Acquired Heart Disease

The Wolff-Parkinson-White syndrome is an electrocardiographic syndrome which is the expression of an anomalous atrioventricular conduction pathway, congenital in origin. This pathway forms a bypass which enables the supraventricular impulse to bypass the AV node, bundle of His and distal conducting system, and so activate or pre-excite the ventricles. The anomalous bypass is also known as the Bundle of Kent, is a thin filamentous structure which may be situated ectopically anywhere along the atrioventricular ring – the fibrous junction separating the atria from the ventricles. Basic ECG presentation of WPW Syndrome Other pathologies mimicked by WPW syndrome

Electrical Alternans is an electrocardiographic manifestation in which there is alternation in the amplitude of the QRS complex, the T wave alone, OR Both QRS and T wave. It often accompanies fast rates and then has no prognostic significance. When found with slow rates, it connotes organic heart disease with an adverse prognosis. Electrical Alternans may occasionally be associated with a pericardial effusion and is usually seen in midprecordial leads. Electrical Alternans does not cause a disturbance of rhythm.

Hypothermia ECG manifestations of Hypothermia are:- Development of J wave :- J wave or Junctional wave or Osborne wave is a hump-like deflection which occurs at the junction of the distal limb of the QRS complex with the ST segment. The amplitude of this deflection is proportional to the degree of hypothermia. It is consistently present when the body temperature is below 25 degree celsius. J wave is most prominent in leads oriented to the left ventricle. PR segment depression QRS prolongation ST segment depression T wave inversion QT interval prolongation Muscle tremors, which are reflected as shivering artefacts Cardiac … Read more

Digitalis Effect ECG in digitalis is manifested as:- Straight downwards slope with a sharp terminal rise like mirror image of a check or correction mark. This does not coonote toxicity and is seen in digitalis therapeutic doses. However, if the beginning of ST segment with the inverse check mark configuration is already depressed below the isoelectric level, it may then be an expression of digitalis toxicity. T wave amplitude is diminished in therapeutic doses of digitalis however, T wave becomes inverted when digitalis toxicity sets in. QT interval shortens as digitalis accelerates the recovery of the ventricular subendocardium. Paroxysmal atrial … Read more

MVP refers to a systolic billowing of one or both mitral leaflets into left atrium with or without mitral regurgitation. The prevalence of this entity is 1% to 2.5% in the population The disease can be primary or secondary in occurence. The primarry MVP syndrome is autosomal inherited while the secondary causes may be due to conditions like Coronary Artery Disease (CAD) , Acute rheumatic carditis , Hypertrophic cardiomyopathy , WPW syndrome etc. ECG features of Primary MVP syndrome:– Mostly the ECG is normal and diagnosis is dependent on clinical auscultation and Echocardiographic findings. However, some abnormalities seen in patients … Read more