Arrhythmias and electrophysiology
Nicholas Green, Steven Gaydos, Hutchison Ewan, Edward Nicol in Handbook of Aviation and Space Medicine, 2019
ECG findings in aircrew that require further investigation: T wave inversion.ST segment flattening or depression.New complete bundle branch block.Multiple ectopic beats.Atrial tachycardia.Delta waves (in Wolff-Parkinson-White).Brugada phenotypes.
Barbiturates, Alcohol, And Tranquilizers
S.J. Mulé, Henry Brill in Chemical and Biological Aspects of Drug Dependence, 2019
Alcoholic cardiomyopathy occurs in patients with a long history of excessive alcohol ingestion. These individuals most commonly notice dyspnea upon exertion, palpitations, night cough, weakness, and edema. In the early stages tachycardia or atrial fibrillation is seen. In later stages cardi-omegaly with frank signs of heart failure develop. Among the electrocardiographic changes considered by some authorities to be distinctive in this form of heart failure are an early “spinous” T wave (needle-like spike), and a T wave which has either a shallow notch or deeper cleft at its summit. These effects may be due to progressive myocardial fibrosis which may eventually lead to inversion of the T wave. Electrocardiographic evidence of atrioventricular block is also common.
Electrocardiography and arrhythmias
Neil Herring, David J. Paterson in Levick's Introduction to Cardiovascular Physiology, 2018
Ventricular repolarization is slower and less synchronous than depolarization, so it generates a broad, but relatively low-magnitude wave, the T wave (Figure 5.3). The second heart sound follows closely after the T waves. Both the T and R waves are upright in most ECG recordings, even though repolarization is the electrical opposite of depolarization. The explanation of this oddity is deferred to Section 5.5, because it depends on the concept of ‘cardiac dipole' (Section 5.4). Myocardial ischaemia can cause T wave inversion (see Section 5.9 and Figure 5.10).
Takotsubo cardiomyopathy and acute manic attack
Published in Baylor University Medical Center Proceedings, 2020
Amr Idris, Jared L. Christensen, Mohanad Hamandi, Swathie Bayya, Zuyue Wang, Sameh Sayfo, Chadi Dib, Srinivasa Potluri, Molly Szerlip, Karim M. Al-Azizi
TC presents with signs and symptoms that are similar to those of acute coronary syndrome. The electrocardiogram in TC may be completely normal; however, several abnormalities including ST segment changes and QT, PR, T, or Q wave abnormalities may be seen.1 Our patient’s electrocardiogram exhibited both diffuse T wave inversions and a prolonged QT interval. Using echocardiogram or left ventriculogram findings, TC can be classified as focal, basal midventricular, and apical. Our patient had apical TC, which is the most reported type, found in more than 80% of patients with TC.1 TC should be differentiated from other causes of acute heart failure given the elevated brain natriuretic peptide, left ventricular end diastolic pressure, and low left ventricular ejection fraction in these conditions. When a patient with TC undergoes cardiac angiography, the coronary arteries show no angiographic evidence of coronary artery disease. Therefore, TC should be differentiated from myocardial infarction, as both have different management and prognosis. Unfortunately, there are no current trials evaluating the treatment of TC; most current treatments are hypothetical and directed toward relieving symptoms, possibly decreasing the likelihood of future events, and following guideline-directed medical therapy for heart failure.
Central Nervous System and Cardiac Involvement in the Hypereosinophilic Syndrome: A Case Report
Published in Immunological Investigations, 2021
Reza Kiani, Batoul Naghavi, Ahmad Amin, Anita Sadeghpour, Ali Zahedmehr, Ata Firouzi, Hamid Reza Pouraliakbar, Saeed Ebrahimi Meymand, Armin Marashizadeh, Simin Almasi
The hypereosinophilic cardiac disease may involve the three cardiac layers, presented from acute myocarditis to endomyocardial fibrosis. The clinical presentation manifested mainly by heart failure and embolic events (Davies et all. 1983; Filippetti et al. 2017). Pericardium predominantly involved as pericardial effusion and tamponade in some cases due to HES (Arvie and Duggal 2009; Kline et al. 2016). In this patient, cardiac tamponade was the first clinical presentation. T wave inversion was the only ECG abnormality in this case. In previous studies, Electrocardiographic abnormalities present only in 1/3 of the patients and T wave inversion is the most common finding on the ECG (Mankad et al. 2016). Other symptoms such as chest pain, palpitations, syncope, and sudden cardiac death were rarely reported in the context of hypereosinophilia (Coelho-Filho et al. 2010; Parrillo et al. 1979).
Association between Tpeak-Tend/QT and major adverse cardiovascular events in patients with Takotsubo syndrome
Published in Acta Cardiologica, 2021
Annabella Braschi, Arian Frasheri, Renzo M. Lombardo, Maurizio G. Abrignani, Rosalia Lo Presti, Daniele Vinci, Marcello Traina
Considering only ventricular tachyarrhythmias and death and subdividing the study population on the basis of their occurrence, it was found that, the group, in which the aforementioned in-hospital complications occurred, was characterised by older age (75.7 ± 7.5 years versus 65.6 ± 9.8 years) and lower EF (39.0 ± 7.9% versus 46.2 ± 10.5%); however, these differences were not statistically significant (p > 0.05 for both variables). A significantly higher percentage of patients showing T wave inversion in the anterior leads (100% versus 8.5%; p < 0.001) and anterior Q waves (33.3% versus 2.1%; p-value <0.01) was demonstrated. The anterior STE, despite more common in patients with adverse events (66.7% versus 21.3%), did not reach the statistical significance (p = 0.07).
Related Knowledge Centers
- Action Potential
- Qt Interval
- Refractory Period
- Tetanic Contraction
- Ventricle
- Repolarization
- Electrocardiography
- Qrs Complex
- T Wave Alternans
- Cardiac Action Potential