…g mitral stenosis) requires intervention. Valve replacement can be performed with biological or mechanical prostheses. The former is preferred due to the lower risk of…

…Figure 1. Anatomy of the mitral valve The leaflets are connected to the papillary muscles via chordae tendineae (Figure 1). The anterolateral papillary muscle receives…

…mitral regurgitation Chronic mitral regurgitation causes a gradual volume and pressure overload, such that LVEDP and LAP rise slowly. This leads to compensatory dilatation of…

…consisting of the chordae tendineae and the papillary muscles . As compared to the mitral valve, the tricuspid valve is located slightly more apically (<0.8…

…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): [ …

…during which there is no significant flow across the mitral valve. The duration of diastasis is inversely related to heart rate (diastasis is shorter at…

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

…This reduces the filling of the left atrium and, accordingly, the left ventricle. The reduced flow over the mitral valve results in reduced E wave…

…septum, or mitral valve apparatus. These lesions can cause acute severe regurgitation, a left to right shunt, tamponade, or sudden loss of effective cardiac output…

…does not determine the anticoagulation indication. Previous stroke or TIA. The presence of mitral stenosis, a mechanical heart valve or hypertrophic cardiomyopathy. Heart failure, hypertension…

…Swedish medicines compendium (FASS). Rhythm control: the time limit before cardioversion Duration Management : : Reliably < 24 hours, no mechanical valve, CHA₂DS₂ VA 0–1 Cardioversion…

…right ventricular hypertrophy. Next chapter Biventricular Hypertrophy Related chapters Overview of Hypertrophy and Dilatation Left Ventricular Hypertrophy Atrial Hypertrophy and Dilatation (P mitrale, P pulmonale…

…suggests a raised filling pressure Marked respiratory variation in mitral and tricuspid inflow The echocardiographic counterpart of pulsus paradoxus Contraindications In overt tamponade with shock…

…in some patients, bendopnea. Congestion may also aggravate functional mitral regurgitation, ventricular dilatation, myocardial wall stress and subendocardial ischemia. Neurohormonal activation and vascular and renal…

…displacement, annular dilatation, or both; progressive ventricular remodeling may also occur in primary valvular disease. Increasing severity of mitral regurgitation is associated with worse outcomes…

…particularly in lead II. P mitrale: increased P wave duration and increased bifid appearance in II, together with a more pronounced biphasic deflection in V1…

…hump in the inferior limb leads (particularly lead II). P mitrale : increased P wave duration, enhanced second hump in lead II and enhanced negative deflection…

…hump in the inferior limb leads (particularly lead II). P mitrale : increased P wave duration, enhanced second hump in lead II and enhanced negative deflection…

…light causes rapid bilateral pupillary constriction (a brisk reflex), whereas low light causes dilation. This reflex is highly sensitive to brainstem integrity and cerebral perfusion…

…DCM) Dilated cardiomyopathy (DCM) is defined as dilation of one or both ventricles. Dilation of the left ventricle is virtually always accompanied by impaired left…

…ventricular tachyarrhythmias (including recurrent episodes of ventricular tachycardia) can also cause this cardiomyopathy. The duration of the tachyarrhythmia appears to be a stronger risk factor…

…Tetralogy of Fallot Marfan syndrome Takayasu's arteritis Iatrogenic (e.g complication of catheterization) Congenital dysplasia/aplasia of the pulmonary valve Idiopathic pulmonary artery dilation…

…Time to onset of action 5 to 15 minutes Duration of action 1.5 to 5 hours Delivery IV Dose 5–15 mg/hour IV…

…and the arrhythmia itself. This remodeling manifests as interstitial fibrosis, atrial dilation, and endocardial denudation, which collectively promote local inflammation and create a highly prothrombotic…

…Table 1. Causes of aortic regurgitation Bicuspid aortic valve Rheumatic heart disease Calcified aortic valves Idiopathic aortic dilatation (aneurysm) Hypertension Aortic dissection, proximal Marfan syndrome…

…ventricle, which is counteracted by dilatation of the ventricle. Dilatation of the right ventricle results in reduced intraventricular pressure and thereby reduced myoardial load. Pulmonary…

…inhibitors Enalaprilat Enalaprilat is rarely used in hypertensive crisis due to its slow onset, prolonged duration of effect, and significant individual variations in its effect…

…inhibitors Enalaprilat Enalaprilat is rarely used in hypertensive crisis due to its slow onset, prolonged duration of effect, and significant individual variations in its effect…

…although the exact exposure threshold and duration required are not established. The source material identifies chronic intake of approximately 60 g daily in males and…

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

…days duration. Vernakalant does not convert atrial flutter to sinus rhythm. Vernakalant is only administered in a monitored clinical setting appropriate for cardioversion. Administration of…

…the dilution step, not in the choice of dose. Paediatric doses are calculated on actual body weight unless otherwise stated. When the weight of a…

…of fraction of left ventricular volume ejected per beat and of ventricular end diastolic and residual volumes. Experimental and clinical observations with a precordial dilution…

…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…

…titration. Half of all opioid dosing errors arise at the dilution step, and an undiluted syringe of 10 mg/mL makes small adjustments impossible. Procedure…

ECG Introduction to ECG interpretation The QRS complex (ventricular complex): normal and abnormal configurations and intervals A complete QRS complex consists of a Q , R…

…is increased) and aortic stenosis (in which the narrowing of the opened aortic valve orifice makes it difficult for blood to flow from the ventricle…

…to measure the QT interval Measurement of the QT interval may be difficult due to T wave changes. Causes of prolonged QTc duration Antiarrhythmics (procainamide…

…is also indicated. Possible shortening of DAPT A duration of 6 months after ACS is generally considered too short for routine use, but it may…

…is also what makes the decision hold afterwards. Organ preserving treatment — treatment given solely for the sake of the donation — may continue for at m

…Reperfusion therapy Management Recommendation Level of evidence Reperfusion is indicated in all patients with symptoms of ischaemia of <12 h duration and persistent ST segment…

…reflection of the electrical potentials generated by the left ventricle. QRS duration QRS duration is the time duration from the start to the end of…

…than the base rate should inhibit the pacemaker. P waves The appearance of the P wave depends on where the atrial lead is fixed. Typically…

…circulatory flow arrest. No flow time : The duration (minutes) from circulatory collapse to initiation of CPR. During no flow there is no cerebral perfusion and…

…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…

…based interventions. Many tachyarrhythmias carry a potential risk of serious morbidity or mortality, underscoring the need for a structured and guideline directed approach. This chapter…

…Causes of right axis deviation Normal in newborns. Right ventricular hypertrophy. Acute cor pulmonale (pulmonary embolism). Chronic cor pulmonale (COPD, pulmonary hypertension, pulmonary valve stenosis…

…Causes of right axis deviation Normal in newborns. Right ventricular hypertrophy. Acute cor pulmonale (pulmonary embolism). Chronic cor pulmonale (COPD, pulmonary hypertension, pulmonary valve stenosis…

…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…

…choice of site, the use of ultrasound throughout the puncture, and maintaining maximal barrier precautions without shortcuts. The most common serious error is dilating a…

Enalaprilat Enalaprilat is rarely used in hypertensive crisis due to its slow onset, prolonged duration of effect, and significant individual variations in its effect. Drug…

…QRS is indicative of 'Ventricular pre excitation', and QRS duration ≥140 ms is considered 'Profound nonspecific intra ventricular conduction delay', both of which are not…

…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…

…Time to onset of action 50 to 10 minutes Duration of action 30 to 60 minutes Delivery IV Dose Initial infusion dose: 0.1 μ…

…Time to onset of action 1 to 2 minutes Duration of action 10 to 30 minutes Delivery IV Dose Bolus injection : 5 to 15 mg…

…patients with an initial shockable rhythm, compressions and ventilation can extend the duration of the shockable rhythm by several minutes, allowing for EMS or bystanders…

Procedurer The result of a repair is determined before the first needle goes in. A wound that has not been irrigated clean, has not been…

…of Cardiology (ESC) guidelines advocate for ICD implantation in high risk LQTS patients, emphasizing a comprehensive risk assessment that includes genetic factors and QTc duration…

…the ventricles at 100 bpm (cycle length: <600 ms). Classification according to duration: Sustained VT : VT 30 seconds, or VT <30 seconds terminated by therapy…