I'm 68 fem ale, normal weight, swim 3hours a week, practice QiGong, read more DrKarenB Family Medicine Physician MD 373 satisfied customers Can you please read this? If drug side effects are believed to be the cause, it is fundamental to judge the risk of terminatingdrug therapy as compared with implementing an artificial pacemaker in order to be able to continue drug therapy. Disclaimer. A QTc 500 msec is suggestive of long QT syndrome. ECG criteria for left (LAE) and right atrial enlargement (RAE) were compared to CMR atrial volume index measurements for 275 consecutive subjects referred for CMR (67% males, 51 14 years). Support stockings may be beneficial. While left atrial enlargement can cause chest pain and breathing problems, alerting you to the dangerous condition, right atrial enlargement usually develops with no symptoms at all. Heart hypertrophy as a risk factor. We are vaccinating all eligible patients. 43 year old female. Possible left atrial enlargement is a nonspecific finding which is commonly seen in 12 lead EKG. [1] Also, a study found that LAE can occur as a consequence of atrial fibrillation (AF),[3] although another study found that AF by itself does not cause LAE. worrisome? 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. Left Atrial Enlargement on the Electrocardiogram - My EKG Interpretation of neonatal and pediatric electrocardiograms (ECG) The negative deflection of biphasic (diphasic) P-waves is generally <1 mm deep. The duration of the P-wave will exceed 120 milliseconds in lead II. poss left atrial enlargement Also known as: Left Atrial Enlargement (LAE), Left atrial hypertrophy (LAH), left atrial abnormality. It is mandatory to procure user consent prior to running these cookies on your website. New York, NY A 29-year-old female asked: Ekg says "borderline ecg" and "probable left atrial enlargement." is this anything of concern? is this anything of concern? } normal sinus rhythm The atria may become dilated and/or hypertrophic during pathological circumstances. Usually the chest pain is not like classic angina, but can be recurrent and incapacitating. High blood pressure and blood volume cause right atrial enlargement. The Framingham Heart Study. Left atrial enlargement (LAE) is when the upper left part of your heartone of the heart's four chambers is larger than it should be. worrisome? The P-wave amplitude is >2.5 mm in P pulmonale. Privacy Policy. Left Atrial Enlargement (LAE) ECG Review | Learn the Heart - Healio Echo 2005 normal for structure issues. PMC The following are the most common symptoms of Mitral Valve Prolapse. The mitral valve is located between the left atrium and the left ventricle and is composed of two flaps. 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. If atrial fibrillation or severe left atrial enlargement is present, treatment with an anticoagulant may be recommended. Based on a work athttps://litfl.com. The following are key points from his talk: Clinical Topics: Arrhythmias and Clinical EP, Congenital Heart Disease and Pediatric Cardiology, Heart Failure and Cardiomyopathies, Sports and Exercise Cardiology, Implantable Devices, EP Basic Science, Genetic Arrhythmic Conditions, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, Congenital Heart Disease, CHD and Pediatrics and Arrhythmias, CHD and Pediatrics and Prevention, Sports and Exercise and Congenital Heart Disease and Pediatric Cardiology, Keywords: Sports, Athletes, Brugada Syndrome, Bundle-Branch Block, Torsades de Pointes, Hypertrophy, Left Ventricular, Atrioventricular Block, Hypertrophy, Right Ventricular, Atrial Fibrillation, Bradycardia, Depression, Electrocardiography, Cardiomyopathies, Long QT Syndrome, Syncope, Physical Examination, Diabetes Mellitus, Type 2. These symptoms include: Fainting. The most important causes are as follows: Figure 1 shows sinus bradycardia at paper speed 25 mm/s. The click or murmur may be the only clinical sign. A test that is performed while a patient walks on a treadmill to monitor the heart during exercise. These cookies help provide information on metrics the number of visitors, bounce rate, traffic source, etc. Unconfirmed means a cardiologist hasn't reviewed the EKG yet. A test that records the electrical activity of the heart, shows abnormal rhythms (arrhythmias or dysrhythmias), and can sometimes detect heart muscle damage. You also have the option to opt-out of these cookies. Hypertension. Left Atrial Enlargement LITFL Medical Blog ECG Library Basics Breathing and blood pressure rates are also monitored. By accepting all cookies, you agree to our use of cookies to deliver and maintain our services and site, improve the quality of Reddit, personalize Reddit content and advertising, and measure the effectiveness of advertising. Dreslinski GR, Frohlich ED, Dunn FG, Messerli FH, Suarez DH, Reisin E. Am J Cardiol. Federal government websites often end in .gov or .mil. I'm not sure how they can tell about the left atrial enlargement from an ecg, until . When the bradycardia causes hemodynamic symptoms it should be treated. Before Bookshelf official website and that any information you provide is encrypted Right atrial enlargement (hypertrophy) leads to stronger electrical currents and thus enhancement of the contribution of the right atrium to the P-wave. The site is secure. In addition, the function of the heart and the valves may be assessed. Always consult your doctor for a diagnosis. Vaziri SM, Larson MG, Lauer MS, et al. 1995; 25: 1155-1160. doi: 4. We also use third-party cookies that help us analyze and understand how you use this website. ecg read: Appointments 800.659.7822. For example, because of the smaller distance in the thoracic cavity between the sternum and spine, compared to the other directions, less room exists for enlargement of the left atrium along the anteroposterior axis. The presence of a negative final component of the P wave in lead V1 greater than 40 ms may indicate left atrial enlargement5. Aortic insufficiency generates left cavities overload propitiating left atrial and left ventricular enlargement. What does probable left atrial enlargement mean on a EKG? - JustAnswer The Diagnostic Yield of Routine Electrocardiography in Hypertension and Implications for Care in a Southwestern Nigerian Practice. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. EKG normal sinus rhythm / possible left atrial enlargement / borderline ECG - having chest and neck pressure (no pain) - can't get me in for an echo for 3 weeks. Note that patients with chronotropic incompetence may require pacemaker to increase exercise capacity and reduce symptoms. These ECG changes, including T-wave inversions, can often return to normal with detraining (see below ECGs); outside the context of age <16 years and black ethnicity, T wave inversions beyond V2 should be investigated. hospital never told me. Look for other features of arrhythmogenic cardiomyopathy if the preceding J-point is not elevated. In the next few weeks, we will post summaries of key sessions written by cardiology Fellows-in-Training (FIT). References: Sinus bradycardia fulfills the criteria for sinus rhythm but the heart rate is slower than 50 beats per minute. 2014 Mar 4;9(3):e90903. 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 routine diagnostic cardiac catheterization for echocardiographic left atrial enlargement. The left atrium receives newly oxygenated blood from. Mitral valve prolapse may not cause any symptoms. This website uses cookies to improve your experience while you navigate through the website. If your health care provider thinks you have left ventricular hypertrophy, imaging tests may be done to look at the heart. All patients had normal coronary arteriography, sinus rhythm, normal left ventricular volumes and function, no valvular disease, and no echocardiographic or ECG left ventricular hypertrophy. 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. She had an ECG taken a month back and it was normal. Palpitations (sensation of fast or irregular heart beat) are the most common complaint among patients with Mitral Valve Prolapse. As the left atrium depolarizes after the right atrium, an enlargement thereof will cause a longer duration of the depolarization time and therefore a widening of the Pwave, greater than 0.12s. Sometimes the right and left component of the Pwave are separated slightly giving the Pwave a form of "letterm" lower case, classically called Pmitrale. Characterizing the size of the left atrium according to its volume is preferred over a single linear dimension since enlargement can be different for different directions. The values for volume/BSA in the following table are the best validated, and are the same for both men and women.[9]. 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. Signs and symptoms [ edit] Left atrial enlargement can be mild, moderate or severe depending on the extent of the underlying condition. Study technics (electrocardiogram, echocardiography, exercise test and Holter]. Obesity has also been related to left atrial enlargement, although the mechanism is not very clear2. left ventricular hypertrophy is clearly related to the left atrial enlargement, so those causes that cause LVH as hypertension, aortic stenosis or hypertrophic cardiomyopathy can lead to left atrial enlargement. Right Atrial Enlargement LITFL Medical Blog ECG Library Basics Doctors typically provide answers within 24 hours. background: #fff; The reasons for this are explained below. Connect with a U.S. board-certified doctor by text or video anytime, anywhere. Conditions affecting the left side of the heart. In all other situations it is necessary to findthe underlyingcauseand direct treatments towards it. Determinants of left atrial appendage volume in stroke patients without chronic atrial fibrillation. Secondary Mitral Valve Prolapse may result from damage to valvular structures during acute myocardial infarction, rheumatic heart disease, or hypertrophic cardiomyopathy (occurs when the muscle mass of the left ventricle of the heart is larger than normal). T wave inversions in contiguous inferior leads or lateral leads warrant investigation in all athletes. People with rhythm disturbances may need to be treated with beta blockers or other medications to control tachycardias (fast heart rhythms). These drugs reduce the amount of sodium and water in the body, which can help lower blood pressure. . Barlow's syndrome, balloon mitral valve, or floppy valve syndrome, Dr. Jerome Zacks answered. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. The negative intrathoracic pressure may cause the left atrium to expand and stretch its walls during each OSA event. These symptoms include weakness, fatigue, and shortness of breath. 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 . Unauthorized use of these marks is strictly prohibited. Left atrial enlargement can be mild, moderate or severe depending on the extent of the underlying condition. LAE is suggested by an electrocardiogram (ECG) that has a pronounced notch in the P wave. Learn how we can help 290 views Answered >2 years ago Thank A 36-year-old female asked: In addition to a complete medical history and physical examination, diagnostic procedures for Mitral Valve Prolapse may include any, or a combination, of the following: Electrocardiogram (ECG or EKG). [8] In any case, LAE can be diagnosed and measured using an echocardiogram (ECHO) by measuring the left atrial volume (LAVI). Congenital Heart Disease and Pediatric Cardiology, Invasive Cardiovascular Angiography and Intervention, Pulmonary Hypertension and Venous Thromboembolism, ACC Anywhere: The Cardiology Video Library, CardioSource Plus for Institutions and Practices, Annual Scientific Session and Related Events, ACC Quality Improvement for Institutions Program, National Cardiovascular Data Registry (NCDR). This difference is more striking in the lead V1 where the Pwave has a biphasic morphology, with a first positive component (right atrium) and a second negative component (left atrium)1. borderline/ normal ecg Cardiology 53 years experience. Left atria is one of the chamber of heart out of four chambers its situated above left ventricle it takes oxygenated blood from lungs and forward it to left ventrical so if the left atrial is enlarged it is most commonly in association with diastolic dysfunction, left ventricular hypertrophy, mitral valvular disease, and systemic hypertension. 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 . Left atrial enlargement , r-axis -57 This is often (but not always) seen on ordinary ECG tracings and it is explained by the fact that the atria are depolarized sequentially, with the right atrium being depolarized before the left atrium. It is estimated that mitral valve prolapse occurs in around 3 [3], Indexing the left atrial volume to body surface area (volume/BSA) is recommended by the American Society of Echocardiography and the European Association of Echocardiography. If atrial fibrillation or severe left atrial enlargement is present, treatment with an anticoagulant may be recommended. Its not uncommon to discover SB in healthy young individuals who are not well-trained. The amplitude of the normal P-wave does not exceed 2.5 mm in anylimb lead. ECG Criteria of Right Atrial Enlargement. The Septal Q wave can hint on a possible left sided disease if any. Ecg borderline left atrial abnormality - Practo } Electrocardiogram (ECG) This imaging test records the electrical actions of the heart, including the speed of the heartbeats. Int J Mol Sci. However, each individual may experience symptoms differently. Dr. Sanjay Sharma, co-senior author of the International Recommendations for ECG Interpretation in Athletes, reviewed his approach to the Athlete's ECG. . BMJ 2002;324:1264. doi: 3. Left atrial enlargement - Wikipedia By using our website, you consent to our use of cookies. These cookies track visitors across websites and collect information to provide customized ads. Electrocardiogram (ECG or EKG). Left ventricular hypertrophy - Diagnosis and treatment - Mayo Clinic People with Mitral Valve Prolapse often have no symptoms and detection of a click or murmur may be discovered during a routine examination. Science Photo Library / Getty Images Types percent of the population. Your heart rate increases when you breathe in and slows down when you breathe out. There are numerous pathological conditions that cause sinus bradycardia. The P-wave in lead II may, however,be slightly asymmetric by having two humps. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). It was normal or at least not concerning. at home i saw that it said possible left atrial enlargement but dr said nothing about this. Preference cookies are used to store user preferences to provide content that is customized and convenient for the users, like the language of the website or the location of the visitor. Left atrial enlargement (LAE) or left atrial dilation refers to enlargement of the left atrium (LA) of the heart, and is a form of cardiomegaly . On this Wikipedia the language links are at the top of the page across from the article title. eCollection 2021. 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. Learn how we can help Answered May 14, 2022 Thank 1 thank Dr. Donald Colantino answered Type 1 Brugada ECG pattern (coved type) is abnormal. The interatrial block pattern presents a Pwave widening that is frequently bimodal, which often leads to interpretation as left atrial enlargement, but these two electrocardiographic patterns are two different entities5. Primary and secondary forms of Mitral Valve Prolapse are described below. The overflow capacity of attendees and number of live streaming participants exceeded 220 in total. Alterations of the mitral valve are the classic causes of left atrial enlargement, both mitral stenosis due to increased pressure, and mitral insufficiency due to volume increase. Left atrial enlargement can cause medical problems such as arrhythmias or abnormal heart rhythms. still having mild vertigo, dizziness and fatigue. Regular checkups with a doctor are advised. Echocardiogram This imaging technique uses sound waves to project a. eCollection 2022. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. Borderline left atrial enlargement | HealthTap Online Doctor Related article: Bays syndrome and interatrial blocks. By rejecting non-essential cookies, Reddit may still use certain cookies to ensure the proper functionality of our platform. There the circle starts. Undefined cookies are those that are being analyzed and have not been classified into a category as yet. [Heart effect of arterial hypertension. Interatrial blocks. Video chat with a U.S. board-certified doctor 24/7 in less than one minute for common issues such as: colds and coughs, stomach symptoms, bladder infections, rashes, and more. In secondary Mitral Valve Prolapse, the flaps are not thickened. As it is to be supposed, the dilation of the Left Atrium produces, in most cases, changes in the Pwave, especially in its final component. flow of blood), if present at all, is generally mild. The second hump in lead II becomes larger and the negative deflection in V1 becomes deeper. 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 You took a b complex viramin then felt ill and went to ED. RBBB is considered a borderline criterion. What are the symptoms of left atrial enlargement? 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. Your heart may be unusually thick or dilated (stretched). normal sinus rhythm Congenital Heart Disease and Pediatric Cardiology. 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. Left Atrial Enlargement: Seen a cardiologistecg normal apart from possible left atrial enlargement, no further tests done and discharged.please advise? need cardio follow up? Enlargement of the left and right atria causes typical P-wave changes in lead II and lead V1 (Figure 1, second and third panel). . The normal Pwave measures less than 2.5mm (0.25mV) in height and less than 0.12s in length (3small squares). Cookie Notice 8600 Rockville Pike Left atrial enlargement can develop too, resulting in problems with how blood is pumped out to the body. LAE is often a precursor to atrial fibrillation. Primary Mitral Valve Prolapse is distinguished by thickening of one or both valve flaps. Conditions affecting the left side of the heart, Electrocardiography in Emergency, Acute, and Critical Care, Critical Decisions in Emergency and Acute Care Electrocardiography, Chous Electrocardiography in Clinical Practice: Adult and Pediatric, Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, Bifid P wave with > 40 ms between the two peaks, Biphasic P wave with terminal negative portion > 40 ms duration, Biphasic P wave with terminal negative portion > 1mm deep, Broad (>110ms), bifid P wave in lead II (P mitrale) with > 40ms between the peaks. A QTc >470 msec in males or >480 msec in females is abnormal especially if there is T-wave notching or paradoxical prolongation of the QT interval with exercise. An official website of the United States government. By clicking Accept, you consent to the use of ALL the cookies. results read "normal sinus rhythm with sinus arrhythmia. An enlarged heart (cardiomegaly) describes a heart that's bigger than what is typical. Ecg done and dr said everything was normal. The unusual 'P'wave is common in cases of left atrial enlargement. ECG criteria follows: Sinus bradycardia (SB) is considered a normal finding in the following circumstances: In all other situations, sinus bradycardia should be regarded as a pathological finding. Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. Surawicz B, et al. 2014 Mar;97 Suppl 3:S132-8. 2023 American College of Cardiology Foundation. [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. Mechanism of left atrial enlargement related to ventricular diastolic impairment in hypertension. When in doubt whether the bradycardia is physiological, it is useful to perform a Holter ECG (ambulatory recording). 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. This is a noninvasive test that produces comprehensive images of the heart. Left atrial enlargement: ECG criteria for LAE and RAE were assessed by an expert observer blinded to CMR data. 13(5), 541550 (2015). This is caused by too much pressure on the heart, which could be related to high blood pressure, stress, and underlying heart disease. This is also a normal finding. What does sinus rhythm possible right atrial enlargement borderline left axis deviation borderline ecg unconfirmed report mean? Ther. Left atrial enlargement (LAE) is due to pressure or volume overload of the left atrium. Primary Mitral Valve Prolapse. font-weight: normal; Is Borderline ECG Dangerous? Understanding Your ECG Reports - Ayu Health A pathological Q-wave (depth exceeding 25% of the height of proceeding R wave) is abnormal. An axis of 57 degrees is not a 'ri Had an ecg that showed borderline abnormal, possible left atrial enlargement. 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. Normal automaticity and pacemaker cells in the heart, Sinus tachycardia & Inappropriate Sinus Tachycardia. Healthy lifestyle behaviors and regular exercise are encouraged. To learn more, please visit our. Learn more: Vaccines, Boosters & Additional Doses | Testing | Patient Care | Visitor Guidelines | Coronavirus. Blood and urine tests may be done to check for conditions that affect heart health. Bombelli M, Facchetti R, Cuspidi C et al. EKG normal sinus rhythm / possible left atrial enlargement / borderline This rule does not apply to aVL. Top answers from doctors based on your search: Created for people with ongoing healthcare needs but benefits everyone. Left atrial enlargement is also referred to asP mitrale, andright atrial enlargement is oftenreferred to as P pulmonale. borderline/ normal ecg doi: 10.1371/journal.pone.0090903. This category only includes cookies that ensures basic functionalities and security features of the website. Analytical cookies are used to understand how visitors interact with the website. } #mergeRow-gdpr { Right atrial enlargement means your heart has an abnormally large right atrium. } 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.