…function and perform troubleshooting should be considered a basic clinical skill. Pacing activity may be visible or invisible, depending on e.g the type of…

…machine for analysis. The reflected sound waves will have the same speed as the emitted sound waves, but the amplitude, frequency and angle of incidence…

…now a permanent part of the programme and is widely used — a woman who does not attend for a gynaecological examination, or who prefers to…

…bursts of ventricular tachycardia occur. ECG 3. Repeated bursts of VT. ECG 4. There are now visible ST segment elevations and Q waves not seen…

…1. ECG changes seen in left ventricular hypertrophy (LVH) and right ventricular hypertrophy (RVH). The electrical vector of the left ventricle is enhanced in LVH…

…and a button battery is an emergency — it can cause perforation in seven hours. Indications Every foreign body in the ear canal or the nasal…

…Structure and contractile function of myocardial fibers The left ventricular wall can be subdivided into several layers. These layers are similar to those seen in…

…branch block, fascicular block and AV block, are common in myocardial ischemia and infarction. These conditions may be seen as signs of ischemia, which is…

…haematemesis and can also be seen when the bleeding is slow or has stopped. The first steps Step Content : : 1 ABCDE. Assess the level of…

…patient (blue) and the corresponding high risk morph (red). Beyond the difference in R wave amplitude, note the slurred terminal portion of the R wave…

…substantially exceeding those seen with native vessel PCI. Mechanisms The principal mechanism is distal embolization of atheromatous and thrombotic material. Plaque or thrombus may be…

…humps. This is often (but not always) seen on ordinary ECG tracings and it is explained by the fact that the atria are depolarized sequentially…

…cardiovascular interventions. Dressler syndrome now occurs in fewer than 1% of AMI cases and is seen predominantly after larger infarctions and/or delayed reperfusion. Its…

…Hypertrophy and dilatation may coexist. Moreover, the ECG cannot distinguish whether large QRS amplitudes are due to dilatation or hypertrophy. Because the majority of the…

…1. ECG changes seen in left ventricular hypertrophy (LVH) and right ventricular hypertrophy (RVH). The electrical vector of the left ventricle is enhanced in LVH…

…complete airway obstruction results in PEA and cardiac arrest within 8 minutes. Cardiac arrest as a result of asphyxia or hypoxia is managed according to…

…No conversion formula (between troponin I and T) has been validated. The risk of interference with antibodies in the blood is higher for troponin I…

…can be seen in arrhythmogenic tumors of the myocardium; in these cases, the tumor can debut with ventricular arrhythmias that result in asystole and sudden…

…centers and is generally reserved for meticulously selected cases. Extracorporeal Life Support (ECLS) encompasses several extracorporeal systems designed to assist in cases of cardiac or…

…humps. This is often (but not always) seen on ordinary ECG tracings and it is explained by the fact that the atria are depolarized sequentially…

…to construct images with high spatial and temporal resolution. PET offers higher spatiotemporal quality, as compared with SPECT. Quantification of blood flow using PET Quantitative…

…the onset of atrial depolarization is prolonged. As seen in Figure 1 this merely entails that the distance between the sinus impulse and P wave…

…by myocardial ischemia (affecting the sinoatrial node), sinus node dysfunction or side effects of digoxin treatment. If the rhythm becomes completely regular when holding the…

Arrhythmias and arrhythmology ECG Sinus rhythm: the normal rhythm of the heart A rhythm is defined as three consecutive heartbeats with identical waveforms on the…

…Relapse of VF and new shock. ECG 12 . Sinus rhythm. ECG 13 . Recurring VT. ECG 14 . Sinus rhythm, with ST segment elevations not seen previously…

…occurs in diastole or the decompression phase during CPR). High aortic pressure and low right atrial pressure favor coronary blood flow. A CPP of approximately …

…features of ventricular fibrillation The ECG shows irregular waves with varying morphology and amplitude. No P wave, QRS complex or T wave can be seen…

…forehead against the band and the chin in the rest. Support your working hand against the patient's zygoma or the bridge of the nose…

…plug. The tympanic membrane cannot be inspected and the examination is needed for the diagnosis. Before audiometry or the fitting of a hearing aid. Recurrent…

…due to sinus pause or post VPC pause) results in augmentation of early afterdpolarization amplitude (typically seen with large T wave amplitude), and QT prolongation…

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

…and the start of the QRS complex is called the PR segment. The PR segment is the baseline (also referred to as reference line or…

…below. Short (QT) QTc syndrome Short QT syndrome (QTc <0,390 seconds) is uncommon and can be seen in hypocalcemia and during digoxin treatment. It…

…of discomfort to the trapezius ridge is not seen in STEMI and suggests pericarditis instead. Pain is not uniformly present. The proportion of painless or…

…ischemic and normal myocardium and it results in displacement of the ST segment. The ST segment may be displaced upwards (ST segment elevation) or downwards…

…in high, pointed and asymmetric T waves. These must be differentiated from hyperacute T waves seen in the very early phase of myocardial ischemia. Hyperacute…

…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…

Arrhythmias and arrhythmology ECG Aberrant ventricular conduction (aberrancy, aberration) Aberrant conduction is not a mechanism of arrhythmia; it is a ventricular conduction disturbance . It is…

…due to sinus pause or post VPC pause) results in augmentation of early afterdpolarization amplitude (typically seen with large T wave amplitude), and QT prolongation…

…re entry circuit) and re entry circuits are vulnerable processes that usually self terminate within minutes, hours, or days. In the vast majority of cases…

…unipolar or bipolar mode of pacing (Figure 3). In bipolar pacing, the voltage difference is established at the lead tip, between the anode and cathode…

…coved shape in V1, V2 or V3. The ST segment starts at the apex of the second R wave and is downsloping. The T wave…

…arterial supply of the conduction system. As seen, the sinoatrial node is supplied by the right coronary artery in 60% of individuals, and by the…

…small amount of serous fluid which acts as a lubricant that prevents friction during ventricular contraction and relaxation. Pericardial effusion is the presence of an…

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

…complete heart block (third degree AV block) the block may be located anywhere between the atrioventricular node and the bifurcation of the bundle of His…

…on the etiology, may be more or less echogenic. It is important to estimate the volume, echogenicity and location of the effusion. Regarding the location…

…effusion ). Hemodynamic compromise may occur if accumulation of fluid in the pericardial sac compromises the relaxation and/or contraction of the ventricles and atria. This…

…metal, or tissue and fluids in the human body. Sound waves arise when a sound source generates mechanical vibrations in the particles of the medium…

…changes. This is due to the fact that pre excitation leads to abnormal depolarization of the ventricles and this leads to abnormal repolarization as well…

…is discharged in the ventricles it will spread partly or entirely outside of the conduction system and thus produce a wide QRS complex (QRS duration…

…equals 200 ms). The hallmark of both RBBB and LBBB is the QRS duration which is by definition 120 ms or longer. ECG criteria for…

…events and factors: Cause of cardiac arrest : Shockable rhythms (ventricular fibrillation, pulseless ventricular tachycardia) are mostly due to acute myocardial ischemia or myocardial infarction, and…

…reversible causes are absent and the patient is symptomatic or at risk of developing symptoms. The most common non reversible causes of sinus bradycardia are…

…American and European guidelines assert that the ST segment must be either downsloping or horizontal. Otherwise, ischemia is unlikely to be the cause of the…

…These ST segment depressions are mirror images of the ST segment elevations, and they are seen in leads with a roughly opposite angle to the…

…pressure and systemic vascular resistance increases. Harmful neurohormonal pathways are activated, similar to those seen in heart failure. A thorough review on the pathophysiology of…

…is a rather peculiar and certainly acute condition. Much research has been devoted to it in recent years. Most cases (70%) of takotsubo cardiomyopathy occur…

…create a 90° wide and 15 cm deep image requires approximately 40 milliseconds (ms). Increasing the number of ultrasound lines or image depth will reduce…

…the ectopic impulses that cause these rhythms spread partially or entirely outside of the ventricular conduction system, and thus the ventricular depolarization is slow (yielding…