# Docs

- Books
  - [Knowledge base](/docs/books): Every chapter from all eight teaching books on ECG, echocardiography, CPR and cardiovascular medicine — searchable and filterable by book and section.
  - Basic Cardiac Anatomy & Physiology
    - [Basic Cardiac Anatomy & Physiology](/docs/books/ecg-video-course): In this course you will learn about cardiac physiology, anatomy and the principles of electrocardiography.
    - [Basic cardiac anatomy](/docs/books/ecg-video-course/basic-cardiac-anatomy-anatomy-of-the-heart): Basic cardiac anatomy
    - [Introduction to Electrocardiology and ECG Interpretation](/docs/books/ecg-video-course/introduction-to-electrocardiology-and-ecg-interpretation): Introduction to Electrocardiology and ECG Interpretation
    - [Cardiac electrophysiology: action potentials and electrical vectors](/docs/books/ecg-video-course/ecg-cardiac-electrophysiology-action-potentials-and-electrical-vectors): Cardiac electrophysiology: action potentials and electrical vectors
  - The Normal ECG: From Normality to Pathology
    - [The Normal ECG: From Normality to Pathology](/docs/books/the-normal-ecg-normal-findings-normal-variants-pathology): In the second part of the course you will learn all about the normal ECG, normal variants and diagnosis of pathological findings. A total of 8 lessons will guide you through all…
    - [Approach to ECG Interpretation, Assessment of Rhythm and the P-wave](/docs/books/the-normal-ecg-normal-findings-normal-variants-pathology/approach-to-ecg-interpretation-assessment-of-rhythm-and-the-p-wave): Approach to ECG Interpretation, Assessment of Rhythm and the P-wave
    - [The PR Interval & PR segment](/docs/books/the-normal-ecg-normal-findings-normal-variants-pathology/the-pr-interval-pr-segment): The PR interval stretches from the onset of the P-wave to the onset of the QRS complex. It reflects the time interval from start of atrial activation…
    - [The QRS Complex: Q-wave, R-wave, S-wave, R-wave progression](/docs/books/the-normal-ecg-normal-findings-normal-variants-pathology/the-qrs-complex-q-wave-r-wave-s-wave-r-wave-progression): The QRS Complex: Q-wave, R-wave, S-wave, R-wave progression
    - [The ST segment: J-point, J-60 point, ST depression, ST elevation](/docs/books/the-normal-ecg-normal-findings-normal-variants-pathology/the-st-segment-j-point-j-60-point-st-depression-st-elevation): The ST segment: J-point, J-60 point, ST depression, ST elevation
    - [The T-wave: T-wave inversions, hyperacute T-waves, large T-waves, flat T-waves](/docs/books/the-normal-ecg-normal-findings-normal-variants-pathology/the-t-wave-t-wave-inversions-hyperacute-t-waves-large-t-waves-flat-t-waves): The T-wave: T-wave inversions, hyperacute T-waves, large T-waves, flat T-waves
    - [The QT and QTc Interval](/docs/books/the-normal-ecg-normal-findings-normal-variants-pathology/the-qt-and-qtc-interval): The QT and QTc Interval
    - [The Electrical Axis of the Heart](/docs/books/the-normal-ecg-normal-findings-normal-variants-pathology/the-electrical-axis-of-the-heart): The Electrical Axis of the Heart
  - Clinical ECG Interpretation
    - [Clinical ECG Interpretation](/docs/books/the-ecg-book): The ECG book is a comprehensive e-book, covering all aspects of clinical ECG interpretation, and will take you from cell to bedside.
    - Introduction to ECG Interpretation
      - [Introduction to ECG Interpretation](/docs/books/the-ecg-book/introduction-to-ecg-interpretation-2): Chapters in Introduction to ECG Interpretation.
      - [Cardiac electrophysiology and ECG interpretation](/docs/books/the-ecg-book/introduction-to-ecg-interpretation-2/introduction-electrocardiography-ecg-book): To ensure effective cardiac pumping function, the atria and the ventricles must be activated rapidly and sequentially. Rapid activation is important in…
      - [Cardiac electrophysiology: Action potential, automaticity and vectors](/docs/books/the-ecg-book/introduction-to-ecg-interpretation-2/cardiac-electrophysiology-ecg-action-potential-automaticity-vector): The following video lecture summarises this chapter.
      - [The ECG leads: Electrodes, limb leads, chest (precordial) leads and the 12-Lead ECG](/docs/books/the-ecg-book/introduction-to-ecg-interpretation-2/ekg-ecg-leads-electrodes-systems-limb-chest-precordial): Before discussing the ECG leads and various lead systems, we need to clarify the difference between ECG leads and ECG electrodes. An electrode is a…
      - [The Cabrera format of the 12-lead ECG and inverted lead aVR](/docs/books/the-ecg-book/introduction-to-ecg-interpretation-2/12-lead-ecg-cabrera-format-inverting-lead-avr): Numerous conditions that can be diagnosed using the 12-lead ECG require that ECG changes occur in two or more anatomically contiguous leads, which implies…
      - [ECG interpretation: Characteristics of the normal ECG (P-wave, QRS complex, ST segment, T-wave)](/docs/books/the-ecg-book/introduction-to-ecg-interpretation-2/ecg-normal-p-wave-qrs-complex-st-segment-t-wave-j-point): This is arguably one of the most important chapters throughout this course. At the heart of ECG interpretation lies the ability to determine whether the ECG…
      - [How to interpret the ECG: A systematic approach](/docs/books/the-ecg-book/introduction-to-ecg-interpretation-2/systematic-clinical-ecg-interpretation-review-guide): The ECG must always be interpreted systematically. Failure to perform a systematic interpretation of the ECG may be detrimental. The interpretation…
    - Arrhythmias and arrhythmology
      - [Arrhythmias and arrhythmology](/docs/books/the-ecg-book/arrhythmias-and-arrhythmology): Chapters in Arrhythmias and arrhythmology.
      - [Mechanisms of cardiac arrhythmias: from automaticity to re-entry (reentry)](/docs/books/the-ecg-book/arrhythmias-and-arrhythmology/mechanisms-cardiac-arrhythmias-automaticity-reentry-triggered-activity): This section introduces the most common arrhythmias encountered in clinical practice, beginning with a discussion of the underlying mechanisms of cardiac…
      - [Aberrant ventricular conduction (aberrancy, aberration)](/docs/books/the-ecg-book/arrhythmias-and-arrhythmology/aberrant-ventricular-conduction-aberrancy): Aberrant conduction is not a mechanism of arrhythmia; it is a ventricular conduction disturbance. It is discussed in this chapter because the phenomenon is…
      - [Premature ventricular contractions (premature ventricular complex, premature ventricular beats)](/docs/books/the-ecg-book/arrhythmias-and-arrhythmology/premature-ventricular-contractions-complex-beats-ecg): Premature ventricular complexes are also referred to as premature ventricular beats, premature ventricular contractions or just ventricular…
      - [Premature atrial contraction (premature atrial beat / complex): ECG and clinical implications](/docs/books/the-ecg-book/arrhythmias-and-arrhythmology/premature-atrial-contraction-beat-complex): A premature atrial contraction is produced by an impulse discharged from an ectopic focus located anywhere in the atria. In most cases, the premature atrial…
      - [Sinus rhythm: physiology, ECG criteria & clinical implications](/docs/books/the-ecg-book/arrhythmias-and-arrhythmology/normal-sinus-rhythm-ecg-criteria-sinoatrial-node): A rhythm is defined as three consecutive heartbeats with identical waveforms on the ECG. The similarity of the waveforms indicates that the origin of the…
      - [Sinus arrhythmia (respiratory sinus arrhythmia)](/docs/books/the-ecg-book/arrhythmias-and-arrhythmology/sinus-arrhythmia-respiratory-ecg-cause-criteria): Sinus arrhythmia and respiratory sinus arrhythmia both refer to the same phenomenon. Sinus arrhythmia fulfill all criteria for sinus rhythm except from the…
      - [Sinus bradycardia: definitions, ECG, causes and management](/docs/books/the-ecg-book/arrhythmias-and-arrhythmology/sinus-bradycardia-ecg-causes-treatment): Sinus bradycardia fulfills the criteria for sinus rhythm but the heart rate is slower than 50 beats per minute. ECG criteria follow:
      - [Chronotropic incompetence (inability to increase heart rate)](/docs/books/the-ecg-book/arrhythmias-and-arrhythmology/chronotropic-incompetence-ecg-ekg): Chronotropic incompetence is an independent predictor of overall and cardiovascular mortality. The condition is very common among individuals with heart…
      - [Sinoatrial arrest & sinoatrial pause (sinus pause / arrest)](/docs/books/the-ecg-book/arrhythmias-and-arrhythmology/sinoatrial-arrest-sinoatrial-pause-sinus): A sinoatrial arrest occurs when the sinoatrial node does not discharge an impulse for ≥2 seconds. Failure to discharge an impulse within <2 seconds is…
      - [Sinoatrial block (SA block): ECG criteria, causes and clinical features](/docs/books/the-ecg-book/arrhythmias-and-arrhythmology/sinoatrial-block-sa-criteria-ecg-causes-management): Sinoatrial SA block implies that the impulses discharged in the sinoatrial node are either not conducted to the atria or are so with a delay. This manifests…
      - [Sinus node dysfunction (SND) and sick sinus syndrome (SSS)](/docs/books/the-ecg-book/arrhythmias-and-arrhythmology/sinus-node-dysfunction-snd-sick-sinus-syndrome-sss): Sinus node dysfunction is an umbrella term for conditions that either affect the automaticity of the sinoatrial node or block the impulse from reaching the…
      - [Sinus tachycardia & Inappropriate sinus tachycardia](/docs/books/the-ecg-book/arrhythmias-and-arrhythmology/sinus-tachycardia-causes-ecg-inappropriate-management): Sinus tachycardia is the most common tachyarrhythmia tachycardia. Sinus tachycardia is the result of an increased rate of depolarization i.e increased…
      - [Atrial fibrillation: ECG, classification, causes, risk factors & management](/docs/books/the-ecg-book/arrhythmias-and-arrhythmology/atrial-fibrillation-ecg-ekg-causes-classification-management): Atrial fibrillation is the most common abnormal tachyarrhythmia only sinus tachycardia is…
      - [Atrial flutter: classification, causes, ECG criteria and management](/docs/books/the-ecg-book/arrhythmias-and-arrhythmology/atrial-flutter-ecg-treatment-management): Atrial flutter is the second most common pathological tachyarrhythmia. Only atrial fibrillation is more common.…
      - [Ectopic atrial rhythm (EAT), atrial tachycardia (AT) & multifocal atrial tachycardia (MAT)](/docs/books/the-ecg-book/arrhythmias-and-arrhythmology/ectopic-atrial-rhythm-multifocal-tachycardia-multifocal): Ectopic atrial tachycardia EAT, or atrial tachycardia arises when an ectopic focus within the atria generates electrical impulses at a rate exceeding that…
      - [Atrioventricular nodal reentry tachycardia (AVNRT): ECG features & management](/docs/books/the-ecg-book/arrhythmias-and-arrhythmology/av-atrioventricular-nodal-reentrant-tachyarrrhythmia-reentry): Atrioventricular nodal reentrant tachycardia AVNRT is a common tachyarrhythmia observed across all age groups, from children to the elderly, and frequently…
      - [Pre-excitation, Atrioventricular Reentrant (Reentry) Tachycardia (AVRT), Wolff-Parkinson-White (WPW) syndrome](/docs/books/the-ecg-book/arrhythmias-and-arrhythmology/pre-excitation-avrt-wolff-parkinson-white-wpw-syndrome): The atrioventricular node and bundle of His are normally the only communication between the atria and the ventricles. The atrial impulse must pass through…
      - [Junctional rhythm (escape rhythm) and junctional tachycardia](/docs/books/the-ecg-book/arrhythmias-and-arrhythmology/junctional-rhythm-junctional-tachycardia): In this article, you will learn about rhythms arising in, or near, the atrioventricular AV node. The most common rhythm arising in the AV node is…
      - [Ventricular rhythm and accelerated ventricular rhythm (idioventricular rhythm)](/docs/books/the-ecg-book/arrhythmias-and-arrhythmology/ventricular-rhythm-and-accelerated-ventricular-rhythm-idioventricular-rhythm): This article provides an overview of ventricular rhythm and accelerated ventricular rhythm, the latter also known as idioventricular rhythm. Recognizing…
      - [Ventricular tachycardia (VT): ECG criteria, causes, classification, treatment](/docs/books/the-ecg-book/arrhythmias-and-arrhythmology/ventricular-tachycardia-vt-ecg-treatment-causes-management): This chapter deals with ventricular tachycardia from a clinical perspective, with emphasis on ECG diagnosis, definitions, management, and clinical…
      - [Long QT (QTc) interval, long QT syndrome (LQTS) & torsades de pointes](/docs/books/the-ecg-book/arrhythmias-and-arrhythmology/longt-qt-syndrome-interval-lqts-torsades-de-pointes): The QT interval is the time interval from the beginning of the QRS complex to the end of the T-wave. This interval represents the total time taken to…
      - [Ventricular fibrillation, pulseless electrical activity and sudden cardiac arrest](/docs/books/the-ecg-book/arrhythmias-and-arrhythmology/ventricular-fibrillation-pulseless-electrical-activity-sudden-cardiac-arrest): This chapter will focus on ventricular fibrillation and pulseless electrical activity PEA. These are highly lethal arrhythmias that lead to death if…
      - [Pacemaker-mediated tachycardia (PMT): ECG and management](/docs/books/the-ecg-book/arrhythmias-and-arrhythmology/pacemaker-medicate-tachycardia): Pacemaker-mediated tachycardia may arise if the pacemaker records a rapid atrial rate e.g. during a supraventricular tachycardia and stimulates the…
      - [Diagnosis and management of supraventricular and ventricular tachyarrhythmias: Narrow complex tachycardia & wide complex tachycardia](/docs/books/the-ecg-book/arrhythmias-and-arrhythmology/diagnosis-management-tachycardia-tachyarrhythmia-wide-narrow): All clinically significant supraventricular and ventricular tachyarrhythmias have been reviewed in previous sections. However, given that each arrhythmia…
    - Myocardial Ischemia & Infarction
      - [Myocardial Ischemia & Infarction](/docs/books/the-ecg-book/myocardial-ischemia-infarction): Chapters in Myocardial Ischemia & Infarction.
      - [Introduction to Coronary Artery Disease (Ischemic Heart Disease)](/docs/books/the-ecg-book/myocardial-ischemia-infarction/coronary-artery-disease-ischemic-ecg-risk-factors-atherosclerosis): Coronary artery disease, which is synonymous with ischemic heart disease, is the most common form of cardiovascular disease. It has been the number one…
      - [Classification of Acute Coronary Syndromes (ACS) & Acute Myocardial Infarction (AMI)](/docs/books/the-ecg-book/myocardial-ischemia-infarction/acute-coronary-syndromes-acs-myocardial-infarction-ami): Acute coronary syndromes occur when atherosclerotic plaques disrupt, resulting in the activation of thrombocytes and coagulation factors causing the…
      - [A New Approach to Acute Coronary Syndromes: Occlusion MI (OMI) vs. Non-Occlusion MI (NOMI)](/docs/books/the-ecg-book/myocardial-ischemia-infarction/a-new-approach-to-acute-coronary-syndromes-occlusion-mi-omi-vs-non-occlusion-mi-nomi): The traditional classification of acute coronary syndromes ACS into ST-segment elevation myocardial infarction STEMI, non-STEMI NSTEMI, and unstable angina…
      - [Clinical application of ECG in chest pain & acute myocardial infarction](/docs/books/the-ecg-book/myocardial-ischemia-infarction/ecg-chest-pain-acute-myocardial-infarction-coronary-syndrome): An ECG must be performed on all patients seeking medical attention due to chest discomfort or other symptoms that may be caused by myocardial ischemia.…
      - [Diagnostic Criteria for Acute Myocardial Infarction: Cardiac troponins, ECG & Symptoms](/docs/books/the-ecg-book/myocardial-ischemia-infarction/diagnostic-criteria-acute-myocardial-infarction-troponins-ecg-symptoms): Acute myocardial infarction is the most severe complication of coronary artery disease. The most common initiating mechanism is rupture or erosion of a…
      - [Cardiac troponin I (TnI) and T (TnT): Interpretation and evaluation in acute coronary syndromes](/docs/books/the-ecg-book/myocardial-ischemia-infarction/cardiac-troponin-i-tni-and-t-tnt-interpretation-and-evaluation-in-acute-coronary-syndromes): Troponin is a protein complex expressed in cardiac and skeletal muscle. The complex consists of troponin I TnI, troponin C TnC and troponin T TnT, which…
      - [Myocardial Ischemia & infarction: Cellular changes, ECG and symptoms](/docs/books/the-ecg-book/myocardial-ischemia-infarction/myocardial-ischemia-infarction-reaction-ecg-changes-symptoms): Like all other cells in the human body, cardiac myocytes use ATP adenosine triphosphate as the primary energy source. ATP is produced by metabolizing…
      - [The left ventricle in myocardial ischemia and infarction](/docs/books/the-ecg-book/myocardial-ischemia-infarction/left-ventricle-ischemia-acute-myocardial-infarction-coronary-artery): Myocardial infarction is virtually synonymous with left ventricular infarction. All myocardial infarctions affect the left ventricle. Right ventricular…
      - [Factors that modify the natural course in acute myocardial infarction (AMI)](/docs/books/the-ecg-book/myocardial-ischemia-infarction/factors-modify-course-acute-myocardial-infarction-infarct-size-ami): The traditional distinction between NSTE-ACS NSTEMI,…
      - [ECG in myocardial ischemia: ischemic changes in the ST segment & T-wave](/docs/books/the-ecg-book/myocardial-ischemia-infarction/ecg-myocardial-ischemia-ischemic-changes-st-segment-t-wave): This chapter discusses typical and atypical changes in the ST segment and the T-wave during myocardial ischemia. A thorough discussion of the…
      - [ST segment depression in myocardial ischemia and differential diagnoses](/docs/books/the-ecg-book/myocardial-ischemia-infarction/ecg-st-segment-depression-ischemia-infarction-differential-diagnoses): ST segment depressions caused by ischemia are characterized by a horizontal or downsloping ST segment. Indeed, North American and European guidelines assert…
      - [ST segment elevation in acute myocardial ischemia and differential diagnoses](/docs/books/the-ecg-book/myocardial-ischemia-infarction/ecg-st-elevation-segment-ischemia-myocardial-infarction-stemi): ST segment elevations with straight horizontal, upsloping, or downsloping or convex ST segment strongly suggest acute transmural ischemia Figure 1 A.…
      - [ST elevation myocardial infarction (STEMI) without ST elevations on 12-lead ECG](/docs/books/the-ecg-book/myocardial-ischemia-infarction/stemi-without-st-elevations-ecg-posterior-posterolateral): This chapter covers situations in which the 12-lead ECG does not exhibit ST…
      - [T-waves in ischemia: hyperacute, inverted (negative), Wellen's sign & de Winter's sign](/docs/books/the-ecg-book/myocardial-ischemia-infarction/t-wave-negative-inversions-hyperacute-wellens-sign-de-winters): A thorough discussion regarding the physiology of the T-wave was previously provided. Only aspects…
      - [ECG manifestations of left main coronary artery (LMCA) occlusion and critical stenosis](/docs/books/the-ecg-book/myocardial-ischemia-infarction/ecg-manifestations-of-left-main-coronary-artery-lmca-occlusion-and-critical-stenosis): Left main coronary artery LMCA occlusion is a rare but catastrophic manifestation of acute coronary syndromes. The LMCA supplies a large myocardial…
      - [ECG signs of myocardial infarction: pathological Q-waves & pathological R-waves](/docs/books/the-ecg-book/myocardial-ischemia-infarction/ecg-criteria-myocardial-infarction-pathological-q-waves-r-waves): Myocardial infarction – particularly if extensive in size – typically manifests with pathological Q-waves. These Q-waves are wider and deeper than normally…
      - [Other ECG changes in ischemia and infarction](/docs/books/the-ecg-book/myocardial-ischemia-infarction/other-ecg-changes-in-ischemia-infarction): Normal R-wave progression implies that the R-wave amplitude increases gradually from V1 to V5 and then diminishes again in V6. Refer to Figure 1. Abnormal…
      - [Supraventricular and intraventricular conduction defects in myocardial ischemia and infarction](/docs/books/the-ecg-book/myocardial-ischemia-infarction/conduction-defects-myocardial-ischemia-infarction): Bradycardia and conduction defects, such as bundle branch block, fascicular block and AV block, are common in myocardial ischemia and infarction. These…
      - [ECG localization of myocardial infarction / ischemia and coronary artery occlusion (culprit)](/docs/books/the-ecg-book/myocardial-ischemia-infarction/localization-localize-myocardial-infarction-ischemia-coronary-artery-occlusion-culprit-stemi): Determining the localization of myocardial infarction and ischemia, as well as identifying the occluded coronary artery and the location of the occlusion,…
      - [The ECG in assessment of myocardial reperfusion](/docs/books/the-ecg-book/myocardial-ischemia-infarction/the-ecg-in-assessment-of-reperfusion): The ECG is an invaluable tool to assess whether an occlusion has been resolved and blood flow has been restored. This assessment is performed daily in the…
      - [Approach to patients with chest pain: differential diagnoses, management & ECG](/docs/books/the-ecg-book/myocardial-ischemia-infarction/approach-patients-chest-pain-differential-diagnoses-management): Chest pain is one of the most common symptoms in the emergency department, as well as in primary health care. The cause etiology of chest pain varies…
      - [Stable Coronary Artery Disease (Angina Pectoris): Diagnosis, Evaluation, Management](/docs/books/the-ecg-book/myocardial-ischemia-infarction/stable-coronary-artery-disease-angina-pectoris-management-diagnosis-treatment): Stable coronary artery disease CAD, frequently referred to as stable angina pectoris, has traditionally been defined and managed as a distinct clinical…
      - [NSTEMI (Non-ST Elevation Myocardial Infarction) & Unstable Angina: Diagnosis, Criteria, ECG, Management](/docs/books/the-ecg-book/myocardial-ischemia-infarction/nstemi-non-st-elevation-myocardial-infarction-unstable-angina-criteria-ecg-diagnosis-management): !/img/2024/07/antithrombotic-regimens-in-patients-with-acute-coronary-syndromes-stemi-nstemi-ua-and-an-indication-for-oral-anticoagulation-1024x569.webphttps:…
      - [STEMI (ST Elevation Myocardial Infarction): Diagnosis, ECG, Criteria, and Management](/docs/books/the-ecg-book/myocardial-ischemia-infarction/stemi-st-elevation-myocardial-infarction-criteria-ecg): Acute ST Elevation Myocardial Infarction STEMI is the most severe manifestation of coronary artery disease. This chapter deals with the pathophysiology,…
    - Conduction Defects
      - [Conduction Defects](/docs/books/the-ecg-book/conduction-defects): Chapters in Conduction Defects.
      - [Overview of atrioventricular (AV) blocks](/docs/books/the-ecg-book/conduction-defects/atrioventricular-av-block-ecg-blocks): This article covers the fundamental principles of atrioventricular AV blocks, which are classified into three types: first-degree, second-degree, and…
      - [First-degree AV block (AV block I, AV block 1)](/docs/books/the-ecg-book/conduction-defects/ecg-first-degree-av-block-i-1-criteria-management): This chapter discusses first-degree atrioventricular AV block, also referred to as 1st-degree AV block, AV block I, or AV block 1. Before proceeding, it is…
      - [Second-degree AV block: Mobitz type 1 (Wenckebach) & Mobitz type 2 block](/docs/books/the-ecg-book/conduction-defects/ecg-second-degree-av-block-mobitz-type-1-2-wenckebach): In this chapter, the focus will be on second-degree atrioventricular AV block. Before proceeding, it is advised to review the introductory chapter on AV…
      - [Third-degree AV block (3rd degree AV block, AV block 3, AV block III)](/docs/books/the-ecg-book/conduction-defects/ecg-third-degree-av-block-iii-3-criteria-management): This chapter discusses third-degree AV block, which is synonymous with AV dissociation, complete AV block, AV block III and AV block 3. In third-degree AV…
      - [Management and treatment of AV block (atrioventricular blocks)](/docs/books/the-ecg-book/conduction-defects/av-block-1-2-3-treatment-management-ecg): Evaluation of patients with suspected AV blocks requires a thorough medical history with emphasis on causes of AV blocks; please refer to the Causes of AV…
      - [Intraventricular conduction delay: bundle branch blocks & fascicular blocks](/docs/books/the-ecg-book/conduction-defects/intraventricular-conduction-delay-ecg-bundle-branch-fascicular-block): This chapter discusses intraventricular conduction delays defects, which are caused by functional or anatomical defects in the components of the…
      - [Right bundle branch block (RBBB): ECG, criteria, definitions, causes & treatment](/docs/books/the-ecg-book/conduction-defects/right-bundle-branch-block-rbbb-ecg-criteria-treatment): Right bundle branch block RBBB is due to an anatomical or functional dysfunction in the right bundle branch, such that the electrical impulse is blocked.…
      - [Left bundle branch block (LBBB): ECG criteria, causes, management](/docs/books/the-ecg-book/conduction-defects/left-bundle-branch-block-lbbb-ecg-criteria-treatment): Left bundle branch block LBBB results from anatomical or functional impairment of the left bundle branch LBB, leading to a blockage of electrical impulse…
      - [Left bundle branch block (LBBB) in acute myocardial infarction: the Sgarbossa criteria](/docs/books/the-ecg-book/conduction-defects/left-bundle-branch-block-acute-coronary-syndromes-sgarbossa): Contrary to right bundle branch block, left bundle branch block is always a pathological finding that affects cardiovascular and total mortality. Left…
      - [Fascicular block (hemiblock): Left anterior & left posterior fascicular block](/docs/books/the-ecg-book/conduction-defects/left-anterior-posterior-fascicular-block-hemiblock-ecg): Fascicular blocks were previously referred to as hemiblocks, but the latter term has been deprecated. The left bundle branch is subdivided into the…
      - [Nonspecific intraventricular conduction delay (defect)](/docs/books/the-ecg-book/conduction-defects/nonspecific-intraventricular-conduction-delay-defect): A nonspecific intraventricular conduction delay exists if the ECG displays a widened QRS appearance that is neither a left bundle branch block…
    - Cardiac Hypertrophy & Enlargement
      - [Cardiac Hypertrophy & Enlargement](/docs/books/the-ecg-book/cardiac-hypertrophy-enlargement): Chapters in Cardiac Hypertrophy & Enlargement.
      - [Atrial and ventricular enlargement: hypertrophy and dilatation on ECG](/docs/books/the-ecg-book/cardiac-hypertrophy-enlargement/cardiac-atrial-ventricular-hypertrophy-dilatation-enlargement-ecg): Cardiac chamber enlargement refers to abnormally large atria or abnormally large ventricles. These conditions are referred to as atrial enlargement and…
      - [ECG in left ventricular hypertrophy (LVH): criteria and implications](/docs/books/the-ecg-book/cardiac-hypertrophy-enlargement/ecg-left-ventricular-hypertrophy-lvh-clinical-characteristics): The following figure shows characteristic ECG changes in left ventricular hypertrophy LVH and right ventricular hypertrophy…
      - [Right ventricular hypertrophy (RVH): ECG criteria & clinical characteristics](/docs/books/the-ecg-book/cardiac-hypertrophy-enlargement/right-ventricular-hypertrophy-ecg-ekg-criteria): Figure 1. ECG changes seen in left ventricular hypertrophy LVH and right ventricular hypertrophy RVH. The electrical vector of the left ventricle is…
      - [Biventricular hypertrophy ECG and clinical characteristics](/docs/books/the-ecg-book/cardiac-hypertrophy-enlargement/biventricular-hypertrophy-ecg-clinical-characteristics): Simultaneous hypertrophy of the left and right ventricle is rather common. The…
      - [Left atrial enlargement (P mitrale) & right atrial enlargement (P pulmonale) on ECG](/docs/books/the-ecg-book/cardiac-hypertrophy-enlargement/ecg-left-right-atrial-enlargement-p-pulmonale-mitrale): The atria may become dilated and/or hypertrophic during pathological circumstances. As for ventricular enlargement, the…
    - Drugs & Electrolyte Imbalance
      - [Drugs & Electrolyte Imbalance](/docs/books/the-ecg-book/drugs-electrolyte-imbalance): Chapters in Drugs & Electrolyte Imbalance.
      - [Digoxin - ECG changes, arrhythmias, conduction defects & treatment](/docs/books/the-ecg-book/drugs-electrolyte-imbalance/digoxin-ecg-changes-arrhythmias-digoxin-digitalis): Digoxin may be used in patients with heart failure, atrial fibrillation, atrial flutter, and in selected cases of paroxysmal supraventricular tachycardia.…
      - [ECG changes caused by antiarrhythmic drugs, beta blockers & calcium channel blockers](/docs/books/the-ecg-book/drugs-electrolyte-imbalance/ecg-arrhythmias-antiarrhythmic-drugs-beta-blockers-calcium-channel-blockers): Although the purpose of antiarrhythmic drugs is to control arrhythmias, these medications may also cause arrhythmias and confusing ECG changes. ECG changes…
      - [ECG changes due to electrolyte imbalance (disorder)](/docs/books/the-ecg-book/drugs-electrolyte-imbalance/ecg-electrolyte-imbalance-electrolyte-disorder-calcium-potassium-magnesium): The normal cardiac action potential may be altered by electrolyte imbalance, owing to changes in intra- and extracellular electrolyte concentrations. Some…
    - Genetics, Syndromes & Miscellaneous
      - [Genetics, Syndromes & Miscellaneous](/docs/books/the-ecg-book/genetics-syndromes-miscellaneous): Chapters in Genetics, Syndromes & Miscellaneous.
      - [ECG J wave syndromes: hypothermia, early repolarization, hypercalcemia & Brugada syndrome](/docs/books/the-ecg-book/genetics-syndromes-miscellaneous/j-wave-syndromes-hypothermia-early-repolarization-calcium-brugada-syndrome): The J wave – also referred to as Osborn's wave – is defined as a wave occurring at the J point Figure 1. Conditions in which the J wave occurs may be…
      - [Brugada syndrome: ECG, clinical features and management](/docs/books/the-ecg-book/genetics-syndromes-miscellaneous/brugada-syndrome-ecg-treatment-type-1-2-3): Pedro Brugada and his two brothers, Josep and Ramon, described this syndrome in 1992. The syndrome is characterized by a rather peculiar…
      - [Early repolarization pattern on ECG (early repolarization syndrome)](/docs/books/the-ecg-book/genetics-syndromes-miscellaneous/early-repolarization-pattern-syndrome-ecg): Although the early repolarization pattern has been recognized for almost 50 years, it is still one of the most frequently confused ECG findings. This is…
      - [Takotsubo cardiomyopathy (broken heart syndrome, stress induced cardiomyopathy)](/docs/books/the-ecg-book/genetics-syndromes-miscellaneous/takotsubo-cardiomyopathy-broken-heart-syndrome-stress-induced-cardiomyopathy-ecg): Takotsubo cardiomyopathy broken heart syndrome is a rather peculiar and certainly acute condition. Much research has been devoted to it in recent years.…
      - [Pericarditis, myocarditis & perimyocarditis: ECG, criteria & treatment](/docs/books/the-ecg-book/genetics-syndromes-miscellaneous/ecg-pericarditis-myocarditis-perimyocarditis): The pericardium is a double-walled sac in which the heart and the roots of the great vessels are contained Figure 1. The pericardial sac encloses the…
      - [Eletrical alternans: the ECG in pericardial effusion & cardiac tamponade](/docs/books/the-ecg-book/genetics-syndromes-miscellaneous/pericardial-effusion-cardiac-tamponade-electrical-alternans-ecg): The pericardial space cavity always contains a small amount of serous fluid which acts as a lubricant that prevents friction during ventricular contraction…
      - [Long QT Syndrome (LQTS)](/docs/books/the-ecg-book/genetics-syndromes-miscellaneous/long-qt-syndrome-lqts): Please refer to the previous chapter: LQTS Long QT Syndrome
    - Exercise Stress Testing (Exercise ECG)
      - [Exercise Stress Testing (Exercise ECG)](/docs/books/the-ecg-book/exercise-stress-testing-exercise-ecg): Chapters in Exercise Stress Testing Exercise ECG.
      - [Introduction to exercise stress testing (treadmill test, exercise ECG)](/docs/books/the-ecg-book/exercise-stress-testing-exercise-ecg/exercise-stress-test-treadmill-ecg-indications-background): Exercise stress testing has been used routinely for over 60 years to evaluate cardiopulmonary function and to diagnose cardiovascular disease. The value of…
      - [Indications, Contraindications, and Preparations for Exercise Stress Testing](/docs/books/the-ecg-book/exercise-stress-testing-exercise-ecg/exercise-stress-test-ecg-indications-contraindications-preparation): In this article, we will discuss indications, contraindications, and subject preparations. We will also discuss the relevance of withholding specific…
      - [Exercise stress test (exercise ECG): protocols, evaluation & termination](/docs/books/the-ecg-book/exercise-stress-testing-exercise-ecg/exercise-stress-test-exercise-ecg-protocols-evaluation-parameters): The choice of exercise equipment and protocol depends mainly on local traditions. The treadmill and cycle ergometer bicycle are the most frequently used…
      - [Exercise stress testing in special patient populations](/docs/books/the-ecg-book/exercise-stress-testing-exercise-ecg/exercise-stress-testing-patient-populations-ami-ecg-acs): Clinicians should be familiar with the special challenges posed by some patient populations. The sensitivity, specificity, risks, and results of the…
      - [Exercise physiology: from normal response to myocardial ischemia & chest pain](/docs/books/the-ecg-book/exercise-stress-testing-exercise-ecg/physiological-mechanisms-exercise-stress-testing): Understanding the basic principles of exercise physiology is essential to conduct and evaluate the exercise stress test. Exercise induces physiological…
      - [Evaluation of exercise stress test: ECG, symptoms, blood pressure, heart rate, performance](/docs/books/the-ecg-book/exercise-stress-testing-exercise-ecg/exercise-stress-test-ecg-symptoms-blood-pressure-heart-rate-performance): The ECG reaction has always been a central component of the exercise stress test. Indeed, clinicians often use the term exercise ECG instead of the correct…
  - Clinical Echocardiography
    - [Clinical Echocardiography](/docs/books/clinical-echocardiography): Clinical Echocardiography enables you to use echocardiography to its fullest potential in your initial diagnosis, decision making, and clinical management of patients with a wide…
    - Introduction to echocardiography and ultrasound imaging
      - [Introduction to echocardiography and ultrasound imaging](/docs/books/clinical-echocardiography/introduction-to-echocardiography-and-ultraound-imaging): Chapters in Introduction to echocardiography and ultrasound imaging.
      - [Physics of ultrasound](/docs/books/clinical-echocardiography/introduction-to-echocardiography-and-ultraound-imaging/ultrasound-physics): Unlike light waves, which can propagate through vacuum, sound waves can only propagate through a physical medium. This medium may consist of any matter, e.g…
      - [The ultrasound transducer](/docs/books/clinical-echocardiography/introduction-to-echocardiography-and-ultraound-imaging/the-ultrasound-transmitter-probe): The ultrasound transducer generates ultrasound ultrasonic waves The transducer is held with one hand and…
      - [Technical aspects of the ultrasound image](/docs/books/clinical-echocardiography/introduction-to-echocardiography-and-ultraound-imaging/technical-aspects-of-the-ultrasound-image): The ultrasound transducer generates short bursts pulses of ultrasound waves. Reflected…
      - [Two-dimensional (2D) echocardiography](/docs/books/clinical-echocardiography/introduction-to-echocardiography-and-ultraound-imaging/two-dimensional-2d-echocardiography): Two-dimensional 2D ultrasound is the most commonly used modality in echocardiography. The two dimensions presented are width x axis and depth y axis. The…
      - [Optimization of the ultrasound image](/docs/books/clinical-echocardiography/introduction-to-echocardiography-and-ultraound-imaging/optimization-of-the-ultrasound-image): In order to obtain optimal ultrasound images, it is necessary to adjust several parameters continuously during the examination. Typically, examinations in…
      - [M-mode (motion mode) echocardiography](/docs/books/clinical-echocardiography/introduction-to-echocardiography-and-ultraound-imaging/m-mode-motion-mode-echocardiography): M-mode was previously the dominating modality in echocardiography. Although it has now largely been replaced by 2D…
      - [Doppler effect and Doppler echocardiography](/docs/books/clinical-echocardiography/introduction-to-echocardiography-and-ultraound-imaging/doppler-effect-and-doppler-studies-in-echocardiography): When sound waves hit objects some of the sound waves are reflected back to the sound source. If the reflector i.e the object reflecting the sound waves is…
      - [Pulsed Wave Doppler](/docs/books/clinical-echocardiography/introduction-to-echocardiography-and-ultraound-imaging/pulsed-wave-doppler): The pulsed wave Doppler PW Doppler sends short pulses of ultrasound and analyzes reflected sound waves between the pulses. This is accomplished by using the…
      - [Continuous Wave Doppler (CW Doppler)](/docs/books/clinical-echocardiography/introduction-to-echocardiography-and-ultraound-imaging/continuous-wave-doppler-cw-doppler): In continuous wave Doppler CW Doppler, ultrasound waves are continuously emitted from the transducer and the reflections of these waves are analyzed…
      - [Color Doppler](/docs/books/clinical-echocardiography/introduction-to-echocardiography-and-ultraound-imaging/color-doppler): Velocities recorded in a sample volume of the pulsed wave Doppler can be presented with a color. A color scale…
      - [Tissue Doppler (Tissue Velocity Imaging)](/docs/books/clinical-echocardiography/introduction-to-echocardiography-and-ultraound-imaging/tissue-doppler-tissue-velocity-imaging): Previous chapters on Doppler imaging have all focused on measurements of blood flow. However, the Doppler…
      - [Artifacts in ultrasound imaging](/docs/books/clinical-echocardiography/introduction-to-echocardiography-and-ultraound-imaging/artifacts-in-ultrasound-imaging): The following artifacts are common in ultrasound imaging:
    - Principles of hemodynamics
      - [Principles of hemodynamics](/docs/books/clinical-echocardiography/principles-of-hemodynamics): Chapters in Principles of hemodynamics.
      - [Hemodynamic principles and calculations](/docs/books/clinical-echocardiography/principles-of-hemodynamics/hemodynamic-principles-and-calculations): Hemodynamics is the study of blood flow dynamics. The physical laws that govern blood flow are fundamental in echocardiography. Conventional two-dimensional…
      - [The Bernoulli principle and estimation of pressure gradients](/docs/books/clinical-echocardiography/principles-of-hemodynamics/the-bernoulli-principle-and-calculation-of-pressure-difference-pressure-gradient): Continuous wave Doppler and pulsed wave…
      - [The Continuity Equation (The Principle of Continuity)](/docs/books/clinical-echocardiography/principles-of-hemodynamics/the-continuity-equation): As previously discussed, stroke volume is usually calculated by…
      - [Proximal Isovelocity Surface Area (PISA)](/docs/books/clinical-echocardiography/principles-of-hemodynamics/proximal-isovelocity-surface-area-pisa): PISA Proximal Isovelocity Surface Area is a phenomenon that occurs when liquid flows through a circular orifice. The flow will converge and accelerate just…
      - [Stroke Volume, VTI (Velocity Time Integral) & Cardiac Output](/docs/books/clinical-echocardiography/principles-of-hemodynamics/stroke-volume-vti-velocity-time-integral-cardiac-output): If the flow in a cylinder is constant, then flow Q is the product of the cylinder area a and flow velocity v:
    - The echocardiographic examination
      - [The echocardiographic examination](/docs/books/clinical-echocardiography/the-standard-echocardiographic-exam): Chapters in The echocardiographic examination.
      - [Principles and Preparations for Echocardiographic Examinations](/docs/books/clinical-echocardiography/the-standard-echocardiographic-exam/standard-adult-echocardiogram-principles-and-preparations): The use of echocardiography has increased dramatically during the past few decades. Advances in echocardiography have been propelled by breakthroughs in…
      - [Performing Echocardiographic Examinations](/docs/books/clinical-echocardiography/the-standard-echocardiographic-exam/performing-echocardiographic-studies): In small children, it is possible to perform the entire transthoracic echocardiography…
      - [Standard Transthoracic Echocardiogram: Complete Imaging Protocol](/docs/books/clinical-echocardiography/the-standard-echocardiographic-exam/the-standard-adult-transthoracic-echocardiogram-a-protocol-to-obtain-a-complete-study): This chapter presents a sequential series of images that comprise a complete standard echocardiographic examination. The image views are discussed in the…
    - Left ventricular systolic function and contractility
      - [Left ventricular systolic function and contractility](/docs/books/clinical-echocardiography/left-ventricular-function-systolic-function-and-contractility): Chapters in Left ventricular systolic function and contractility.
      - [Left Ventricular Function](/docs/books/clinical-echocardiography/left-ventricular-function-systolic-function-and-contractility/left-ventricular-function): Cardiac function depends on a large number of parameters, including atrial function, valvular function, and ventricular function. A large body of science…
      - [Myocardial Mechanics: Structure and Function of Myocardial Fibers](/docs/books/clinical-echocardiography/left-ventricular-function-systolic-function-and-contractility/structure-and-function-of-myocardial-fibers-myocardium): The left ventricular wall can be subdivided into several layers. These layers are similar to those seen in arteries throughout the circulatory system Figure…
      - [Ventricular Pressure-Volume Relationship: Preload, Afterload, Stroke Volume, Wall Stress & Frank-Starling's law](/docs/books/clinical-echocardiography/left-ventricular-function-systolic-function-and-contractility/pressure-volume-curves-preload-afterload-stroke-volume-wall-stress-frank-starlings-law): Left ventricular pressure-volume relationship can be described by a loop diagram with volume depicted on the x-axis and left ventricular pressure on the…
      - [Assessing left ventricular systolic function](/docs/books/clinical-echocardiography/left-ventricular-function-systolic-function-and-contractility/assessing-left-ventricular-systolic-function-echocardiography): Several echocardiographic measurements are available to assess left ventricular systolic function. These methods elucidate slightly different aspects of…
      - [Left ventricular mass and volume (size)](/docs/books/clinical-echocardiography/left-ventricular-function-systolic-function-and-contractility/left-ventricular-mass-and-volume-size): Left ventricular mass is a flawed proxy for ventricular systolic function and load. The mass is, however, an important parameter in the assessment of…
      - [Ejection fraction (EF): Physiology, Measurement & Clinical Evaluation](/docs/books/clinical-echocardiography/left-ventricular-function-systolic-function-and-contractility/ejection-fraction-ef-physiology-measurement-echocardiography): For several decades, ejection fraction EF has been the dominating method for assessing left ventricular systolic function. Ejection fraction is simple to…
      - [Fractional shortening for estimation of ejection fraction](/docs/books/clinical-echocardiography/left-ventricular-function-systolic-function-and-contractility/fractional-shortening-for-estimation-of-ejection-fraction): Fractional shortening FS is calculated by measuring the percentage change in left ventricular diameter during systole. It is measured in parasternal long…
      - [Strain, strain rate and speckle tracking: Myocardial deformation](/docs/books/clinical-echocardiography/left-ventricular-function-systolic-function-and-contractility/deformation-strain-strain-rate-speckle-tracking-echocardiography): As previously discussed, the left ventricular wall can be subdivided into three layers: the inner lining endocardium, a thick muscle layer myocardium and an…
      - [Left Ventricular Segments for Echocardiography and Cardiac Imaging](/docs/books/clinical-echocardiography/left-ventricular-function-systolic-function-and-contractility/left-ventricular-segments-echocardiography-cardiac-imaging): Cardiovascular imaging modalities have developed rapidly in the past few decades. The repertoire of available methods includes echocardiography,…
      - [The Coronary Arteries](/docs/books/clinical-echocardiography/left-ventricular-function-systolic-function-and-contractility/the-coronary-arteries): The two main coronary arteries emanate from the aortic bulb Figure 1:
      - [Regional Myocardial Contractile Function: Wall Motion Abnormalities](/docs/books/clinical-echocardiography/left-ventricular-function-systolic-function-and-contractility/regional-myocardial-contractile-function-wall-motion-abnormality): Systolic ventricular function is one of the strongest predictors of total and cardiovascular mortality. Previous chapters have discussed several methods for…
    - Left ventricular diastolic function
      - [Left ventricular diastolic function](/docs/books/clinical-echocardiography/left-ventricular-function-diastolic-function): Chapters in Left ventricular diastolic function.
      - [Left ventricular diastolic function](/docs/books/clinical-echocardiography/left-ventricular-function-diastolic-function/diastolic-heart-function-left-ventricular-diastolic-function): The importance of systolic function can be understood on an…
      - [Relaxation of the left ventricle](/docs/books/clinical-echocardiography/left-ventricular-function-diastolic-function/relaxation-left-ventricle-compliance-diastolic-function): Diastolic function is determined by the efficiency of myocardial relaxation. The degree and velocity of relaxation are the key parameters. Ideally,…
      - [Assessment of diastolic function by echocardiography](/docs/books/clinical-echocardiography/left-ventricular-function-diastolic-function/assessment-of-diastolic-function-by-echocardiography): Methods for evaluating left ventricular diastolic function have evolved considerably in the past two decades. Currently recommended methods evaluate left…
    - Cardiomyopathies
      - [Cardiomyopathies](/docs/books/clinical-echocardiography/cardiomyopathies): Chapters in Cardiomyopathies.
      - [Heart failure: Causes, types, diagnosis, treatments & management](/docs/books/clinical-echocardiography/cardiomyopathies/heart-failure-causes-types-diagnosis-treatments-management): Heart failure is a major public health problem worldwide. While the incidence of coronary heart…
      - [Echocardiography in cardiomyopathies: an overview](/docs/books/clinical-echocardiography/cardiomyopathies/echocardiography-in-cardiomyopathies-an-overview): Cardiomyopathy implies that the myocardium is structurally and functionally altered, and the pathological changes are not explained by coronary heart…
      - [Hypertrophic Cardiomyopathy (HCM) & Hypertrophic Obstructive Cardiomyopathy (HOCM)](/docs/books/clinical-echocardiography/cardiomyopathies/hypertrophic-cardiomyopathy-hcm-hocm-echocardiography): Hypertrophic cardiomyopathy is a genetic disorder that causes left ventricular hypertrophy under normal loading conditions. Hypertrophic cardiomyopathy…
      - [Dilated Cardiomyopathy (DCM): Definition, Types, Diagnostics & Treatment](/docs/books/clinical-echocardiography/cardiomyopathies/dilated-cardiomyopathy-dcm-definition-types-diagnostics-treatment): Dilated cardiomyopathy DCM is defined as dilation of one or both ventricles. Dilation of the left ventricle is virtually always accompanied by impaired left…
      - [Arrhythmogenic Right Ventricular Cardiomyopathy / Dysplasia (ARVC, ARVD)](/docs/books/clinical-echocardiography/cardiomyopathies/arrhythmogenic-right-ventricular-cardiomyopathy-dysplasia-arvc-arvd): Arrhythmogenic Right Ventricular Cardiomyopathy ARVC is considered a genetic cardiomyopathy that predominantly affects the right ventricle. ARVC is defined…
      - [Tachycardia induced cardiomyopathy](/docs/books/clinical-echocardiography/cardiomyopathies/tachycardia-induced-cardiomyopathy): A prolonged tachycardia can cause cardiomyopathy with left ventricular dilation. This type of cardiomyopathy, referred to as tachycardia-induced…
    - Valvular heart disease
      - [Valvular heart disease](/docs/books/clinical-echocardiography/valvular-heart-disease): Chapters in Valvular heart disease.
      - [Tricuspid stenosis](/docs/books/clinical-echocardiography/valvular-heart-disease/tricuspid-valve-stenosis): Tricuspid stenosis is a rare condition that may be caused by rheumatic valvular disease, congenital heart disease, Whipple’s disease, or tumors. Rheumatic…
      - [Tricuspid regurgitation (TR/TI)](/docs/books/clinical-echocardiography/valvular-heart-disease/tricuspid-regurgitation-tr-ti): The tricuspid valve separates the right ventricle and the right atrium. It normally consists of three leaflets anterior, posterior and septal leaflet. The…
      - [Pulmonary regurgitation](/docs/books/clinical-echocardiography/valvular-heart-disease/pulmonic-pulmonary-valve-regurgitation-echocardiography): Pulmonary regurgitation is also called pulmonic regurgitation.
      - [Pulmonary stenosis](/docs/books/clinical-echocardiography/valvular-heart-disease/pulmonic-valve-stenosis): Pulmonary stenosis is virtually always a consequence of congenital heart disease. The stenosis can be fixed or dynamic, depending on the underlying…
      - [Mitral regurgitation](/docs/books/clinical-echocardiography/valvular-heart-disease/mitral-valve-regurgitation): The most common cause of mitral regurgitation in high-income countries is age-related degeneration of the valvular apparatus. Age-related degeneration…
      - [Mitral valve stenosis](/docs/books/clinical-echocardiography/valvular-heart-disease/mitral-valve-stenosis): The mitral valve separates the left atrium and the left ventricle. The valve is attached to the mitral annulus, which is continuous with annulus fibrosus…
      - [Aortic regurgitation](/docs/books/clinical-echocardiography/valvular-heart-disease/aortic-valve-regurgitation): Aortic regurgitation implies that the aortic valve leaks during diastole, such that blood regurgitates back from the aorta into the left ventricle. This…
      - [Aortic stenosis](/docs/books/clinical-echocardiography/valvular-heart-disease/aortic-valve-stenosis): The aortic valve area is normally 3.0 to 4.0 cm2. Aortic stenosis is a progressive disease that leads to a gradual reduction in the orifice area. As the…
    - Miscellaneous conditions
      - [Miscellaneous conditions](/docs/books/clinical-echocardiography/miscellaneous-conditions): Chapters in Miscellaneous conditions.
      - [Congenital heart disease & GUCH (Grown Up Congenital Heart disease)](/docs/books/clinical-echocardiography/miscellaneous-conditions/congenital-heart-disease-guch-grown-up-congenital-heart-disease): Survival in congenital heart disease CHD has increased dramatically over the past few decades. This has resulted in an increased prevalence of congenital…
      - [Cardiac thromboembolism: cardiac sources of embolism](/docs/books/clinical-echocardiography/miscellaneous-conditions/cardiac-thromboembolism-cardiac-sources-of-embolism): Thromboembolism is a leading cause of death worldwide 1. Emboli originating in the atria, left atrial appendage LAA, ventricles, valves, and proximal aorta…
      - [Endocarditis: definitions, causes, diagnosis, echocardiography & treatment](/docs/books/clinical-echocardiography/miscellaneous-conditions/endocarditis-definitions-causes-diagnosis-echocardiography-treatment): Endocarditis implies that a bacterial infection engages the heart valves and this is a serious condition. The focus of infection on the flap is called…
      - [Right ventricular strain: definition, causes, echocardiography](/docs/books/clinical-echocardiography/miscellaneous-conditions/right-ventricular-strain-definition-causes-echocardiography): When assessing the right half of the heart, it is important to familiarize yourself with the principles of hemodynamics and conditions prevailing on the…
      - [Cardiac tumors](/docs/books/clinical-echocardiography/miscellaneous-conditions/cardiac-tumors): Cardiac tumors are rare. They can occur anywhere in the heart or surrounding tissue. Tumors can be localized in the myocardium, pericardium, perivalvular…
    - Pericardial disease
      - [Pericardial disease](/docs/books/clinical-echocardiography/pericardial-disease): Chapters in Pericardial disease.
      - [Constrictive pericarditis: definition, causes, diagnosis & echocardiography](/docs/books/clinical-echocardiography/pericardial-disease/constrictive-pericarditis-definition-causes-diagnosis-echocardiography): Constrictive pericarditis is the result of chronic inflammation of the pericardium. In principle, all causes of pericarditis can result in constrictive…
      - [Pericardial Effusion & Cardiac tamponade](/docs/books/clinical-echocardiography/pericardial-disease/pericardial-effusion-cardiac-tamponade): A long series of conditions can affect the pericardium pericardium. The most common of these are acute pericarditis perimyocarditis, constrictive…
  - Pediatric and Neonatal ECG Interpretation
    - [Pediatric and Neonatal ECG Interpretation](/docs/books/pediatric-ecg-interpretation): Chapters from Pediatric and Neonatal ECG Interpretation.
    - [Introduction to pediatric & neonatal ECG interpretation](/docs/books/pediatric-ecg-interpretation/introduction-to-pediatric-neonatal-ecg-interpretation): Pediatric and neonatal ECG interpretation follow the same principles as ECG interpretation in adults, but there are important differences. These differences…
    - [Pediatric aspects of ECG leads & anatomy](/docs/books/pediatric-ecg-interpretation/pediatric-aspects-of-ecg-leads-anatomy): Principles of ECG leads, lead anatomy and electrical vectors have been discussed in the chapter The ECG…
    - [Interpretation of neonatal and pediatric electrocardiograms (ECG)](/docs/books/pediatric-ecg-interpretation/practical-pediatric-ecg-interpretation): The neonatal and pediatric electrocardiogram ECG is interpreted using the same principles as in ECG interpretation in adults. The ECG must always be…
    - [Reference values for pediatric and neonatal ECG](/docs/books/pediatric-ecg-interpretation/reference-values-for-pediatric-electrocardiogram-ecg): These reference values are the best available for the neonatal period. The intervals are 98% confidence intervals the mean is presented in the parenthesis.…
  - Pacemakers and Cardiac Devices
    - [Pacemakers and Cardiac Devices](/docs/books/cardiac-devices-pacemaker-icd-crt): Chapters from Pacemakers and Cardiac Devices.
    - [Introduction to Cardiac Pacing and Devices: Pacemaker, ICD, CRT](/docs/books/cardiac-devices-pacemaker-icd-crt/introduction-till-cardiac-devices-pacemaker-icd-crt): The artificial pacemaker is one of the great medical inventions of the 20th century. Cardiac pacing has evolved from a hazardous experiment in the 1930s, to…
    - [Components and construction of a pacemaker](/docs/books/cardiac-devices-pacemaker-icd-crt/how-pacemakers-work): Myocardium is excitable not only by action potentials originating in the sinus node, but also by external electrical stimuli that drive the cells to…
    - [Basic cardiac pacing, pacemaker functions and settings](/docs/books/cardiac-devices-pacemaker-icd-crt/basic-cardiac-pacing-pacemaker-functions-and-settings): As previously discussed, myocardium may be excited by external electrical stimuli that drive the cells to threshold. Stimulation threshold is the minimum…
    - [Indications for pacemaker](/docs/books/cardiac-devices-pacemaker-icd-crt/indications-for-pacemaker): Bradyarrhythmia is the main indication for the implantation of a pacemaker. When…
    - [Interpretation of Pacemaker ECG](/docs/books/cardiac-devices-pacemaker-icd-crt/ecg-pacemaker-rhythm-malfunction-failure-tachyarrhythmia): Assessing pacemaker function requires knowledge of the mode of pacing, and careful analysis of ECG tracings. Most modern devices are capable of transmitting…
    - [Assessment of Pacemaker Malfunction](/docs/books/cardiac-devices-pacemaker-icd-crt/assessment-of-pacemaker-malfunction-using-ecg): Conventional surface ECG can reveal the following types of pacemaker dysfunction:
  - Cardiovascular Medicine
    - [Cardiovascular Medicine](/docs/books/cardiovascular-medicine): Chapters from Cardiovascular Medicine.
    - Structural Heart Disease
      - [Structural Heart Disease](/docs/books/cardiovascular-medicine/structural-heart-disease): Chapters in Structural Heart Disease.
      - [Hypertension: Causes, investigations, complications & treatment](/docs/books/cardiovascular-medicine/structural-heart-disease/hypertension-causes-investigations-complications-treatment): Hypertension is the leading cause of morbidity and mortality worldwide. The individual and public health effects of hypertension are devastating. Due to the…
      - [Heart failure: Introduction](/docs/books/cardiovascular-medicine/structural-heart-disease/heart-failure-introduction): Heart failure is a major public health problem worldwide. While the incidence of coronary heart…
      - [Heart Failure with Reduced Ejection Fraction (HFrEF)](/docs/books/cardiovascular-medicine/structural-heart-disease/heart-failure-with-reduced-ejection-fraction-hfref): Heart failure HF is a complex clinical syndrome characterized by symptoms and signs resulting from structural or functional impairment of ventricular…
      - [Heart Failure with Preserved Ejection Fraction (HFpEF)](/docs/books/cardiovascular-medicine/structural-heart-disease/heart-failure-with-preserved-ejection-fraction-hfpef): Heart failure with preserved ejection fraction HFpEF is a complex clinical syndrome characterized by the cardinal symptoms and signs of heart failure HF in…
      - [Coronary Artery Disease](/docs/books/cardiovascular-medicine/structural-heart-disease/coronary-artery-disease): Stable coronary artery disease CAD, frequently referred to as stable angina pectoris, has traditionally been defined and managed as a distinct clinical…
      - [Physiological Assessment of Coronary Stenoses and Revascularization Decisions](/docs/books/cardiovascular-medicine/structural-heart-disease/physiological-assessment-of-coronary-stenoses-and-revascularization-decisions): Angiographic stenosis severity is a poor surrogate for the hemodynamic significance of a coronary lesion, with anatomic and functional assessment discordant…
      - [ST-Elevation Myocardial Infarction (STEMI): Pathophysiology, Diagnosis, and Management](/docs/books/cardiovascular-medicine/structural-heart-disease/st-elevation-myocardial-infarction-stemi-an-exhaustive-review-of-pathophysiology-diagnosis-and-contemporary-management): Coronary atherosclerosis is a chronic, progressive, and highly complex lipid-driven inflammatory disease of the arterial intima that serves as the…
      - [Non-ST Elevation Acute Myocardial Infarction (NSTEMI) and Unstable Angina](/docs/books/cardiovascular-medicine/structural-heart-disease/non-st-elevation-acute-myocardial-infarction-nstemi-and-unstable-angina): Coronary atherosclerosis is a chronic, progressive, and highly dynamic inflammatory disease of the arterial wall. It is characterized by the subendothelial…
      - [Pulmonary Embolism (PE)](/docs/books/cardiovascular-medicine/structural-heart-disease/pulmonary-embolism-causes-risk-factors-diagnosis-wells-score-treatment): Pulmonary embolism occurs when venous thrombi embolize to the pulmonary artery or its branches. In the majority of cases, the thrombus is formed in the deep…
      - [Management of bradycardia (bradyarrhythmia)](/docs/books/cardiovascular-medicine/structural-heart-disease/management-of-acute-bradycardia-bradyarrhythmia): https://ekg.nu/amne/bradykardi-behandling-diagnos-bradyarytmi-pacemaker/#Acute bradycardia with hemodynamic effects is a potentially life-threatening…
      - [Anticoagulation Strategies in Atrial Fibrillation](/docs/books/cardiovascular-medicine/structural-heart-disease/atrial-fibrillation-anticoagulation-strategies): Atrial fibrillation AF is the most common sustained cardiac arrhythmia and a profound driver of global cardiovascular morbidity and mortality, primarily due…
      - [Brugada Syndrome: Diagnosis & SCD Prevention](/docs/books/cardiovascular-medicine/structural-heart-disease/brugada-syndrome-diagnosis-scd-prevention): Since its initial description in 1992 as a syndrome of right bundle branch block, ST-segment elevation, and sudden cardiac death SCD, Brugada syndrome BrS…
      - [Ventricular Tachycardia](/docs/books/cardiovascular-medicine/structural-heart-disease/ventricular-tachycardia): Ventricular tachycardia VT represents a complex and potentially lethal spectrum of cardiac arrhythmias that remains a formidable challenge in contemporary…
    - Drug Manuals
      - [Drug Manuals](/docs/books/cardiovascular-medicine/drug-manuals): Chapters in Drug Manuals.
      - [Antiarrhythmic drugs in ventricular tachyarrhythmias](/docs/books/cardiovascular-medicine/drug-manuals/antiarrhythmic-drugs-in-ventricular-tachyarrhythmias): This manual presents recommendations for the management of ventricular tachyarrhythmias VT, VF. It is primarily intended for use in an emergency setting.…
      - [Inotropes and Vasopressors: Doses, indications, contraindications and effects](/docs/books/cardiovascular-medicine/drug-manuals/inotropes-and-vasopressors-doses-indications-contraindications-and-effects): Vasopressors induce vasoconstriction and increase mean arterial pressure MAP. Inotropes increase cardiac contractile force contractility. Several endogenous…
      - [Levosimendan (Simdax, Simendan) in acute heart failure](/docs/books/cardiovascular-medicine/drug-manuals/levosimendan-simdax-simendan-in-acute-heart-failure): Levosimendan exhibits both inotropic and vasodilatory effects. The drug exerts its effects through three pharmacological mechanisms: 1 augmentation of…
      - [Hypertensive emergency (crisis)](/docs/books/cardiovascular-medicine/drug-manuals/hypertensive-emergency-crisis): This drug manual is provided for use in patients with hypertensive emergency also referred to as hypertensive crisis or malignant hypertension. Hypertensive…
      - [Adenosine for tachyarrhythmias (AVNRT, AVRT, NCT)](/docs/books/cardiovascular-medicine/drug-manuals/adenosine): Substance: Adenosine
    - Myocardial perfusion imaging (SPECT, PET)
      - [Myocardial perfusion imaging (SPECT, PET)](/docs/books/cardiovascular-medicine/myocardial-perfusion-imaging-spect-pet): Chapters in Myocardial perfusion imaging SPECT, PET.
      - [Principles of myocardial perfusion imaging (SPECT, PET), coronary blood flow and flow reserve (CFR)](/docs/books/cardiovascular-medicine/myocardial-perfusion-imaging-spect-pet/principles-of-myocardial-perfusion-imaging-vasodilators-radiotracers-and-imaging-techniques): Myocardial perfusion imaging MPI is a non-invasive technique for detecting and quantifying coronary artery disease CAD. It offers visual and numerical…
      - [Indications and contraindications for myocardial perfusion imaging](/docs/books/cardiovascular-medicine/myocardial-perfusion-imaging-spect-pet/indications-and-contraindications-for-myocardial-perfusion-imaging): 2. Diagnosis of coronary artery disease CAD: Myocardial perfusion imaging can confirm or rule out CAD in patients with symptoms suggestive of CAD.
      - [The ischemic cascade](/docs/books/cardiovascular-medicine/myocardial-perfusion-imaging-spect-pet/the-ischemic-cascade): The ischemic cascade describes the sequence of events during myocardial ischemia, beginning with perfusion abnormalities and ultimately leading to chest…
      - [Physics of myocardial perfusion imaging (SPECT, PET): Radiotracers, perfusion, blood flow and viability](/docs/books/cardiovascular-medicine/myocardial-perfusion-imaging-spect-pet/physics-of-myocardial-perfusion-imaging-spect-pet-radiotracers-perfusion-and-blood-flow): Quantitative PET perfusion imaging offers precise measurements of myocardial blood flow in milliliters per minute per gram of tissue mL/min/g. This…
      - [Pharmacologic agents in myocardial perfusion imaging](/docs/books/cardiovascular-medicine/myocardial-perfusion-imaging-spect-pet/pharmacologic-agents-in-myocardial-perfusion-imaging): Pharmacologic stress tests are indicated in the following scenarios:
      - [Interpretation of myocardial perfusion images (Myocardial SPECT / PET)](/docs/books/cardiovascular-medicine/myocardial-perfusion-imaging-spect-pet/interpretation-of-myocardial-perfusion-images-spect-pet): Interpreting myocardial perfusion SPECT images involves a systematic comparison of rest and stress images to assess myocardial ischemia and infarction. The…
  - Sudden Cardiac Arrest and Cardiopulmonary Resuscitation (CPR)
    - [Sudden Cardiac Arrest and Cardiopulmonary Resuscitation (CPR)](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr): Chapters from Sudden Cardiac Arrest and Cardiopulmonary Resuscitation (CPR).
    - Introduction to sudden cardiac arrest and resuscitation
      - [Introduction to sudden cardiac arrest and resuscitation](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/introduction-to-sudden-cardiac-arrest-and-resuscitation): Chapters in Introduction to sudden cardiac arrest and resuscitation.
      - [Terminology of sudden cardiac arrest and resuscitation](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/introduction-to-sudden-cardiac-arrest-and-resuscitation/terminology-of-sudden-cardiac-arrest-and-resuscitation): This chapter will introduce the most common and essential terms used in resuscitation science, providing a foundation for understanding subsequent chapters.
      - [Introduction to cardiac arrest](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/introduction-to-sudden-cardiac-arrest-and-resuscitation/introduction-to-cardiac-arrest): In 1961 the Journal of the American Medical Association JAMA published an article titled Hearts too good to die JAMA,…
      - [Epidemiological aspects of cardiac arrest](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/introduction-to-sudden-cardiac-arrest-and-resuscitation/epidemiological-aspects-of-cardiac-arrest): There are currently several large registries monitoring resuscitation practices. Some data sources also monitor sudden cardiac arrest. The EuReCA…
      - [The chain of survival in sudden cardiac arrest](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/introduction-to-sudden-cardiac-arrest-and-resuscitation/the-chain-of-survival): Time is the most critical factor for survival in cardiac arrest. Life-saving interventions must be initiated momentarily to maximize the probability of…
    - Resuscitation physiology and mechanisms
      - [Resuscitation physiology and mechanisms](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/resuscitation-physiology-and-mechanisms): Chapters in Resuscitation physiology and mechanisms.
      - [The 3-phase model of sudden cardiac arrest](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/resuscitation-physiology-and-mechanisms/the-3-phase-model-of-sudden-cardiac-arrest): The course from sudden cardiac arrest SCA to death follows a pathophysiological process that affects the effectiveness of the interventions. Numerous…
      - [The physiology of cardiopulmonary resuscitation (CPR)](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/resuscitation-physiology-and-mechanisms/the-physiology-of-cardiopulmonary-resuscitation): The forces that drive coronary and cerebral perfusion, and ventilation of the lungs during cardiopulmonary resuscitation CPR differ substantially from…
    - Causes of sudden cardiac arrest and death
      - [Causes of sudden cardiac arrest and death](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/causes-of-sudden-cardiac-arrest-and-death): Chapters in Causes of sudden cardiac arrest and death.
      - [Risk factors for sudden cardiac arrest](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/causes-of-sudden-cardiac-arrest-and-death/risk-factors-for-sudden-cardiac-arrest): The purpose of discovering and measuring risk factors is to obtain estimates of risk, tailor management according to the risk and monitor risk…
      - [Causes of sudden cardiac arrest](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/causes-of-sudden-cardiac-arrest-and-death/causes-of-sudden-cardiac-arrest): It is commonly stated that approximately 80% of all cardiac arrests are caused by acute or chronic coronary artery disease, with the latter being the most…
    - ECG atlas of ventricular tachyarrhythmias in cardiac arrest
      - [ECG atlas of ventricular tachyarrhythmias in cardiac arrest](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/ecg-atlas-of-ventricular-tachyarrhythmias-in-cardiac-arrest): Sudden cardiac arrest is mostly heralded by ventricular tachyarrhythmias. This chapter presents the electrocardiographic ECG manifestations of ventricular…
      - [Sudden cardiac arrest: Case 1](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/ecg-atlas-of-ventricular-tachyarrhythmias-in-cardiac-arrest/case-1): Each recording presents two leads recorded simultaneously.
      - [Sudden cardiac arrest: Case 2](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/ecg-atlas-of-ventricular-tachyarrhythmias-in-cardiac-arrest/case-2): Each recording presents two leads recorded simultaneously.
      - [Sudden cardiac arrest: Case 3](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/ecg-atlas-of-ventricular-tachyarrhythmias-in-cardiac-arrest/case-3): ECG 1. Sinus rhythm interrupted by ventricular tachycardia VT.
      - [Sudden cardiac arrest: Case 4](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/ecg-atlas-of-ventricular-tachyarrhythmias-in-cardiac-arrest/case-4): ECG 1. Sinus rhythm interrupted by ventricular tachycardia VT.
      - [Sudden cardiac arrest: Case 5](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/ecg-atlas-of-ventricular-tachyarrhythmias-in-cardiac-arrest/case-5): ECG 1. Sinus rhythm interrupted by polymorphic VT.
      - [Sudden cardiac arrest: Case 6](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/ecg-atlas-of-ventricular-tachyarrhythmias-in-cardiac-arrest/cardiac-arrest-case-6): ECG 1. The initial rhythm is atrial fibrillation. The fifth beat is a ventricular premature beat. A ventricular tachycardia VT emerges. As evident,…
      - [Sudden cardiac arrest: Case 7](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/ecg-atlas-of-ventricular-tachyarrhythmias-in-cardiac-arrest/sudden-cardiac-arrest-case-7): ECG 1. The underlying rhythm is atrial fibrillation, which is interrupted by polymorphic ventricular tachycardia VT.
      - [Sudden cardiac arrest: Case 8](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/ecg-atlas-of-ventricular-tachyarrhythmias-in-cardiac-arrest/sudden-cardiac-arrest-case-8): !/img/2023/11/ventricular-tachycardia-fibrillation-flutter-monomorphic-polymorphic-1-2.webp
    - Cardiopulmonary Resuscitation
      - [Cardiopulmonary Resuscitation](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/cardiopulmonary-resuscitation): Chapters in Cardiopulmonary Resuscitation.
      - [Basic Life Support (BLS) in cardiac arrest](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/cardiopulmonary-resuscitation/basic-cardiopulmonary-resuscitation-bls-basic-life-support): Basic life support BLS can be provided by anyone, including laypeople. As shown in Table 1, BLS is an exceptionally effective treatment, with a very low…
      - [Arrhythmias before and during cardiac arrest](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/cardiopulmonary-resuscitation/arrhythmias-before-and-during-cardiac-arrest): Cardiac arrest is a result of tachyarrhythmia, bradyarrhythmia or asystole. The tachyarrhythmias include ventricular fibrillation VF and pulseless…
      - [Advanced cardiopulmonary resuscitation (CPR) - Advanced cardiovascular life support (ACLS)](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/cardiopulmonary-resuscitation/advanced-cpr-acls): This chapter discusses interventions and evaluations performed during advanced cardiovascular life support ACLS. While basic life support BLS can be…
      - [Interpretation of ECG after ROSC (Return of Spontaneous Circulation)](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/cardiopulmonary-resuscitation/interpretation-of-ecg-after-rosc-return-of-spontaneous-circulation): A standard 12-lead ECG should be recorded in all patients after return of spontaneous circulation ROSC. The purpose of a 12-lead ECG is to detect…
      - [Care after return of spontaneous circulation (ROSC)](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/cardiopulmonary-resuscitation/post-resuscitation-care): Victims of out-of-hospital cardiac arrest OHCA who achieve ROSC in the emergency room ER are transferred to the intensive care unit ICU, coronary care unit…
      - [Short and long-term prognostication in cardiac arrest](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/cardiopulmonary-resuscitation/short-and-long-term-prognostication-in-cardiac-arrest): Neurons are exceptionally vulnerable to hypoxia and anoxia Casas et al. In cardiac arrest without chest compressions i.e. if cerebral perfusion ceases,…
      - [Assessment of the pupillary reflex in cardiac arrest](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/cardiopulmonary-resuscitation/assessment-of-pupils-pupillary-reflex-in-cardiac-arrest): In cardiac arrest, constricted, light-responsive pupils suggest a favorable prognosis. In contrast, dilated, light-unresponsive pupils are indicative of…
      - [Ultrasound (echocardiography) in cardiac arrest and resuscitation](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/cardiopulmonary-resuscitation/ultrasound-echocardiography-in-cardiac-arrest-and-resuscitation): In the context of cardiac arrest, focused echocardiography entails a swift evaluation of ventricular contractions and the status of the pericardium by an…
      - [Capnography (end-tidal carbon dioxide measurement, ETCO2) during cardiac arrest](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/cardiopulmonary-resuscitation/capnography-etco2-in-cardiac-arrest-and-resuscitation): Capnography refers to the measurement of end-tidal carbon dioxide ETCO2 in the respiratory system. ETCO2 is the partial pressure of carbon dioxide CO2 at…
      - [Extracorporeal cardiopulmonary resuscitation (ECPR)](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/cardiopulmonary-resuscitation/extracorporeal-cardiopulmonary-resuscitation-ecpr): Survival after cardiac arrest depends on the restoration of spontaneous cardiac rhythm. The likelihood of achieving spontaneous cardiac activity is a…
    - Special Circumstances
      - [Special Circumstances](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/special-circumstances): Chapters in Special Circumstances.
      - [Cardiac arrest in hypothermia (accidental hypothermia)](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/special-circumstances/cardiac-arrest-in-hypothermia-accidentel-hypothermia): Accidental hypothermia is defined as an unintentional decrease in body temperature to below 35°C. The lowest recorded body temperatures from which patients…
      - [Cardiac arrest in hyperthermia and malignant hyperthermia](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/special-circumstances/cardiac-arrest-in-hyperthermia-and-malignant-hyperthermia): Hyperthermia is characterized by a body temperature exceeding the typical range of 36.5-37.6°C 97.7-99.7°F. It arises when heat production or acquisition…
      - [Cardiac arrest due to electrolyte imbalance](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/special-circumstances/cardiac-arrest-in-electrolyte-disturbances): Significant electrolyte imbalances can precipitate cardiac arrest and are potentially reversible etiologies when promptly and appropriately addressed. Both…
      - [Cardiac arrest during pregnancy and childbirth](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/special-circumstances/cardiac-arrest-during-pregnancy-and-childbirth): All healthcare units capable of managing pregnant women in cardiac arrest should engage in specialized clinical training to manage cardiac arrest during…
      - [Cardiac arrest during sepsis](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/special-circumstances/cardiac-arrest-in-sepsis): Sepsis is a life-threatening condition characterized by systemic inflammatory response syndrome SIRS, disseminated intravascular coagulation DIC, and…
      - [Cardiac arrest due to pneumothorax](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/special-circumstances/cardiac-arrest-due-to-pneumothorax): Pneumothorax is characterized by the presence of free air in the thoracic cavity. While this can occasionally be benign and manifest even in healthy…
      - [Cardiac tamponade causing cardiac arrest](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/special-circumstances/cardiac-arrest-at-tamponade-cardiac-tamponade): Cardiac arrest associated with tamponade has an exceptionally poor prognosis. In the vast majority of these cases, the tamponade develops acutely or…
      - [Cardiac arrest due to anaphylaxis](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/special-circumstances/hjartstopp-vid-anafylaxi): Anaphylactic cardiac arrest is managed following the cardiopulmonary resuscitation CPR algorithm, incorporating an intravenous administration of 1 mg…
      - [Cardiac arrest in intoxication (poisoning)](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/special-circumstances/cardiac-arrest-in-intoxication-poisoning): In adolescents and young adults, intoxication events leading to cardiac arrest are notably prevalent, primarily due to the misuse of prescription…
      - [Cardiac arrest due to hypoxia and asphyxia](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/special-circumstances/cardiac-arrest-due-to-hypoxia-and-asphyxia): Etiologies of hypoxic cardiac arrest:
      - [Traumatic cardiac arrest](/docs/books/sudden-cardiac-arrest-and-cardiopulmonary-resuscitation-cpr/special-circumstances/traumatic-cardiac-arrest): In cases of traumatic cardiac arrest, addressing reversible etiologies takes precedence over chest compressions. If trauma is not definitively established…
- Clinical Tools
  - [Clinical Tools](/docs/tools): Interactive calculators, reference values, drug manuals and treatment summaries for cardiovascular care.
  - Calculators
    - [Clinical calculators](/docs/tools/calculators): Interactive clinical calculators and risk scores with unit switching, live results and references to the primary literature.
  - Reference values
    - [Reference values](/docs/tools/reference-values): Normal ranges for ECG, echocardiography, haemodynamics and paediatric measurements.
    - [Reference values for adult ECG](/docs/tools/reference-values/reference-values-for-adult-ecg): Rhythm Checklist Assess ventricular (RR intervals) and atrial (PP intervals) rate and rhythm: Is ventricular rhythm regular? What is the ventricular rate (beats/min)? Is atrial…
    - [Reference values for pediatric and neonatal ECG](/docs/tools/reference-values/reference-normal-values-for-pediatric-neonatal-ecg-interpretation): Neonatal period Table 1. Normal limits for ECG parameters during neonatal period (Davignon et al) These reference values are the best available for the neonatal period. The…
    - [Heart rate and cycle length conversion table](/docs/tools/reference-values/heart-rate-and-cycle-length-conversion-table): Heart rate (bpm) = 60000 / cycle length Cycle length (ms) = 60000 / heart rate Heart rate (BPM) Cycle length (ms) Heart rate (BPM) Cycle length (ms) 20 3000 215 279 25 2400 220…

    - **Echocardiography**
    - [Left ventricular dimension and systolic function](/docs/tools/reference-values/left-ventricular-dimension-and-systolic-function): Visual assessment of regional wall motion (left ventricle) TYPE OF MOTION DEFINITION WALL MOTION SCORE Normal Normal thickening (typically 30% thickening from end-diastole to…
    - [Left ventricular diastolic function](/docs/tools/reference-values/left-ventricular-diastolic-function): Diastolic function Criteria Normal, young Normal, adult Abnormal relaxation (grade 1 dysfunction) Pseudonormal (grade 2 dysfunction) Reversible restrictive filling (grade 3…
    - [Left and right atrium](/docs/tools/reference-values/left-and-right-atrium): Reference values for atrial size and volume Women Men Normal range Mildly abnormal Moderately abnormal Severely abnormal Normal range Mildly abnormal Moderately abnormal Severely…
    - [Aorta, aortic stenosis (AS), aortic regurgitation (AR)](/docs/tools/reference-values/reference-values-for-aorta-aortic-stenosis-as-aortic-regurgitation-ar): Aortic dimensions using 2D echocardiography Normal interval Normal interval, adjusted Aortic annulus 20-31 mm 12-14 mm/m2 Sinus valsalva 29-45 mm 15-20 mm/m2 Sinotubular junction…
    - [Mitral valve](/docs/tools/reference-values/mitral-valve): Mitral valve regurgitation Primary parameters Mild regurgiation Moderate regurgitation Severe regurgitation Vena contracta (cm) 0,3 0,3-0,69 0,69 EROA (cm²) 0,20 0,20-0,39 0,39…
    - [Tricuspid valve](/docs/tools/reference-values/tricuspid-valve): Tricuspid valve regurgitation Primary parameters Mild regurgiation Moderate regurgitation Severe regurgitation PISA radius 0,6 0,6-0,9 0,9 Vena contracta (cm) not defined 0,7 0,7…
    - [Pulmonary valve](/docs/tools/reference-values/pulmonary-valve): Pulmonary valve regurgitation Mild regurgiation Moderate regurgitation Severe regurgitation Pulmonary valve morphology normal normal/abnormal abnormal Density CW-Doppler weak,…
    - [Right ventricle, pulmonary artery, pulmonary artery pressure](/docs/tools/reference-values/right-ventricle-pulmonary-artery-pulmonary-artery-pressure): Right ventricle and pulmonary artery Normal interval Mildly abnormal Moderately abnormal Severely abnormal RV DIMENSIONS Basal RV diameter (RVD 1), cm 2.0–2.8 2.9–3.3 3.4–3.8 3.9…
  - Drug manuals
    - [Drug manuals](/docs/tools/drug-manuals): Dosing, indications, contraindications and cautions for cardiovascular drugs.
    - [QT Drugs: Drugs causing QT prolongation, torsade de pointes (TdP) and long QT syndrome (LQTS)](/docs/tools/drug-manuals/comprehensive-list-of-drugs-causing-qt-prolongation-torsade-de-pointes-and-long-): A comprehensive list of conditions and drugs that may prolong the QT interval, and cause torsade de pointes (TdP) and long QT syndrome (LQTS) is presented below. With regards to…
    - [Inotropes and Vasopressors](/docs/tools/drug-manuals/inotropes-and-vasopressors-doses-indications-contraindications-and-effects): Inotropes and vasopressors Vasopressors induce vasoconstriction and increase mean arterial pressure (MAP). Inotropes increase cardiac contractile force (contractility). Several…
    - [Prasugrel (Effient, Efient, Prasita)](/docs/tools/drug-manuals/prasugrel-effient-efient-prasita): Brand names : Effient, Efient, Prasita Indications Prasugrel, administered in combination with acetylsalicylic acid (ASA), is indicated for the prevention of atherothrombotic…
    - [Ticagrelor (Brilinta, Brilique)](/docs/tools/drug-manuals/cv-drugs-ticagrelor-brilinta-brilique): Table 1 provides a summary of the indications, contraindications, dosage, administration, warnings, precautions, and other relevant information for the drug Ticagrelor . Table 1…
    - [Clevidipine](/docs/tools/drug-manuals/clevidipine): Clevidipine Drug Clevidipine Brand names Cleviprex ® Indications Hypertension and hypertensive emergency. Treatment of postoperative hypertension. Mechanism of action Ultra-short…
    - [Nicardipine](/docs/tools/drug-manuals/nicardipine): Nicardipine Drug Nicardipine Brand names Cardene ® Indications Hypertension, hypertensive emergency/crisis. Pregnancy induced hypertension. Angina pectoris Prinzmetal's angina…
    - [Enalaprilat](/docs/tools/drug-manuals/enalaprilat): Enalaprilat Enalaprilat is rarely used in hypertensive crisis due to its slow onset, prolonged duration of effect, and significant individual variations in its effect. Drug…
    - [Esmolol](/docs/tools/drug-manuals/esmolol): Esmolol Drug Esmolol Brand names Brevibloc ® Indications Short-term control of ventricular rate (including perioperative tachycardia) and hypertension (including hypertensive…
    - [Labetalol](/docs/tools/drug-manuals/labetalol): Labetalol Drug Labetalol Brand names Trandate ® Indications Mycoardial ischemia. Hypertension. Hypertensive emergency, including in pregnancy. Postoperative hypertension.…
    - [Metoprolol](/docs/tools/drug-manuals/metoprolol): Metoprolol Drug Metoprolol Brand names Dutoprol ®, Kapspargo ®, Lopressor ®, Lopressor Hct ®, Toprol ®, Seloken ® Indications Mycoardial ischemia. Perioperative hypertension.…
    - [Fenoldopam](/docs/tools/drug-manuals/fenoldopam): Fenoldopam Drug Fenoldopam Brand names Corlopam ® Indications Short term management of hypertension, including hypertensive emergency. Mechanism of action • Systemic Dopamine-1…
    - [Clonidine](/docs/tools/drug-manuals/clonidine): Clonidine Drug Clonidine Brand names Catapresan ®, Catapres ®, Dixarit ®, Catapres-TTS ®, Catapres-TTS-1 ®, Duraclon ®, Kapvay ® Indications • Agitated delirium • Analgesia •…
    - [Nitroglycerin](/docs/tools/drug-manuals/nitroglycerin): Nitroglycerin Patients using nitroglycerin regularly may have developed tolerance and require higher doses, alternatively nitroprusside to achieve desirable blood pressure lowring…
    - [Nitroprusside](/docs/tools/drug-manuals/nitroprusside): Nitroprusside Drug Nitroprusside Brand names Nipride ®, Nipride RTU ®, Nitropress ®. Indications Pulmonary edema, congestive heart failure. Angina pectoris. Hypertension,…
    - [Phentolamine](/docs/tools/drug-manuals/phentolamine): Phentolamine Drug Phentolamine Brand names Oraverse ®, Rogitine ® Indications Hypertensive crisis. Mechanism of action Phentolamine is a non-selective alpha-adrenergic blocker.…
    - [Hydralazine](/docs/tools/drug-manuals/hydralazine): Hydralazine Hydralazine is not preferred for hypertensive emergencies due to the high risk of reflex sympathetic stimulation. Drug Hydralazine Brand names Apresoline ®, Bidil ®…
    - [Drug-Induced Cardiotoxicity](/docs/tools/drug-manuals/drug-induced-cardiotoxicity): DICTrank: The Largest Reference List of 1318 Human Drugs Ranked by Risk of Drug-Induced Cardiotoxicity Using FDA Labeling . Drug Discovery Today. 2023. DICT = Drug-induced…
    - [Aspirin (Acetylsalicylic acid)](/docs/tools/drug-manuals/aspirin): Indications Acute myocardial infarction. Unstable coronary artery disease. Stable angina pectoris. Secondary prophylaxis to prevent recurrence of cerebrovascular diseases, such…
  - Treatment summaries
    - [Treatment summaries](/docs/tools/treatment-summaries): Guideline-based management summaries by condition, for bedside use.

    - **Acute coronary syndromes**
    - [Management of STEMI (ST-Elevation Acute Myocardial Infarction)](/docs/tools/treatment-summaries/management-of-stemi-st-elevation-acute-myocardial-infarction): This page summarises the most current recommendations for the management of acute coronary syndromes with persistent ST-segment elevations (i.e STEMI, ST-segment elevation acute…
    - [Reperfusion therapy (primary PCI, fibrinolysis) in patients with acute coronary syndromes (STEMI, NSTEMI, unstable angina)](/docs/tools/treatment-summaries/reperfusion-therapy-primary-pci-fibrinolysis-in-patients-with-acute-coronary-syn)
    - [Reperfusion strategy and fibrinolysis in patients with STEMI](/docs/tools/treatment-summaries/reperfusion-strategy-and-fibrinolysis-in-patients-with-stemi)
    - [Management of multivessel disease in patients with ACS undergoing PCI](/docs/tools/treatment-summaries/management-of-multivessel-disease-in-patients-with-acs-undergoing-pci)
    - [Antiplatelet therapy and anticoagulants in STEMI, NSTEMI and unstable angina](/docs/tools/treatment-summaries/antiplatelet-therapy-and-anticoagulants-in-stemi-nstemi-and-unstable-angina)
    - [Antithrombotic regimens in patients with ACS with and without an indication for oral anticoagulation](/docs/tools/treatment-summaries/antithrombotic-regimens-in-patients-with-acs-with-and-without-an-indication-for-)
    - [Lipid lowering therapy after ACS](/docs/tools/treatment-summaries/lipid-lowering-therapy-after-acs): Initial Focus: High-potency statin therapy is foundational unless contraindicated. Combination Therapy: Ezetimibe is the next step if LDL-C targets are not met with statins alone.…
    - [Lipid lowering therapy after acute coronary syndromes](/docs/tools/treatment-summaries/lipid-lowering-therapy-after-acute-coronary-syndromes): Adapted from AHA, ACC and ESC guidelines.

    - **Heart failure**
    - [Diagnosis and initial management of heart failure (HFrEF, HFmrEF, HFpEF)](/docs/tools/treatment-summaries/diagnosis-and-initial-management-of-heart-failure-hfref-hfmref-hfpef): Overview of diagnosis, classification and management of heart failure
    - [Management of heart failure with reduced ejection fraction (HFrEF)](/docs/tools/treatment-summaries/management-of-heart-failure-with-reduced-ejection-fraction-hfref)
    - [Device therapy in patients with heart failure and reduced ejection fraction (HFrEF)](/docs/tools/treatment-summaries/device-therapy-in-patients-with-heart-failure-and-reduced-ejection-fraction-hfre)

    - **Arrhythmia and hypertension**
    - [Antiarrhythmic drugs in acute ventricular arrhythmias (ventricular tachycardia, ventricular fibrillation)](/docs/tools/treatment-summaries/antiarrhythmic-drugs-in-acute-ventricular-arrhythmias-ventricular-tachycardia-ve): Antiarrhythmic drugs and management of ventricular tachycardia, ventricular fibrillation This manual presents recommendations for the management of ventricular tachyarrhythmias…
    - [Hypertensive emergency (crisis) – Drugs, doses & management](/docs/tools/treatment-summaries/hypertensive-emergency-crisis-drugs-doses-management): This drug manual is provided for use in patients with hypertensive emergency (also referred to as hypertensive crisis or malignant hypertension ). Hypertensive emergency is…
- ICD-10
  - [ICD-10 Codes](/docs/icd): Fast lookup across 46,146 ICD-10 diagnosis codes.
- Quizzes
  - [Exams](/docs/quizzes): Interactive question banks across ECG interpretation, clinical management and general cardiology.
- Clinical Q&A
  - [Clinical Q&A](/docs/clinical-qa): Referenced answers to common clinical questions in cardiology.
  - [What is the difference between cardioversion and defibrillation for arrhythmias?](/docs/clinical-qa/what-is-the-difference-between-cardioversion-and-defibrillation-for-arrhythmias): Electrical cardioversion is the delivery of a precisely regulated electrical shock to terminate a tachyarrhythmia, and it encompasses both synchronized cardioversion and…
  - [ECG Criteria for STEMI (ST Elevation Myocardial Infarction)](/docs/clinical-qa/ecg-criteria-for-stemi-st-elevation-myocardial-infarction): ECG Criteria for ST Elevation Myocardial Infarction (STEMI) The diagnosis of STEMI relies on specific electrocardiographic thresholds for ST segment elevation measured at the J…
  - [Differential Diagnosis of Chest Pain: A Clinical Overview](/docs/clinical-qa/differential-diagnosis-of-chest-pain-a-clinical-overview): Differential Diagnosis of Chest Pain: A Clinical Overview The evaluation of acute chest discomfort requires a systematic differential diagnosis, as the syndrome associated with…
  - [Left Bundle Branch Block: ECG criteria and clinical implications](/docs/clinical-qa/left-bundle-branch-block-ecg-criteria-and-clinical-implications): Left Bundle Branch Block (LBBB) Electrocardiographic Criteria and Characteristics Left bundle branch block is characterized by a significant reorganization of the activation and…
  - [Torsades de Pointes: Definition, Characteristics, and Management](/docs/clinical-qa/torsades-de-pointes-definition-characteristics-and-management): Torsades de Pointes: Definition, Characteristics, and Management Definition and Clinical Characteristics Torsades de pointes (TdP) represents a multifactorial clinical entity…
- Blog
  - [Blog](/docs/blog): Articles and clinical commentary on cardiovascular medicine.
  - [A new ECG biomarker for sudden cardiac death](/docs/blog/a-new-ecg-biomarker-for-sudden-cardiac-death): A deep-learning ECG biomarker for sudden cardiac death: what the new Nature study shows Low-risk (blue) versus high-risk (red) ECG morphs in lead aVL (adapted from Obermeyer et al…
  - [Incretins in Cardiometabolic Medicine: Leveraging GLP-1, GIP, and Glucagon Receptor Agonism for Cardiovascular Risk Reduction](/docs/blog/incretins-in-cardiometabolic-medicine-leveraging-glp-1-gip-and-glucagon-receptor): Cardiovascular medicine is currently witnessing a paradigm shift. For decades, the management of type 2 diabetes mellitus (T2DM) and obesity was siloed, with clinicians focusing…
  - [Quiz: ECG in athletes](/docs/blog/quiz-ecg-in-athletes): 1. Which of the following ECG findings is typically considered a normal variant in asymptomatic athletes with no significant family history? A: Mobitz Type II 2nd AV block B:…
  - [Posterior acute myocardial infarction (STEMI)](/docs/blog/posterior-acute-myocardial-infarction-stemi): Posterior (posterolateral) acute myocardial infarction (STEMI) The heart is rotated 30° to the left in the thorax. This positions the basal portion of the left lateral wall…
  - [The electrical axis of the heart (ECG axis)](/docs/blog/the-electrical-axis-of-the-heart-ecg-axis): The electrical axis of the heart Although often ignored, assessment of the electrical axis is an integral part of ECG interpretation. The electrical axis reflects the average…
  - [The Best Clinical ECG Book: ECG Made Easy or Complete?](/docs/blog/the-best-ecg-book-recommended-ekg-book): The best ECG book is not the one making it simple In the thrilling and ever-evolving field of medicine, a question echoes in the hallways of hospitals, universities, and medical…
  - [Cardiovascular effects of COVID-19 (Coronavirus Disease 2019)](/docs/blog/cardiovascular-effects-of-covid-19-coronavirus-disease-2019): Cardiovascular effects of COVID-19 Coronavirus disease 2019 (COVID-19) has caused a global public health crisis. It is believed that the virus was transmitted from bats to humans…
  - [Download certificates of completion](/docs/blog/download-certificates-of-completion): In January of this year, we administered a poll to see whether our users were interested in obtaining certificates. The results were clear: 89% of users were interested in…
  - [A Novel Familial Cardiac Arrhythmia Syndrome Identified Using ECG](/docs/blog/novel-familial-cardiac-arrhythmia-syndrome-identified-using-ecg): A novel potentially life-threatening cardiac arrhythmia syndrome identified with ECG The ECG may be used to diagnose several cardiac genetic disorders, such as Brugada syndrome ,…
  - [The electrical axis of the heart (heart axis): ECG & physiology](/docs/blog/electrical-axis-of-the-heart-ecg-physiology-definition): The electrical axis of the heart (heart axis) Although often ignored, assessment of the electrical axis is an integral part of ECG interpretation. The electrical axis reflects the…
  - [The T-wave: physiology, variants and ECG features](/docs/blog/the-t-wave-physiology-variants-and-ecg-features): The normal T-wave Assessment of the T-wave represents a difficult but fundamental part of ECG interpretation. The normal T-wave in adults is positive in most precordial and limb…
  - [The ST segment: physiology, normal appearance, ST depression & ST elevation](/docs/blog/st-segment-normal-abnormal-depression-elevation-causes): The ST segment: physiology, normal appearance, ST depression ST elevation The ST segment corresponds to the plateau phase of the action potential ( Figure 13 ). The ST segment…
  - [QT duration & corrected QT (QTc) duration: ECG features & implications](/docs/blog/qt-duration-corrected-qt-qtc-duration-ecg-features): QT duration and corrected QT (QTc) duration ECG interpretation always includes an assessment of the QT interval (QT duration). The QT duration represents the total time for…
  - [P-wave, PR interval, PR segment: physiology, criteria & ECG findings](/docs/blog/p-wave-pr-interval-segment-physiology-criteria-ecg): Physiology and ECG features of the P-wave, PR interval and PR segment The P-wave ECG interpretation usually starts with assessment of the P-wave. The P-wave is a small, positive…
  - [Answer to ECG quiz 5](/docs/blog/answer-to-ecg-quiz-5): The ECG shows AV-block III (complete heart block) . P-waves are not related to QRS. PP-interval is constant, but independent of RR-interval, which is also constant. Atria and…
  - [The QRS complex: ECG features of the Q-wave, R-wave, S-wave & duration](/docs/blog/ecg-qrs-complex-q-r-s-wave-duration-interval): The QRS complex (ventricular complex): normal and abnormal configurations and intervals A complete QRS complex consists of a Q-, R- and S-wave. However, all three waves may not be…
  - [Overview of the ECG Waves, Deflections, Intervals, Durations](/docs/blog/overview-of-the-ecg-waves-deflections-intervals-durations): Video lecture: The ECG curve: P-wave, PR Interval, Q-wave, R-wave, S-wave, QRS complex, ST segment, T-wave and QT interval
  - [CME: How dietary fat affects coronary arteries, LDL cholesterol and body weight](/docs/blog/ischemic-heart-disease-ldl-cholesterol-dietary-fat-statins): Coronary artery disease: On LDL cholesterol, dietary fat statins You are probably aware that ischemic heart disease , also known as coronary artery disease, has been the number…
  - [Introduction to pediatric & neonatal ECG interpretation](/docs/blog/pediatric-neonatal-ecg-interpretation): Principles of pediatric neonatal ECG interpretation Pediatric and neonatal ECG interpretation follows the same principles as ECG interpretation in adults, but there are important…
  - [Our friends](/docs/blog/friends): E-resources you should bookmark Taming the SRU Drs Jeffery Hill, Ryan Lafollette and Bill Hinckley run this amazing website which includes everything from ultrasound knobology and…
  - [Download the Pocket Guide to ECG Interpretation (PDF)](/docs/blog/pocket-guide-to-ecg-interpretation-pdf): The ECG must always be interpreted systematically. Failure to perform systematic interpretation may actually be detrimental. We have therefore compiled a pocket guide with a…
  - [Myocardial ischemia and infarction: lack of oxygen or imbalance between supply/demand](/docs/blog/myocardial-ischemia-ischaemia-grand-textbook-failure): 2016
  - [Early repolarization on ECG: when guidelines confuse ECG criteria](/docs/blog/guidelines-confuse-ecg-criteria): 2016
- Board exams
  - [Cardiology board exams](/docs/board-exams): Guides to the cardiology certification examinations: the European Exam in Core Cardiology (EECC) in Europe, the ABIM Cardiovascular Disease exam in the United States, and the Royal College examination in Canada.
  - [European Exam in Core Cardiology (EECC): format, eligibility and preparation](/docs/board-exams/european-exam-in-core-cardiology-eecc): A complete guide to the European Exam in Core Cardiology — 120 multiple-choice questions in three hours, sat online under proctoring, registered through your National Cardiac Society and aligned to the ESC Core Curriculum.
  - [Cardiology board certification in the USA and Canada: ABIM and Royal College exams](/docs/board-exams/cardiology-board-certification-usa-canada): A guide to the ABIM Cardiovascular Disease Certification Examination and the Royal College of Canada examination in Cardiology (Adult) — eligibility, format, content, ECG and imaging components, and how to prepare.