course. Anticoagulation Assess the risk with CHA₂DS₂ VA (the sex…

…reserved for patients with a CHA₂DS₂ VA score of 0–1. Check what applies in your own region. Duration above the threshold or unknown: at…