Cardiac Measurements, ECG Findings, and Heart Conditions

DS Dydis Diastole (RV): N (Upper Limit): 38

TCZJA (Tricuspid): N: >16

KP Dydis (LA): M: 42, F: 38

KP Turio Index (LA Index): N (Upper Limit): 34 mm

Aorta: N (Upper Limit): 40

Pulmonary Artery: N: 24

DP Dydis (RA): N (Upper Limit): 45

Right Atrial Enlargement (RAE):

• II: Tall P wave (>2.5mm)
• V1: >1 small box (+)
• Right Axis Deviation (RAD)

Left Atrial Enlargement (LAE):

• II: Biphasic P wave, >0.12s
• V1: >1 small box (-)
• Left Axis Deviation (LAD)

Left Ventricular Hypertrophy (LVH):

• Tall R waves: I, aVL, V5, V6
• Deep S waves: V1, V2
• Left Axis Deviation (LAD)
• Sokolow-Lyon Criteria: S(V1) + R(V5/V6) > 35 mm
• R(aVL) > 11mm (or 13mm in some sources)
• S Wave (V1, V2) > 30 mm

Right Ventricular Hypertrophy (RVH):

• Tall R waves: Opposite of LVH leads
• Deep S waves: Opposite of LVH leads
• Right Axis Deviation (RAD)
• R > S in V1

Left Bundle Branch Block (LBBB):

• V1: Predominantly negative QRS complex
• V5, V6: Predominantly positive QRS complex

Right Bundle Branch Block (RBBB):

• V1: Predominantly positive QRS complex, often with RSR’ pattern
• QRS complex is wide
• V5, V6: Predominantly negative QRS complex

1st Degree AV Block:

• No dropped beats
• Prolonged PR interval

2nd Degree AV Block:

• Dropped beats
• QRS duration: Normal or increased
• PR interval: Increased or normal

3rd Degree AV Block:

• P waves and QRS complexes are independent
• Ventricular rhythm is usually regular
• PR interval is variable

Restrictive Cardiomyopathy:

• Decreased heart rate
• Decreased QRS voltage
• Increased PR interval

Diagnosis:

1. History:
   • Chest pain lasting >20 minutes, often radiating to the left arm or jaw
   • Nausea and vomiting
2. ECG:
   • Hyperacute T waves
   • ST segment elevation
   • Pathological Q waves
3. Blood Tests (Biomarkers):
   • Troponin I, T (peaks at 48 hours)
   • CK-MB (rises within 2-3 hours, peaks at 24 hours)

Treatment:

1. Observation (to prevent ventricular fibrillation)
2. Angioplasty
3. Medications:
   • Aspirin (for life, antiplatelet)
   • Intravenous beta-blockers (often continued long-term)
   • Heparin (anticoagulant)
   • Nitroglycerin (for pain)
   • Statin (for dyslipidemia)
4. Bed rest, 100% oxygen
5. Repeat ECG
6. Eliminate risk factors: Diet, smoking cessation

• Chest X-ray: Increased heart size
• Pulmonary edema
• S3 murmur
• Displaced apical impulse (5th-6th intercostal space)
• ECG: Atrial fibrillation may be present

• ACE inhibitors (e.g., Captopril)
• Loop diuretics (e.g., Furosemide)
• Beta-blockers (e.g., Metoprolol), after discharge

• Symptoms: Fatigue, dizziness, shortness of breath, stroke
• ECG: Absence of P waves

• Medications to control heart rate
• Medications to reduce clot formation (anticoagulants)

• ECG: F waves (sawtooth pattern)
• Symptoms: Tachycardia

• Anticoagulants
• Rate control (beta-blockers, calcium channel blockers)
• Cardioversion procedure

• May be asymptomatic
• Murmur

Diagnosis:

• Left atrial hypertrophy
• Can be asymptomatic
• Murmur during diastole
• Dyspnea, fatigue, hemoptysis
• Echocardiogram
• ECG

Treatment:

1. Preload reduction via diuretics
2. If atrial fibrillation is present: Digoxin and Warfarin (Digoxin for arrhythmia)
3. Surgery if medical treatment fails:
   • Valvuloplasty
   • Valve replacement

Diagnosis:

• History of previous MI
• Symptoms: Dyspnea, shortness of breath, pulmonary edema
• Systolic murmur at the apex
• S3 heart sound
• Wheezing
• Jugular venous distention
• Echocardiography
• ECG

Treatment:

• Surgery (if LVEF < 60% or LVESD > 45mm)
• Afterload reduction:
  • Nitrates + ACE inhibitors
• If atrial fibrillation is present: Digoxin and Warfarin

Diagnosis:

• Symptoms: Dyspnea, shortness of breath, chest pain
• Paradoxical S2 split
• Late and weak pulse
• Carotid thrill
• Echocardiogram
• ECG

Treatment:

• Surgery (if valve orifice < 0.8 cm²)
• Antibiotic prophylaxis (for certain procedures)

Diagnosis:

• History of hypertension
• Shortness of breath, dyspnea, and palpitations
• Murmur during diastole

Treatment:

• Preload reduction:
  • Sodium restriction
  • Diuretics (e.g., Furosemide)
• Surgery when LVEF < 55%

Diagnosis:

• Pain, palpitations, panic attacks
• Mid-systolic click murmur
• Echocardiogram

Treatment (if symptomatic):

• Beta-blockers for chest pain