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PMC The negative deflection of biphasic (diphasic) P-waves is generally <1 mm deep. Note that left atrial enlargement is not able to be diagnosed in the presence of atrial fibrillation because this rhythm is defined by erratic atrial activity and no visible P wave on the ECG. The amplitude of the normal P-wave does not exceed 2.5 mm in anylimb lead. Primary Mitral Valve Prolapse is distinguished by thickening of one or both valve flaps. Normal ECG findings in athletes - British Journal of Sports Medicine Left Atrial Enlargement (LAE) ECG Review | Learn the Heart - Healio Taina M, Sipola P, Muuronen A, Hedman M, Mustonen P, Kantanen AM, Jkl P, Vanninen R. PLoS One. Your heart may be unusually thick or dilated (stretched). This regurgitation may result in a murmur (abnormal sound in the Out of these cookies, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. Performance cookies are used to understand and analyze the key performance indexes of the website which helps in delivering a better user experience for the visitors. The full CAH agenda can be accessed here. Echocardiogram (also called echo). measurement results are as follows: qrs 68ms qtqtcb 376-441ms pr 140ms p 102ms rr-pp 726-720ms p-qrs-t 79-66-7? We conclude that echocardiographic left atrial enlargement may be an early sign of hypertensive heart disease in patients with no other discernible cause of left atrial enlargement. Thank you to the FITs for all their hard work. The https:// ensures that you are connecting to the The first half of the P-wave is therefore a reflection of right atrial activationand the second half is a reflection of left atrial activation. These cookies do not store any personal information. These drugs reduce the amount of sodium and water in the body, which can help lower blood pressure. Mitral Valve Prolapse may be detected by listening with a stethoscope, revealing a "click" (created by the stretched flaps snapping against each other during contraction) and/or a murmur. The site is secure. T wave inversions in contiguous inferior leads or lateral leads warrant investigation in all athletes. . The palpitations are usually associated with premature ventricular contractions (the ventricles beat sooner than they should), but supraventricular rhythms (abnormal rhythms that begin above the ventricles) have also been detected. 2015 Aug 7;16(8):18454-73. doi: 10.3390/ijms160818454. In order to determine if echocardiographic left atrial enlargement is an early sign of hypertensive heart disease, we evaluated 10 normal and 14 hypertensive patients undergoing ro Possible left atrial enlargement is a nonspecific finding which is commonly seen in 12 lead EKG. He has a passion for ECG interpretation and medical education | ECG Library |, MBBS (UWA) CCPU (RCE, Biliary, DVT, E-FAST, AAA) Adult/Paediatric Emergency Medicine Advanced Trainee in Melbourne, Australia. font-weight: normal; Ecg done and dr said everything was normal. is this anything of concern? 1 doctor answer 5 doctors weighed in Share Dr. John Munshower answered Family Medicine 32 years experience Echocardiography is the most useful diagnostic test for Mitral Valve Prolapse. Necessary cookies are absolutely essential for the website to function properly. ECG criteria follows: Regular rhythm with ventricular rate slower than 50 beats per minute. Swelling in your arms or legs. The reasons for this are explained below. } In association with left ventricular hypertrophy: Emergency Physician in Prehospital and Retrieval Medicine in Sydney, Australia. Learn how your comment data is processed. Such a P-wave is calledP pulmonalebecause pulmonary disease is the most common cause (Figure1). Any cookies that may not be particularly necessary for the website to function and is used specifically to collect user personal data via analytics, ads, other embedded contents are termed as non-necessary cookies. If you have no symptoms/problems because of any structural heart enlargement or defect than there is nothing to be done. margin-top: 20px; percent of the population. heart due to turbulent blood flow). The most important causes are as follows: Figure 1 shows sinus bradycardia at paper speed 25 mm/s. This is also a normal finding. When in doubt whether the bradycardia is physiological, it is useful to perform a Holter ECG (ambulatory recording). Took a b-complex vitamin supplement last week that landed me in er. Clinical electrocardiography and ECG interpretation, Cardiac electrophysiology: action potential, automaticity and vectors, The ECG leads: electrodes, limb leads, chest (precordial) leads, 12-Lead ECG (EKG), The Cabrera format of the 12-lead ECG & lead aVR instead of aVR, ECG interpretation: Characteristics of the normal ECG (P-wave, QRS complex, ST segment, T-wave), How to interpret the ECG / EKG: A systematic approach, Mechanisms of cardiac arrhythmias: from automaticity to re-entry (reentry), Aberrant ventricular conduction (aberrancy, aberration), Premature ventricular contractions (premature ventricular complex, premature ventricular beats), Premature atrial contraction(premature atrial beat / complex): ECG & clinical implications, Sinus rhythm: physiology, ECG criteria & clinical implications, Sinus arrhythmia (respiratory sinus arrhythmia), Sinus bradycardia: definitions, ECG, causes and management, Chronotropic incompetence (inability to increase heart rate), Sinoatrial arrest & sinoatrial pause (sinus pause / arrest), Sinoatrial block (SA block): ECG criteria, causes and clinical features, Sinus node dysfunction (SND) and sick sinus syndrome (SSS), Sinus tachycardia & Inappropriate sinus tachycardia, Atrial fibrillation: ECG, classification, causes, risk factors & management, Atrial flutter: classification, causes, ECG diagnosis & management, Ectopic atrial rhythm (EAT), atrial tachycardia (AT) & multifocal atrial tachycardia (MAT), Atrioventricular nodal reentry tachycardia (AVNRT): ECG features & management, Pre-excitation, Atrioventricular Reentrant (Reentry) Tachycardia (AVRT), Wolff-Parkinson-White (WPW) syndrome, Junctional rhythm (escape rhythm) and junctional tachycardia, Ventricular rhythm and accelerated ventricular rhythm (idioventricular rhythm), Ventricular tachycardia (VT): ECG criteria, causes, classification, treatment, Long QT (QTc) interval, long QT syndrome (LQTS) & torsades de pointes, Ventricular fibrillation, pulseless electrical activity and sudden cardiac arrest, Pacemaker mediated tachycardia (PMT): ECG and management, Diagnosis and management of narrow and wide complex tachycardia, Introduction to Coronary Artery Disease (Ischemic Heart Disease) & Use of ECG, Classification of Acute Coronary Syndromes (ACS) & Acute Myocardial Infarction (AMI), Clinical application of ECG in chest pain & acute myocardial infarction, Diagnostic Criteria for Acute Myocardial Infarction: Cardiac troponins, ECG & Symptoms, Myocardial Ischemia & infarction: Reactions, ECG Changes & Symptoms, The left ventricle in myocardial ischemia and infarction, Factors that modify the natural course in acute myocardial infarction (AMI), ECG in myocardial ischemia: ischemic changes in the ST segment & T-wave, ST segment depression in myocardial ischemia and differential diagnoses, ST segment elevation in acute myocardial ischemia and differential diagnoses, ST elevation myocardial infarction (STEMI) without ST elevations on 12-lead ECG, T-waves in ischemia: hyperacute, inverted (negative), Wellen's sign & de Winter's sign, ECG signs of myocardial infarction: pathological Q-waves & pathological R-waves, Other ECG changes in ischemia and infarction, Supraventricular and intraventricular conduction defects in myocardial ischemia and infarction, ECG localization of myocardial infarction / ischemia and coronary artery occlusion (culprit), The ECG in assessment of myocardial reperfusion, Approach to patients with chest pain: differential diagnoses, management & ECG, Stable Coronary Artery Disease (Angina Pectoris): Diagnosis, Evaluation, Management, NSTEMI (Non ST Elevation Myocardial Infarction) & Unstable Angina: Diagnosis, Criteria, ECG, Management, STEMI (ST Elevation Myocardial Infarction): diagnosis, criteria, ECG & management, First-degree AV block (AV block I, AV block 1), Second-degree AV block: Mobitz type 1 (Wenckebach) & Mobitz type 2 block, Third-degree AV block (3rd degree AV block, AV block 3, AV block III), Management and treatment of AV block (atrioventricular blocks), Intraventricular conduction delay: bundle branch blocks & fascicular blocks, Right bundle branch block (RBBB): ECG, criteria, definitions, causes & treatment, Left bundle branch block (LBBB): ECG criteria, causes, management, Left bundle branch block (LBBB) in acute myocardial infarction: the Sgarbossa criteria, Fascicular block (hemiblock): left anterior & left posterior fascicular block on ECG, Nonspecific intraventricular conduction delay (defect), Atrial and ventricular enlargement: hypertrophy and dilatation on ECG, ECG in left ventricular hypertrophy (LVH): criteria and implications, Right ventricular hypertrophy (RVH): ECG criteria & clinical characteristics, Biventricular hypertrophy ECG and clinical characteristics, Left atrial enlargement (P mitrale) & right atrial enlargement (P pulmonale) on ECG, Digoxin - ECG changes, arrhythmias, conduction defects & treatment, ECG changes caused by antiarrhythmic drugs, beta blockers & calcium channel blockers, ECG changes due to electrolyte imbalance (disorder), ECG J wave syndromes: hypothermia, early repolarization, hypercalcemia & Brugada syndrome, Brugada syndrome: ECG, clinical features and management, Early repolarization pattern on ECG (early repolarization syndrome), Takotsubo cardiomyopathy (broken heart syndrome, stress induced cardiomyopathy), Pericarditis, myocarditis & perimyocarditis: ECG, criteria & treatment, Eletrical alternans: the ECG in pericardial effusion & cardiac tamponade, Exercise stress test (treadmill test, exercise ECG): Introduction, Indications, Contraindications, and Preparations for Exercise Stress Testing (exercise ECG), Exercise stress test (exercise ECG): protocols, evaluation & termination, Exercise stress testing in special patient populations, Exercise physiology: from normal response to myocardial ischemia & chest pain, Evaluation of exercise stress test: ECG, symptoms, blood pressure, heart rate, performance, P pulmonale: right atrial enlargement (hypertrophy, dilatation), P mitrale: left atrial enlargement (hypertrophy, dilatation), P mitrale: leftatrial enlargement (hypertrophy, dilatation). Sinus bradycardia: definitions, ECG, causes and management "Clinical Implications of Left Atrial Enlargement: A Review", "The Aging Process of the Heart: Obesity Is the Main Risk Factor for Left Atrial Enlargement During Aging: The MONICA/KORA (Monitoring of Trends and Determinations in Cardiovascular Disease/Cooperative Research in the Region of Augsburg) Study", "Atrial enlargement as a consequence of atrial fibrillation A prospective echocardiographic study", "Left atrial volume predicts cardiovascular events in patients originally diagnosed with lone atrial fibrillation: three-decade follow-up", "The Relationship between Obstructive Sleep Apnea and Atrial Fibrillation: A Complex Interplay", "ABC of clinical electrocardiography. If atrial fibrillation or severe left atrial enlargement is present, treatment with an anticoagulant may be recommended. Left atrial enlargement is also referred to asP mitrale, andright atrial enlargement is oftenreferred to as P pulmonale. What does probable left atrial enlargement mean on a EKG? - JustAnswer low voltage qrs Normal automaticity and pacemaker cells in the heart, Sinus tachycardia & Inappropriate Sinus Tachycardia. There the circle starts. The trick is to find out which came first, because the left atrial enlargement might be caused by something else. Type 1 Brugada ECG pattern (coved type) is abnormal. By clicking Accept, you consent to the use of ALL the cookies. The left atrium receives newly oxygenated blood from. Bookshelf Athlete ECGs: How to Interpret and Know When and How to Investigate Left atrial enlargement (LAE) is due to pressure or volume overload of the left atrium. border: none; BMJ 2002;324:1264. doi: 3. Difficulty breathing. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). This condition is usually harmless and does not shorten life expectancy. This is caused by too much pressure on the heart, which could be related to high blood pressure, stress, and underlying heart disease. Specific treatment for mitral valve prolapse will be determined by your doctor based on: Your tolerance for specific medications, procedures, or therapies, Expectations for the course of the disease. Echocardiographic diastolic ventricular abnormality in hypertensive heart disease: atrial emptying index. Note that patients with chronotropic incompetence may require pacemaker to increase exercise capacity and reduce symptoms. The EKG is just a guidance to help us . Connect with a U.S. board-certified doctor by text or video anytime, anywhere. poss left atrial enlargement Atrial enlargement/abnormality often accompanies ventricular enlargement. Science Photo Library / Getty Images Types Accuracy of Electrocardiography and Agreement with - Nature EKG normal sinus rhythm / possible left atrial enlargement / borderline Heart palpitations. [9] By approximating the shape of the left atrium as an ellipsoid, its volume can be calculated from measurements of its dimensions along three perpendicular directions. Surawicz B, et al. Left atrial enlargement can cause medical problems such as arrhythmias or abnormal heart rhythms. Habibi M, Samiei S, Ambale Venkatesh B, Opdahl A, Helle-Valle TM, Zareian M, Almeida AL, Choi EY, Wu C, Alonso A, Heckbert SR, Bluemke DA, Lima JA. Medications. People with rhythm disturbances may need to be treated with beta blockers or other medications to control tachycardias (fast heart rhythms). Conditions affecting the left side of the heart", "Atrial Fibrillation (for Professionals)", "Recommendations for chamber quantification", Arrhythmogenic right ventricular dysplasia, https://en.wikipedia.org/w/index.php?title=Left_atrial_enlargement&oldid=1094952349, Creative Commons Attribution-ShareAlike License 3.0, This page was last edited on 25 June 2022, at 14:45. Electrocardiogram (ECG or EKG). The P-wave in lead II may, however,be slightly asymmetric by having two humps. Moreover, the P-wavemay be slightly biphasic (diphasic) in lead V1, implying that the terminal part of the P-wave is negative (Figure 1, upper panel). Study technics (electrocardiogram, echocardiography, exercise test and Holter]. [2] LAE has been found to be correlated to body size, independent of obesity, meaning that LAE is more common in people with a naturally large body size. results read "normal sinus rhythm with sinus arrhythmia. Simple guide to reading and reporting an EKG step by step. Prognostic Significance of Left Atrial Enlargement in a General Population. For the most common type of sinus arrhythmia, the time between heartbeats can be slightly shorter or longer depending on whether you're breathing in or out. Left Atrial Enlargement on the Electrocardiogram Advertising The passage of the electrical stimulus through the atria is reflected in the electrocardiogram as the P wave. Regular checkups with a doctor are advised. The symptoms of mitral valve prolapse may resemble other medical conditions or problems. Hypertension. One or both of the flaps may not close properly, allowing the blood Advertisement cookies are used to provide visitors with relevant ads and marketing campaigns. EKG Left Atrial Enlargement l The EKG Guy - www.ekg.md Join the largest ECG community in the world at https://www.facebook.com/TheEKGGuy/Like this video and . Biatrial abnormality implies that the ECG indicates both left and right atrial enlargement; i.e a large P-wave in lead II and a large biphasic P-wave in lead V1. AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram. 43 year old female. Left atrial enlargement: Causes and more - Medical News Today Circulation. Signs and symptoms [ edit] Left atrial enlargement can be mild, moderate or severe depending on the extent of the underlying condition. The .gov means its official. Look for other features of arrhythmogenic cardiomyopathy if the preceding J-point is not elevated. Learn how we can help Answered May 14, 2022 Thank 1 thank Dr. Donald Colantino answered To confirm left atrial enlargement, the best investigation would be an ECHO. Can left atrial enlargement have symptoms? - AF Association Right Atrial Enlargement LITFL Medical Blog ECG Library Basics (P wave 2.5 mm in II and aVF). Ekg says "borderline ecg" and "probable left atrial enlargement." is Determinants of left atrial appendage volume in stroke patients without chronic atrial fibrillation. last week ecg read: Clin Cardiol. The presence of a negative final component of the P wave in lead V1 greater than 40 ms may indicate left atrial enlargement5. 2022 Nov 2;9:1006380. doi: 10.3389/fcvm.2022.1006380. Influence of Blood Pressure on Left Atrial Size. Privacy Policy. eCollection 2022. Athletes with left axis deviation or left atrial enlargement exhibited larger left atrial and ventricular dimensions compared with athletes with a normal ECG and those with other . She had an ECG taken a month back and it was normal. hospital never told me. You also have the option to opt-out of these cookies. The murmur is caused by some of the blood leaking back into the left atrium. Top answers from doctors based on your search: Created for people with ongoing healthcare needs but benefits everyone. These symptoms include: Fainting. Diego Conde D, Seoane L, et al. The duration of the P-wave will exceed 120 milliseconds in lead II. The mitral valve is located between the left atrium and the left ventricle and is composed of two flaps. T-wave inversions beyond V2 after age 16 warrants further assessment in Caucasian athletes. A pathological Q-wave (depth exceeding 25% of the height of proceeding R wave) is abnormal. Dreslinski GR, Frohlich ED, Dunn FG, Messerli FH, Suarez DH, Reisin E. Am J Cardiol. It is very common that patients with bradycardia have a strong indication for drugs that aggravate or even cause the bradycardia; in such scenarios, it is generally considered to be evidence based to implement an artificial pacemaker that will allow for drug therapy to continue. Right Atrial Enlargement (RAE) ECG Review | Learn the Heart - Healio An abnormal right axis can also occur in conditions with elevated right . Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. I'm not sure how they can tell about the left atrial enlargement from an ecg, until . Unable to load your collection due to an error, Unable to load your delegates due to an error. 13(5), 541550 (2015). Sinus bradycardia fulfills the criteria for sinus rhythm but the heart rate is slower than 50 beats per minute. The mean PR interval at birth is 107 ms (Davignon et al). Surgical Fellow Doctoral Degree 997 satisfied customers EKG said sinus tachycardia, left atrial enlargement, EKG said sinus tachycardia, left atrial enlargement, borderline report. Figure 1. [8] In any case, LAE can be diagnosed and measured using an echocardiogram (ECHO) by measuring the left atrial volume (LAVI). This is shown in Figure 1 (upper panel). Unconfirmed means a cardiologist hasn't reviewed the EKG yet. They show how a patient's heart is beating in real-time. Atrial volume index was computed using the biplane area-length method. and transmitted securely. An enlarged heart may be temporary or permanent, depending on the cause. The cause of Mitral Valve Prolapse is unknown, but is thought to be linked to heredity. LAE is often a precursor to atrial fibrillation. Atrial fibrillation is both cause and effect of left atrial enlargement, although the presence of AF on the EKG makes it difficult to determine left atrial enlargement signs, because P waves are absent4. It is mandatory to procure user consent prior to running these cookies on your website. ABC of clinical electrocardiography. Right atrial enlargement (hypertrophy) leads to stronger electrical currents and thus enhancement of the contribution of the right atrium to the P-wave. sharing sensitive information, make sure youre on a federal eCollection 2021. 2009;doi:10.1161/CIRCULATIONAHA.108.191095. Left atrial enlargement: 2016 Aug;9(8):10.1161/CIRCIMAGING.115.004299 e004299. borderline/ normal ecg flow of blood), if present at all, is generally mild. In any case, the association between interatrial block and left atrial enlargement is relatively frequent. If the left atrium encounters increased resistance (due to mitral valve stenosis, mitral valve regurgitation, hypertension, hypertrophic cardiomyopathy) it becomes enlarged (hypertrophy) which enhancesits contribution to the P-wave. AO 1.8 and ECG criteria independent of left atrial indexed diameter z-score C1: P wave duration 110msec C2 . I am guessing your doctor a You should be fine, trust your doctor, that machine reading is quite common. . doi: 10.1161/CIRCIMAGING.115.004299. J Med Assoc Thai. Atrial Fibrillation/Supraventricular Arrhythmias, Sports and Exercise and Congenital Heart Disease and Pediatric Cardiology, Revascularization for Ischemic Ventricular Dysfunction, ACC.23/WCC Opening Showcase Presidential Address: Edward T. A. Fry, MD, FACC, Personalized Pacing: A New Paradigm for Patients With Diastolic Dysfunction or Heart Failure With Preserved Ejection Fraction, Atrial Fibrillation Ablation for Heart Failure With Preserved Ejection Fraction, Findings From NCDR AFib Ablation Registry, Congenital Heart Disease and Pediatric Cardiology, Invasive Cardiovascular Angiography and Intervention, Pulmonary Hypertension and Venous Thromboembolism. These cookies track visitors across websites and collect information to provide customized ads. Borderline EKG: Your findings of low voltage QRS and borderline left atrial enlargement may not be significant, but it is worthwhile to have a cardiologist evaluate y. Right Atrial Enlargement (RAE) ECG Review | Learn the Heart - Healio In some cases, patients may experience palpitations without observed dysrhythmias (irregular heart rhythm). Common abnormal ECG readings that have a low likelihood of correlating with cardiac disease include the following: Isolated atrial enlargement, especially right atrial enlargement; Ectopic atrial rhythms*: right atrial, left atrial, wandering atrial pacemaker at normal rates; First-degree atrioventricular (AV) block; Borderline QTc 0.44-0.45 #mergeRow-gdpr fieldset label { This category only includes cookies that ensures basic functionalities and security features of the website. font: 14px Helvetica, Arial, sans-serif; Am Heart J. Chou's Electrocardiography in Clinical Practice: Adult and Pediatric, Sixth Edition, Saunders, Philadelphia, 2008. Enlarged Heart (Cardiomegaly): What It Is, Symptoms & Treatment The early repolarization pattern accompanied by concave ST segment elevation is seen in 25-40% of highly trained athletes; more common among males, black athletes and those with voltage criteria for LVH; usually seen in leads V5 and V6. For more information, please see our . Philadelphia: Elservier; 2008. I have my EKG test last night and said I have possible left atrial P-waves with constant morphology preceding every QRS complex. My EKG team recomends you the books that we used to create our website. Left Anterior Fascicular Block: Who Cares? - Healio Bayssyndrome: the association between interatrial block and supraventricular arrhythmias. P wave changes with Left Atrial Enlargement ECG Criteria for Left Atrial Enlargement 1989 Jun;117(6):1409-10. doi: 10.1016/0002-8703(89)90455-9. Bays de Luna A, Platonov P, et al. Clinical electrocardiography and ECG interpretation, Cardiac electrophysiology: action potential, automaticity and vectors, The ECG leads: electrodes, limb leads, chest (precordial) leads, 12-Lead ECG (EKG), The Cabrera format of the 12-lead ECG & lead aVR instead of aVR, ECG interpretation: Characteristics of the normal ECG (P-wave, QRS complex, ST segment, T-wave), How to interpret the ECG / EKG: A systematic approach, Mechanisms of cardiac arrhythmias: from automaticity to re-entry (reentry), Aberrant ventricular conduction (aberrancy, aberration), Premature ventricular contractions (premature ventricular complex, premature ventricular beats), Premature atrial contraction(premature atrial beat / complex): ECG & clinical implications, Sinus rhythm: physiology, ECG criteria & clinical implications, Sinus arrhythmia (respiratory sinus arrhythmia), Sinus bradycardia: definitions, ECG, causes and management, Chronotropic incompetence (inability to increase heart rate), Sinoatrial arrest & sinoatrial pause (sinus pause / arrest), Sinoatrial block (SA block): ECG criteria, causes and clinical features, Sinus node dysfunction (SND) and sick sinus syndrome (SSS), Sinus tachycardia & Inappropriate sinus tachycardia, Atrial fibrillation: ECG, classification, causes, risk factors & management, Atrial flutter: classification, causes, ECG diagnosis & management, Ectopic atrial rhythm (EAT), atrial tachycardia (AT) & multifocal atrial tachycardia (MAT), Atrioventricular nodal reentry tachycardia (AVNRT): ECG features & management, Pre-excitation, Atrioventricular Reentrant (Reentry) Tachycardia (AVRT), Wolff-Parkinson-White (WPW) syndrome, Junctional rhythm (escape rhythm) and junctional tachycardia, Ventricular rhythm and accelerated ventricular rhythm (idioventricular rhythm), Ventricular tachycardia (VT): ECG criteria, causes, classification, treatment, Long QT (QTc) interval, long QT syndrome (LQTS) & torsades de pointes, Ventricular fibrillation, pulseless electrical activity and sudden cardiac arrest, Pacemaker mediated tachycardia (PMT): ECG and management, Diagnosis and management of narrow and wide complex tachycardia, Introduction to Coronary Artery Disease (Ischemic Heart Disease) & Use of ECG, Classification of Acute Coronary Syndromes (ACS) & Acute Myocardial Infarction (AMI), Clinical application of ECG in chest pain & acute myocardial infarction, Diagnostic Criteria for Acute Myocardial Infarction: Cardiac troponins, ECG & Symptoms, Myocardial Ischemia & infarction: Reactions, ECG Changes & Symptoms, The left ventricle in myocardial ischemia and infarction, Factors that modify the natural course in acute myocardial infarction (AMI), ECG in myocardial ischemia: ischemic changes in the ST segment & T-wave, ST segment depression in myocardial ischemia and differential diagnoses, ST segment elevation in acute myocardial ischemia and differential diagnoses, ST elevation myocardial infarction (STEMI) without ST elevations on 12-lead ECG, T-waves in ischemia: hyperacute, inverted (negative), Wellen's sign & de Winter's sign, ECG signs of myocardial infarction: pathological Q-waves & pathological R-waves, Other ECG changes in ischemia and infarction, Supraventricular and intraventricular conduction defects in myocardial ischemia and infarction, ECG localization of myocardial infarction / ischemia and coronary artery occlusion (culprit), The ECG in assessment of myocardial reperfusion, Approach to patients with chest pain: differential diagnoses, management & ECG, Stable Coronary Artery Disease (Angina Pectoris): Diagnosis, Evaluation, Management, NSTEMI (Non ST Elevation Myocardial Infarction) & Unstable Angina: Diagnosis, Criteria, ECG, Management, STEMI (ST Elevation Myocardial Infarction): diagnosis, criteria, ECG & management, First-degree AV block (AV block I, AV block 1), Second-degree AV block: Mobitz type 1 (Wenckebach) & Mobitz type 2 block, Third-degree AV block (3rd degree AV block, AV block 3, AV block III), Management and treatment of AV block (atrioventricular blocks), Intraventricular conduction delay: bundle branch blocks & fascicular blocks, Right bundle branch block (RBBB): ECG, criteria, definitions, causes & treatment, Left bundle branch block (LBBB): ECG criteria, causes, management, Left bundle branch block (LBBB) in acute myocardial infarction: the Sgarbossa criteria, Fascicular block (hemiblock): left anterior & left posterior fascicular block on ECG, Nonspecific intraventricular conduction delay (defect), Atrial and ventricular enlargement: hypertrophy and dilatation on ECG, ECG in left ventricular hypertrophy (LVH): criteria and implications, Right ventricular hypertrophy (RVH): ECG criteria & clinical characteristics, Biventricular hypertrophy ECG and clinical characteristics, Left atrial enlargement (P mitrale) & right atrial enlargement (P pulmonale) on ECG, Digoxin - ECG changes, arrhythmias, conduction defects & treatment, ECG changes caused by antiarrhythmic drugs, beta blockers & calcium channel blockers, ECG changes due to electrolyte imbalance (disorder), ECG J wave syndromes: hypothermia, early repolarization, hypercalcemia & Brugada syndrome, Brugada syndrome: ECG, clinical features and management, Early repolarization pattern on ECG (early repolarization syndrome), Takotsubo cardiomyopathy (broken heart syndrome, stress induced cardiomyopathy), Pericarditis, myocarditis & perimyocarditis: ECG, criteria & treatment, Eletrical alternans: the ECG in pericardial effusion & cardiac tamponade, Exercise stress test (treadmill test, exercise ECG): Introduction, Indications, Contraindications, and Preparations for Exercise Stress Testing (exercise ECG), Exercise stress test (exercise ECG): protocols, evaluation & termination, Exercise stress testing in special patient populations, Exercise physiology: from normal response to myocardial ischemia & chest pain, Evaluation of exercise stress test: ECG, symptoms, blood pressure, heart rate, performance, Normal (physiological) causes of sinus bradycardia, Abnormal (pathological) causes of sinus bradycardia, Treatment of sinus bradycardia: general aspects of management, Algorithm for acute management of bradycardia, Permanent (long-term) treatment of bradycardia, sinus bradycardia due to infarction/ischemia, conduction defects caused byischemia and infarction.