…QRS duration of $\ge 120$ msec , the presence of broad and typically notched R waves in leads I, aVL, and the left precordial leads…

…R wave in V5 and V6. Secondary ST T changes occur invariably in the presence of LBBB. The following ECG criteria and characteristics are used…

…To address these challenges, researchers have developed ECG criteria designed to identify ischemia in the presence of left bundle branch block. The most widely recognized…

…defines: The presence and severity of left main stenosis Ostial, shaft or distal bifurcation involvement Disease in the left anterior descending and left circumflex arteries…

…Ongoing or newly recognized LV systolic dysfunction. A patient may also present because of complications of the underlying infarction or LV remodeling, including heart failure…

…be ignored. The most common situation is when assessing aortic stenosis in the presence of a narrowing of the LVOT (left ventricular outflow tract). Such…

…factors. Plaque erosion Plaque erosion is increasingly recognized and is present in at least one third of acute coronary syndromes in the cited material. Eroded…

…with oxygen demands. Depending on several factors– including the severity of the stenosis/occlusion, microvascular function, myocardial oxygen extraction, presence of collateral circulation, etc –ischemia…

…section (SAX, short axis view), the the ventricle is rather a crescent shaped appendage of the left ventricle. On longitudinal sections (A4C, apical four chamber…

…and signs of heart failure (HF) in the presence of a left ventricular ejection fraction (LVEF) of ≥50%, accompanied by objective evidence of structural and…

…acute phase protein — a normal ferritin does not exclude iron deficiency in the presence of inflammation Transferrin saturation 15–50 % < 15 % indicates iron deficiency…

…the diagnosis of heart failure is clinically secure and the LVEF measurement is reliable. Nevertheless, these findings increase diagnostic confidence. The presence of symptoms alone…

…leads generally indicates very severe ischemia [15]. A key distinguishing feature of ischemic ST elevation is the presence of prominent reciprocal ST depression [4]. Furthermore…

…coronary artery disease (CAD). It combines echocardiographic assessment of left ventricular (LV) structure and function with exercise or pharmacological stress. The physiological basis is an…

…hypertrophy, it may still be normal when compared to reference values. Figure 1. Types of left ventricular hypertrophy. Left ventricular volume is reduced in conc

…branch (RBBB). In the presence of right bundle branch block, depolarization of the right ventricle relies on electrical impulses originating from the left ventricle. However…

…support typically manifests in patients with left ventricular systolic dysfunction, low cardiac output, and dyspnea at rest that persists despite administration of diuretics and vasodilators…

…this combination is associated with a worse prognosis. VA may occur in the presence of obstructive coronary artery disease (CAD), in non obstructive coronary arteries…

…on the right side can compromise venous return to the right ventricle. Therefore, in the presence of a tamponade, chest compressions have limited efficacy. Furthermore…

…sided precordial leads when RVI is suspected in the setting of an inferior infarction. The presence of right sided ST segment elevation supports the diagnosis…

…clinical descriptions. It may be present intermittently during the illness and, in some series, is reported in up to approximately one third of patients. Its…

…The resulting haemodynamic congestion produces a characteristic clinical phenotype of breathlessness, fatigue and oedema. This definition does not depend on left ventricular ejection fraction (LVEF)…

…setting of acute or chronic heart failure are often better categorised as myocardial injury. Clinical Presentation and Symptoms Patients with Type 2 MI frequently present…

…multiple variables, including the number of lesions, their location, and specific characteristics such as bifurcations, chronic total occlusions (CTOs), calcification, and thrombus presence. These factors…

…is present in most cases of significant RVH, although it is not typically classified as a formal diagnostic criterion for the condition [17]. Left Axis…

…= Left anterior descending coronary artery. LCX = left circumflex coronary artery. Arterial blood supply of the conduction system Figure 1 presents the components of…

…induced myocardial ischaemia. Detect and characterize myocardial scar. Estimate the risk of major adverse cardiovascular events. Assess left ventricular volumes, regional wall motion, and ejection…

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

…The presence of ecotdense masses on valves should lead to suspicion of endocarditis (the masses are vegetations). The risk of endocarditis is especially high for…

…to risk of embolization Relative contraindications for exercise ECG Severe hypertension (systolic blood pressure 200 mmHg or diastolic blood pressure 110 mmHg). Left main coronary…

…cause of the arrhythmia already affects cellular function. This results in electrical instability which explains why ventricular tachycardia may progress to ventricular fibrillation. Left untreated…

…consequences of diabetes may present through any major cardiovascular phenotype: CAD, including chronic coronary syndromes and acute coronary syndromes HF across the spectrum of left…

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

…treatment. The presence of ST segment changes or a positive troponin assay identifies patients in whom an invasive strategy is generally preferred over selective angiography…

…Several underlying conditions increase a patient's sensitivity to digitalis related arrhythmias. The clinician must evaluate for the presence of worsening renal function, advanced age…

…further reducing myocardial workload. 1 The pharmacokinetic profile of levosimendan is modulated by the presence of an active metabolite, which exerts sustained hemodynamic effects for…

…The extent of myocardial ischaemia. The presence of viable myocardium supplied by the occluded vessel. Left ventricular function. The anatomical complexity of the CTO and…

…LCx supplies the posterior descending artery (PDA) in a left dominant circulation (i.e. 10 15% of cases). Clinically, patients present with severe chest pain…

…cardinal symptom, chest pain can be present [5]. Distinguishing Features: Pleuritic pain suggests pulmonary infarction, and a history of pain exacerbation with inspiration, along with…

…important to note that a traditional 12 lead ECG only presents a few seconds of myocardial electrical activity and there is a chance that ischemic…

…paper. It would be more efficient to present the limb leads in their anatomically contiguous manner; that is, from left superior basal to right inferior…

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…

…Similarly, structures located on the left hand side of the index marker are presented on the left side of the marker in the image. Echocardiographic…

…the 2D image to facilitate the interpretation of the Doppler signals. Figure 1. The image on the left shows many sample volumes within a Doppler…

…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…

…antihypertensives, should prompt clinical suspicion [1]. Cardiac Signs and Symptoms Patients often present with symptoms of predominant right heart failure, including lower extremity edema, ascites…

…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…

…observational databases report approximately 5–10%. Only about 10% of patients who develop shock present with it at hospital admission; approximately 90% deteriorate during hospitalization…

…considerably. Symptoms of systemic venous congestion include: Peripheral edema Rapid weight gain Increasing abdominal girth Early satiety Bendopnea Abdominal ascites Older patients may present atypically…

…mmHg ≤15 mmHg ≤2 Wood units The source material also presents a CpcPH threshold of PVR ≥3 Wood units in an overlapping clinical classification table…

…NSTEMI) since they present with ST segment depressions on the 12 lead ECG (recall that ST segment depression is the hallmark of NSTE ACS/NSTEMI…

…normally, there is more room for the right ventricle, the filling of which increases and the septum bulges into the left ventricle. During exhalation, the…

…an indicator of cardiac hemodynamic status and may be estimated with echocardiography. The PASP is an independent predictor of survival and for elevated left ventricular…

…may be present despite a high atrial rate (for example atrial fibrillation) if the block in the AV node is high grade. Causes of tachyarrhythmia…

…Diastolic flow reversal – PW doppler aorta descendens if present, early diastolic early diastolic holodiastolic Quantification of jet Mild regurgitation Moderate regurgitation Severe regurgitation Jet width…

…instead presents as encephalopathy, renal failure or simply deterioration. The procedure itself is straightforward: ultrasound to find the fluid, an insertion site in the left…

…the left atrial appendage (LAA). The LAA is a highly trabeculated, windsock like embryonic remnant that exhibits uniquely low flow velocities during the loss of…

…of ultrasound image. This view is called parasternal long axis view. The ultrasound image contains several important parameters (Figure 4). The ECG signal is presented…

…Ventricular fibrillation is the result of numerous re entry circuits , causing rapid and chaotic ventricular depolarizations, rendering the left ventricle incapable of generating effective contractions…

…Injection of contrast media into the ventricle will instead reveal that the apical portion of the left ventricle is dilated (hence the term apical ballooning…