GMCMedicine

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

Systemic Hypertension may manifest electrocardiographically in the following manner:- Electrocardiographic signs of left venticular hypertrophy due to systolic overload Electrocardiographic signs of left atrial abnormality Left Axis Deviation because of chronic systemic hypertension ECG features of Left Ventricular Hypertrophy There are deep S waves in the right oriented leads Tall R waves in the left oriented lead The sum of S wave in leads V1 and R wave in lead V6 is 50mm ECG features of Left Ventricular systolic overload There is a wide frontal plane QRS-T angle T wave is inverted in Left oriented leads

Cardiac failure is not a disease but a manifestation of underlying disease of the heart or the circulatory system. Common causes of heart failure are coronary artery disease, cardiomyopathies, valvular heart disease and hypertensive heart disease. A normal ECG is very unlikely in a patient of left ventricular dysfunction and hyas a negative predictive value of over 90% for presence of heart failure. ECG abnormalities Examples of ECGs of patients with CHF:- Electrocardiograph shows the absence of RS complexes in the precordial leads, a QS pattern in V6, and an R wave in aVR which means patient has VT. ECG … Read more

Myocarditis is an under-recognised cardiac disease which can present from asymptomatic form to acute pump failure with gross ECG changes Myocarditis causes a diffuse, but patchy involvement of myocardium including atrium, ventricles and the conducting system. ECG Presentation of Mocarditis:- 1. Abnormalities of QRS complex Increase in QRS duration Bizzare intaventricular conduction defects Pathological Q waves and loss of R wave amplitude 2. STE or STD 3. Low to inverted T waves in left oriented leads 4. AV block of first degree is more common than higher degree AV blocks 5. Prolonged QT interval 6. Arrhythmias like Sinus Tachycardia Sinus … Read more