This document provides guidance on pediatric EKG interpretation. It discusses the key steps and aspects to analyze when reading a pediatric EKG, including rhythm, rate, QRS axis, intervals, hypertrophy, ST segments, T waves, and electrical heart diseases. Supraventricular tachycardia is highlighted as the most common tachyarrhythmia in childhood, with some cases being asymptomatic and others potentially leading to poor left ventricular function if not treated appropriately.
The ECG shows a pattern of right ventricular hypertrophy with a large R wave in lead V1 and deep S wave in lead V6, suggesting enlarged right ventricle. This, along with the juvenile T wave pattern of inverted T waves in the precordial leads from birth to age 8, are consistent with the normal developmental changes described in the document as the left ventricle increases in dominance from birth through childhood. The document provides an overview of normal pediatric ECG patterns and intervals across age groups as well as common arrhythmias and abnormalities.
The document provides an overview of electrocardiography (ECG) basics including lead positions, ECG paper and timing, standardization, the normal ECG waves including P, PR, QRS, ST segments, T waves, and QT interval, and abnormalities. Key findings of right and left ventricular hypertrophy, atrial enlargement, bundle branch blocks, myocardial infarction, and various degrees of atrioventricular block are also summarized.
1. The pediatric ECG document reviews cardiac physiology and ECG findings in children of different ages. It discusses how the size of the ventricles changes from birth through childhood and how this impacts ECG measurements.
2. Key aspects of the normal pediatric ECG are described, including typical heart rates, axis shifts, and "juvenile" T wave patterns. Common abnormalities seen in pediatric patients such as chamber enlargement, conduction abnormalities, and arrhythmias are also reviewed.
3. The document provides guidance on interpreting ECG findings and correlating them to possible diagnoses in children, taking into account how measurements may differ based on age. Examples of ECG strips are included to illustrate various normal and abnormal
This document provides an overview of ECG interpretation using the PQRST method. It defines the leads used in an ECG and how they are positioned. It describes how to evaluate the rhythm, rate, axis, waves, intervals, and signs of chamber enlargement or hypertrophy. Key things like normal wave durations, rates, intervals and what abnormalities indicate certain conditions are outlined. The document serves as a guide for interpreting ECGs using the standard PQRST method of evaluation.
The 11-step method provides a systematic approach to reading EKGs:
1. Gather data such as heart rate, intervals, and axis.
2. Diagnose rhythm, conduction blocks, enlargement, and infarction by applying specific criteria.
3. Potential diagnoses are identified through disturbances of rhythm, conduction, hypertrophy, and ischemia. The relationship between P waves and QRS complexes helps determine block types.
The 11-step method provides a systematic approach to reading EKGs:
1. Gather data such as heart rate, intervals, and axis.
2. Diagnose rhythm, conduction blocks, enlargement, and infarction by applying specific criteria.
3. Potential diagnoses are identified through disturbances of rhythm, conduction, hypertrophy, and ischemia. The four questions framework is used to characterize rhythms.
The document discusses electrocardiogram (ECG) findings associated with cardiac chamber enlargement. It notes that while ECG is not very sensitive, it can provide clues about underlying heart conditions. Enlargement of cardiac chambers on ECG is seen through changes in wave morphology, amplitude, axis, and duration. Specific criteria are discussed to identify left and right atrial abnormalities as well as left and right ventricular hypertrophy on ECG. Limitations of ECG criteria in the presence of conduction abnormalities are also reviewed.
This document discusses ECG changes that occur due to cardiac chamber enlargement, including left atrial, right atrial, biatrial, left ventricular, right ventricular, and biventricular abnormalities. For each type of chamber enlargement, the document outlines the mechanisms, diagnostic ECG criteria, and examples of ECG patterns. Key findings include prolonged P waves and biphasic P waves in leads indicating left and right atrial enlargement, increased QRS voltages and ST-T wave changes indicating left ventricular pressure overload, and tall R waves in right-sided leads indicating right ventricular hypertrophy. The document provides a detailed reference for understanding ECG manifestations of different cardiac structural abnormalities.
The ECG shows a pattern of right ventricular hypertrophy with a large R wave in lead V1 and deep S wave in lead V6, suggesting enlarged right ventricle. This, along with the juvenile T wave pattern of inverted T waves in the precordial leads from birth to age 8, are consistent with the normal developmental changes described in the document as the left ventricle increases in dominance from birth through childhood. The document provides an overview of normal pediatric ECG patterns and intervals across age groups as well as common arrhythmias and abnormalities.
The document provides an overview of electrocardiography (ECG) basics including lead positions, ECG paper and timing, standardization, the normal ECG waves including P, PR, QRS, ST segments, T waves, and QT interval, and abnormalities. Key findings of right and left ventricular hypertrophy, atrial enlargement, bundle branch blocks, myocardial infarction, and various degrees of atrioventricular block are also summarized.
1. The pediatric ECG document reviews cardiac physiology and ECG findings in children of different ages. It discusses how the size of the ventricles changes from birth through childhood and how this impacts ECG measurements.
2. Key aspects of the normal pediatric ECG are described, including typical heart rates, axis shifts, and "juvenile" T wave patterns. Common abnormalities seen in pediatric patients such as chamber enlargement, conduction abnormalities, and arrhythmias are also reviewed.
3. The document provides guidance on interpreting ECG findings and correlating them to possible diagnoses in children, taking into account how measurements may differ based on age. Examples of ECG strips are included to illustrate various normal and abnormal
This document provides an overview of ECG interpretation using the PQRST method. It defines the leads used in an ECG and how they are positioned. It describes how to evaluate the rhythm, rate, axis, waves, intervals, and signs of chamber enlargement or hypertrophy. Key things like normal wave durations, rates, intervals and what abnormalities indicate certain conditions are outlined. The document serves as a guide for interpreting ECGs using the standard PQRST method of evaluation.
The 11-step method provides a systematic approach to reading EKGs:
1. Gather data such as heart rate, intervals, and axis.
2. Diagnose rhythm, conduction blocks, enlargement, and infarction by applying specific criteria.
3. Potential diagnoses are identified through disturbances of rhythm, conduction, hypertrophy, and ischemia. The relationship between P waves and QRS complexes helps determine block types.
The 11-step method provides a systematic approach to reading EKGs:
1. Gather data such as heart rate, intervals, and axis.
2. Diagnose rhythm, conduction blocks, enlargement, and infarction by applying specific criteria.
3. Potential diagnoses are identified through disturbances of rhythm, conduction, hypertrophy, and ischemia. The four questions framework is used to characterize rhythms.
The document discusses electrocardiogram (ECG) findings associated with cardiac chamber enlargement. It notes that while ECG is not very sensitive, it can provide clues about underlying heart conditions. Enlargement of cardiac chambers on ECG is seen through changes in wave morphology, amplitude, axis, and duration. Specific criteria are discussed to identify left and right atrial abnormalities as well as left and right ventricular hypertrophy on ECG. Limitations of ECG criteria in the presence of conduction abnormalities are also reviewed.
This document discusses ECG changes that occur due to cardiac chamber enlargement, including left atrial, right atrial, biatrial, left ventricular, right ventricular, and biventricular abnormalities. For each type of chamber enlargement, the document outlines the mechanisms, diagnostic ECG criteria, and examples of ECG patterns. Key findings include prolonged P waves and biphasic P waves in leads indicating left and right atrial enlargement, increased QRS voltages and ST-T wave changes indicating left ventricular pressure overload, and tall R waves in right-sided leads indicating right ventricular hypertrophy. The document provides a detailed reference for understanding ECG manifestations of different cardiac structural abnormalities.
1. The document discusses electrocardiographic (ECG) interpretation including determining cardiac rate and rhythm, identifying conduction disturbances, myocardial ischemia or infarction, and other abnormalities.
2. It provides details on properly placing ECG leads and determining the cardiac axis. Common rhythms, conduction blocks, hypertrophy, and other ECG findings are explained.
3. A mnemonic device, RRAHIM, is presented to guide the systematic interpretation of an ECG, covering rate, rhythm, axis, hypertrophy, ischemia/infarction, and other findings.
The ecg in chmaber enlargement approachDheeraj kumar
This document discusses electrocardiogram (ECG) criteria for detecting cardiac chamber enlargement. It provides details on how enlargement of the atria or ventricles can manifest on an ECG through changes in wave morphology, amplitude, axis, and duration. Specific ECG patterns are described that can provide clues about left or right atrial and ventricular abnormalities. The sensitivity and specificity of different ECG criteria are discussed. Underlying cardiac conditions that can cause chamber enlargement and affect ECG interpretation are also reviewed.
The document discusses the basics of interpreting a 12-lead ECG, including measuring heart rate and analyzing rhythm, intervals, axis deviation, and signs of hypertrophy. It covers normal cardiac anatomy and the two basic functions of the heart: circulating blood and adjusting blood flow in response to bodily factors. Key aspects are rate, rhythm, intervals, axis deviation, lead placement, and indicators of left ventricular, right ventricular, and bi-ventricular hypertrophy.
This document discusses the interpretation of electrocardiograms (ECGs) in pediatric patients, particularly those with congenital heart disease. It covers normal variations in ECG findings with age from neonatal to adolescent periods. It then discusses ECG patterns associated with various congenital heart defects, including septal defects, obstructive lesions, cyanotic conditions and miscellaneous defects. Key findings are described for interpreting ECGs and correlating them with specific heart conditions. The document emphasizes that while not diagnostic, the ECG can provide important clues to the presence of chamber enlargement, conduction abnormalities and help classify certain congenital heart diseases.
This document provides information on ECG interpretation including:
1. It describes the limb and chest leads used to record the ECG and how to read the standard ECG including calibrating the rate and rhythm.
2. It outlines the key waves seen on ECG including the P, QRS, and T waves and provides information on normal values and pathological variations.
3. It discusses intervals including the PR and QT intervals and pathological variations. It also covers ST segments and chamber sizes.
4. Part 3 covers arrhythmias, heart block, and interpreting myocardial infarctions including the three stages and identifying the location based on lead changes.
The ECG represents the electrical activity of the heart. It can provide insight into cardiac pathophysiology by analyzing the distinctive waveforms of each cardiac event. The ECG can identify arrhythmias, ischemia, infarction, pericarditis, chamber hypertrophy, and electrolyte disturbances. The standard 12-lead ECG consists of 3 limb leads, 3 augmented limb leads, and 6 precordial leads, which provide different views of the heart. Analysis of the P wave, PR interval, QRS complex, ST segment, T wave, and QT interval can reveal normal sinus rhythm or abnormalities that require further investigation.
This document provides an overview of basics of ECG interpretation. It discusses the history and development of ECG, conduction pathways, standardization, waves and intervals including P wave, PR interval, QRS complex, QT interval, axis determination, and abnormalities indicative of conditions like LVH and RVH. Pediatric ECG variations from adult ECG are also summarized. The document is intended as an educational guide on ECG interpretation for medical professionals.
- The document discusses electrocardiography (ECG), including what an ECG is, how to perform one, and how to interpret the results. Key aspects include placing 10 electrodes on the patient and using them to form 12 leads that examine the heart from different angles. The ECG traces the heart's electrical activity through waves like the P, QRS, and T waves. Interpreting the ECG involves checking various parameters like rate, rhythm, intervals, and amplitudes to identify any abnormalities.
This document provides an overview of pediatric ECG abnormalities and interpretations. It discusses normal variations in pediatric ECGs as well as abnormalities related to conditions like heart blocks, chamber enlargements, congenital heart disease, arrhythmias, and electrolyte imbalances. Examples of ECG readings are provided for abnormalities in P waves, PR interval, QRS complex, QT interval, ST segment, T waves, and U waves. Interpretations of ECG findings related to conditions like chamber hypertrophy, conduction abnormalities, tachyarrhythmias, bradyarrhythmias, bundle branch blocks, WPW syndrome, and various congenital heart defects are also summarized.
An electrocardiogram (ECG or EKG) records the electrical signal from your heart to check for different heart conditions. Electrodes are placed on your chest to record your heart's electrical signals, which cause your heart to beat. The signals are shown as waves on an attached computer monitor or printer
The document discusses the role of ECG in detecting cardiac chamber enlargement. Some key points:
- ECG can detect chamber enlargement through changes in waveform morphology, amplitude/voltage, axis, and duration. These changes apply to both P waves and QRS complexes.
- Common ECG criteria for left atrial enlargement include prolonged/notched P waves in lead II and terminal negative deflection in lead V1. For right atrial enlargement, criteria include tall peaked P waves in leads I, II, III and V1.
- Common ECG patterns of left ventricular hypertrophy include tall R waves in left chest leads, ST-T wave changes, and prolonged QRS duration
The document provides information about ECG basics and how to interpret an ECG. It discusses the placement of limb and chest leads and the standard positions on the ECG paper. It describes the normal P wave, PR interval, QRS complex, and identifies some abnormal findings. It discusses criteria for identifying left ventricular hypertrophy and right ventricular hypertrophy. The overall aim is to help understand how to read an ECG and identify normal and abnormal findings.
The document provides an overview of electrocardiography (ECG/EKG) including its uses in diagnosis, components of an ECG reading, normal values, abnormalities, and interpretations. Key aspects of ECG such as P waves, QRS complex, ST segment, T wave, and measurements including axes are defined. Common conditions involving the heart's rhythm and structure that can be identified on ECG are also summarized.
1. The document describes various EKG abnormalities including early repolarization, pericarditis, fascicular blocks, ventricular hypertrophy, electrolyte abnormalities, prolonged QT interval, and more.
2. Key details are provided on differentiating early repolarization from anterior MI and pericarditis. Stages of pericarditis are outlined.
3. Fascicular blocks are described along with their characteristic axis deviations and block locations. Different forms of ventricular hypertrophy and their EKG patterns are also summarized.
The document provides information about electrocardiograms (ECGs), including what an ECG is, the types of pathology that can be identified from ECGs, ECG paper specifications, the anatomy of the heart and normal ECG signal, ECG leads, determining heart rate and rhythm from ECGs, P waves, the PR interval, the QRS complex, axes determination, bundle branch blocks, ventricular hypertrophy, Q waves, the ST segment, T waves, and the QT interval. Key aspects of the ECG that can help identify conditions like myocardial infarction, pericarditis, and electrolyte abnormalities are discussed.
Pediatric dysrhythmias require careful evaluation and management based on symptoms and underlying heart conditions. Common normal variants include sinus arrhythmia and isolated premature atrial contractions. Supraventricular tachycardia is the most common abnormal rhythm requiring treatment and can often be terminated with vagal maneuvers or adenosine. Third degree atrioventricular block may require pacemaker placement depending on heart rate and symptoms. Ventricular arrhythmias are serious and may necessitate defibrillation or antiarrhythmic medication.
This document discusses cardiac disorders in pediatrics, including congenital and acquired disorders. The two major groups are congenital disorders present at birth, and acquired disorders that develop later in life such as bacterial endocarditis. Common congenital defects include atrial and ventricular septal defects, tetralogy of Fallot, transposition of the great arteries, and hypoplastic left heart syndrome. Management involves medications, oxygen management, nutrition, and surgery depending on the specific defects. Post-operative care focuses on pain management, cardiac monitoring, and family support.
1. The document discusses electrocardiographic (ECG) interpretation including determining cardiac rate and rhythm, identifying conduction disturbances, myocardial ischemia or infarction, and other abnormalities.
2. It provides details on properly placing ECG leads and determining the cardiac axis. Common rhythms, conduction blocks, hypertrophy, and other ECG findings are explained.
3. A mnemonic device, RRAHIM, is presented to guide the systematic interpretation of an ECG, covering rate, rhythm, axis, hypertrophy, ischemia/infarction, and other findings.
The ecg in chmaber enlargement approachDheeraj kumar
This document discusses electrocardiogram (ECG) criteria for detecting cardiac chamber enlargement. It provides details on how enlargement of the atria or ventricles can manifest on an ECG through changes in wave morphology, amplitude, axis, and duration. Specific ECG patterns are described that can provide clues about left or right atrial and ventricular abnormalities. The sensitivity and specificity of different ECG criteria are discussed. Underlying cardiac conditions that can cause chamber enlargement and affect ECG interpretation are also reviewed.
The document discusses the basics of interpreting a 12-lead ECG, including measuring heart rate and analyzing rhythm, intervals, axis deviation, and signs of hypertrophy. It covers normal cardiac anatomy and the two basic functions of the heart: circulating blood and adjusting blood flow in response to bodily factors. Key aspects are rate, rhythm, intervals, axis deviation, lead placement, and indicators of left ventricular, right ventricular, and bi-ventricular hypertrophy.
This document discusses the interpretation of electrocardiograms (ECGs) in pediatric patients, particularly those with congenital heart disease. It covers normal variations in ECG findings with age from neonatal to adolescent periods. It then discusses ECG patterns associated with various congenital heart defects, including septal defects, obstructive lesions, cyanotic conditions and miscellaneous defects. Key findings are described for interpreting ECGs and correlating them with specific heart conditions. The document emphasizes that while not diagnostic, the ECG can provide important clues to the presence of chamber enlargement, conduction abnormalities and help classify certain congenital heart diseases.
This document provides information on ECG interpretation including:
1. It describes the limb and chest leads used to record the ECG and how to read the standard ECG including calibrating the rate and rhythm.
2. It outlines the key waves seen on ECG including the P, QRS, and T waves and provides information on normal values and pathological variations.
3. It discusses intervals including the PR and QT intervals and pathological variations. It also covers ST segments and chamber sizes.
4. Part 3 covers arrhythmias, heart block, and interpreting myocardial infarctions including the three stages and identifying the location based on lead changes.
The ECG represents the electrical activity of the heart. It can provide insight into cardiac pathophysiology by analyzing the distinctive waveforms of each cardiac event. The ECG can identify arrhythmias, ischemia, infarction, pericarditis, chamber hypertrophy, and electrolyte disturbances. The standard 12-lead ECG consists of 3 limb leads, 3 augmented limb leads, and 6 precordial leads, which provide different views of the heart. Analysis of the P wave, PR interval, QRS complex, ST segment, T wave, and QT interval can reveal normal sinus rhythm or abnormalities that require further investigation.
This document provides an overview of basics of ECG interpretation. It discusses the history and development of ECG, conduction pathways, standardization, waves and intervals including P wave, PR interval, QRS complex, QT interval, axis determination, and abnormalities indicative of conditions like LVH and RVH. Pediatric ECG variations from adult ECG are also summarized. The document is intended as an educational guide on ECG interpretation for medical professionals.
- The document discusses electrocardiography (ECG), including what an ECG is, how to perform one, and how to interpret the results. Key aspects include placing 10 electrodes on the patient and using them to form 12 leads that examine the heart from different angles. The ECG traces the heart's electrical activity through waves like the P, QRS, and T waves. Interpreting the ECG involves checking various parameters like rate, rhythm, intervals, and amplitudes to identify any abnormalities.
This document provides an overview of pediatric ECG abnormalities and interpretations. It discusses normal variations in pediatric ECGs as well as abnormalities related to conditions like heart blocks, chamber enlargements, congenital heart disease, arrhythmias, and electrolyte imbalances. Examples of ECG readings are provided for abnormalities in P waves, PR interval, QRS complex, QT interval, ST segment, T waves, and U waves. Interpretations of ECG findings related to conditions like chamber hypertrophy, conduction abnormalities, tachyarrhythmias, bradyarrhythmias, bundle branch blocks, WPW syndrome, and various congenital heart defects are also summarized.
An electrocardiogram (ECG or EKG) records the electrical signal from your heart to check for different heart conditions. Electrodes are placed on your chest to record your heart's electrical signals, which cause your heart to beat. The signals are shown as waves on an attached computer monitor or printer
The document discusses the role of ECG in detecting cardiac chamber enlargement. Some key points:
- ECG can detect chamber enlargement through changes in waveform morphology, amplitude/voltage, axis, and duration. These changes apply to both P waves and QRS complexes.
- Common ECG criteria for left atrial enlargement include prolonged/notched P waves in lead II and terminal negative deflection in lead V1. For right atrial enlargement, criteria include tall peaked P waves in leads I, II, III and V1.
- Common ECG patterns of left ventricular hypertrophy include tall R waves in left chest leads, ST-T wave changes, and prolonged QRS duration
The document provides information about ECG basics and how to interpret an ECG. It discusses the placement of limb and chest leads and the standard positions on the ECG paper. It describes the normal P wave, PR interval, QRS complex, and identifies some abnormal findings. It discusses criteria for identifying left ventricular hypertrophy and right ventricular hypertrophy. The overall aim is to help understand how to read an ECG and identify normal and abnormal findings.
The document provides an overview of electrocardiography (ECG/EKG) including its uses in diagnosis, components of an ECG reading, normal values, abnormalities, and interpretations. Key aspects of ECG such as P waves, QRS complex, ST segment, T wave, and measurements including axes are defined. Common conditions involving the heart's rhythm and structure that can be identified on ECG are also summarized.
1. The document describes various EKG abnormalities including early repolarization, pericarditis, fascicular blocks, ventricular hypertrophy, electrolyte abnormalities, prolonged QT interval, and more.
2. Key details are provided on differentiating early repolarization from anterior MI and pericarditis. Stages of pericarditis are outlined.
3. Fascicular blocks are described along with their characteristic axis deviations and block locations. Different forms of ventricular hypertrophy and their EKG patterns are also summarized.
The document provides information about electrocardiograms (ECGs), including what an ECG is, the types of pathology that can be identified from ECGs, ECG paper specifications, the anatomy of the heart and normal ECG signal, ECG leads, determining heart rate and rhythm from ECGs, P waves, the PR interval, the QRS complex, axes determination, bundle branch blocks, ventricular hypertrophy, Q waves, the ST segment, T waves, and the QT interval. Key aspects of the ECG that can help identify conditions like myocardial infarction, pericarditis, and electrolyte abnormalities are discussed.
Pediatric dysrhythmias require careful evaluation and management based on symptoms and underlying heart conditions. Common normal variants include sinus arrhythmia and isolated premature atrial contractions. Supraventricular tachycardia is the most common abnormal rhythm requiring treatment and can often be terminated with vagal maneuvers or adenosine. Third degree atrioventricular block may require pacemaker placement depending on heart rate and symptoms. Ventricular arrhythmias are serious and may necessitate defibrillation or antiarrhythmic medication.
This document discusses cardiac disorders in pediatrics, including congenital and acquired disorders. The two major groups are congenital disorders present at birth, and acquired disorders that develop later in life such as bacterial endocarditis. Common congenital defects include atrial and ventricular septal defects, tetralogy of Fallot, transposition of the great arteries, and hypoplastic left heart syndrome. Management involves medications, oxygen management, nutrition, and surgery depending on the specific defects. Post-operative care focuses on pain management, cardiac monitoring, and family support.
Congestive heart failure is a syndrome where the heart is unable to pump an adequate amount of blood to meet the body's needs. It is caused by any interference with the normal mechanisms regulating cardiac output. Common causes include hypertension, myocardial infarction, and valvular disorders. The main goals of treatment are to improve left ventricular function by decreasing preload and afterload, improving gas exchange, and enhancing cardiac contractility. Management involves diuretics, vasodilators, and other medications alongside lifestyle modifications like sodium and fluid restrictions.
The document discusses various types of congenital heart disease including acyanotic lesions that involve left-to-right shunts such as atrial septal defects, ventricular septal defects, atrioventricular septal defects, and patent ductus arteriosus. It describes the anatomy, clinical presentation, diagnostic findings, and treatment options for each condition. Key information provided includes descriptions of murmurs caused by various defects and genetic syndromes that are commonly associated with certain heart lesions.
Paediatric Cardiology for General Paediatrics.pptSalam467227
This document provides an overview of paediatric cardiology for general paediatricians. It discusses how to evaluate ECGs by assessing rhythm, rate, intervals, waves and axes. Common causes of syncope are also reviewed, including vasovagal, orthostatic, and cardiac causes. Long QT syndrome is discussed in detail. The pathophysiology of various congenital heart lesions such as atrial and ventricular septal defects, patent ductus arteriosus, atrioventricular septal defect, and cyanotic lesions are outlined. Tips are provided to read more ECGs and ask for help when needed.
This document discusses infective endocarditis (IE) in pediatrics. It covers the epidemiology, pathogenesis, microbiology, diagnosis, treatment, prevention, and prognosis of IE. Some key points include:
- IE mortality has decreased from nearly 100% pre-antibiotics to 15-25% currently. Risk factors include congenital heart disease and prosthetic valves.
- Endothelial damage from trauma or infection allows platelet/fibrin deposition and bacterial colonization on heart valves, leading to IE.
- Common causative organisms are viridans streptococci, staphylococci, and HACEK bacteria. Diagnosis utilizes modified Duke criteria including blood cultures and echocardiogram
This document provides an overview of heart murmurs, including their pathophysiology, description, timing, location, and associated conditions. It discusses systolic murmurs such as those from aortic stenosis and mitral regurgitation. It also reviews diastolic murmurs like aortic regurgitation and mitral stenosis. Continuous murmurs from conditions like patent ductus arteriosus are also summarized. The document aims to help clinicians characterize and diagnose heart murmurs based on key attributes.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
4. 12 Lead ECG
EKG is a voltmeter ie measures voltage
which has magnitude and direction.
Voltage displayed on the Y axis
( 1mV=10mm) and time is displayed on
the x axis ( 1 little block = 0.04 seconds)
12. 1. Rhythm
Sinus or not
Sinus rhythm:
P before every QRS
P wave morphology
Regular PR interval
Normal P wave Axis
13. 1. Rhythm
P wave duration < 0.07 sec in infants, <
0.09 in children
LAH duration > 0.08 sec in infants and
>0.1 sec in children
P wave amplitude < 3 mm
RAH > 3 mm
Combined atrial hypertrophy
16. 2. Rate
1 mm = 0.04 sec, 5 mm = 0.2 sec
Measure between R – R’
measure duration in seconds, Rate =
60/duration
measure large divisions, Rate = 300/
number of large divisions
1 minute = 60 seconds, and 300 large
divisions
19. 2. Rate
Count R-R cycles
In 6 large divisions, multiply cycles by 50
In 3 seconds = marks on top margin of
paper , multiply cycles by 20
Quick and easy; 300/150/100/75/60/50
Tachycardia and Bradycardia, check normal
values for age.
20. 3. QRS Axis
Hexaxial System, Limb leads
Frontal Plane
Left vs right, superior and inferior
Lead I left (positive) vs right (negative)
AvF downward (positive) vs upward
(negative)
22. Horizontal Reference System
Right and left precordial leads
V2 is perpendicular to V6
V2 anterior (positive) posterior (negative)
V6 left (positive) right (negative)
V1 anterior and right (positive) posterior
and left (negative)
25. 3. QRS Axis
RAD, LAD look at normal ranges for age
Superior Axis
DDX:
Endocardial cushion defect
Tricuspid atresia
RBBB
Overlap with LAD may occur with Left anterior
hemiblock
37. RBBB
Terminal Slurring is right and anterior
RAD for terminal portion
Prolonged QRS duration
Wide slurred S in I, V5 V6
Terminal slurred R’ in aVR, V4R, V1, V2
T waves inversion common in adults, but
not in children
44. QTc Interval
Increased QTc DDX;
Cardiac Causes:
Myocarditis, diffuse myocardial disease
(hypertrophic and dilated cardiomyopathy)
Long QT syndrome (Jervell and Lange –
Nielsen , Romano-Ward syndrome
45. Prolonged QTc Interval
None cardiac causes:
Hypocalcemia, head trauma, malnutrition
Drugs;
Antibiotics (Amp, Em,TMP-Sulfa)
Anti psychotic (phenothiazines)
Anti depressants ( tricyclic)
Anti histamines (Seldane)
Anti arrhythmic drugs
Arsenics
Organophosphates
46. Hypertrophy
QRS voltage:
Increases in the direction of the respective
ventricle.
Normal QRS duration
LVH increased R voltages in Leads I, II,
aVL, sometimes aVF and III, tall R’s in V5-
7 with deep S’s in V1-2 and V3R and V4R
47. Hypertrophy
RVH increased R in aVR and III, and deep
S in lead I, increased R in V1-2, V3R and
V4R and deep S ‘s in V5-6
48. Hypertrophy
Changes in T Axis
Abnormal T axis with increased QRS-T
angle = strain
Upright T waves in RPL after day 3 of life
and up to adolescence = strain
Inverted T waves in LPL = strain
49. Hypertrophy
Q waves
Abnormal Q waves are either deep or wide or
both.
Q waves are normally present in LPL and absent
in RPL
Deep and wide Q’s are present in myocardial
infarction
Deep Q’s are present in volume overload VH
Presence of Q’s in RPL (RVH or V inversion)
Absence in LPL ( LBBB or V inversion)
54. CVH
Presence of RVH and LVH criteria
Positive criteria for RVH or LVH and large
voltages for the other
Large equiphasic QRS complexes in 2 or
more limb leads and the mid precordial
leads
55. ST Segments
Up to 1mm elevation or depression is
acceptable in children
Examples of nonpathologic ST segment
shift: Early repolarization, J point
depression
57. St Segment
Pathologic depression;
Downward slant with a diphasic or inverted
T wave
Horizontal elevation or depression
sustained for over 0.08 seconds
ST depression; hypertrophy, strain,
ischemia, digoxin effect
ST elevation; pericarditis, injury
58. T waves
< ½ of QRS
Positive in I, II, aVL, V4-6
Negative in aVR, V3R, V1-2
Abnormal inverted T waves: ischemia,
hypertrophy and hyperventilation
Flattened T waves: hypokalemia
Peaked T waves : hyperkalemia,
ventricular hypertrophy or BBB
60. P wave
Atrial Contraction
Indication of atrial morphology
Does the p wave have a normal axis? (P
waves are positive in I,II and aVF)
Rt atrial enlargement: Peak P wave
>2.5mm in II, V1,V2
Lt atrial enlargement: P wave broad/bifid
(P wave 0.04 to 0.08 in infancy. 0.06 to
0.1sec in older children)
61. RVH
Monophasic or pure R wave in V1 V4R
Upright T wave in V1 after 7 days until 7 years
R/S ration in V1 : 0-3/12:6.5, 3-6/12:4,6/12 to
3years: 2.4 3-5 years:1.6
R in V1 >20mm at all ages
S wave in V6 >15mm in first week, 10mm up to
6 months, 7mm from 6 to 12 months, 5mm
above 1 year
T wave inversion extending to V4
Widening of QRS complex>0.08
62. LVH
Tall R waves in V5/V6( >40mm over
1year, >30mm under 1 year)
Deep S wave in V1
Q wave ≥4mm in V5/V6
Widening of QRS duration/Flattening of T
waves in V5, V6
T wave inversion in V5, V6 (Severe)
ST segment depression (Severe)
63. Electrical Heart Diseases
Tachyarrhythmia
0-5 years
Serious
Non- Specific Symptoms
Maternal History
5- 10 years
Significant
Specific Symptoms
Maternal and Patient History
10-16 years
Significant and Interesting
Specific Symptoms
Patient History
History is the
67. Supraventricular tachycardia
Commonest tachyarrhythmia in childhood
Majority has a structurally normal heart
Short lived SVTs are not life threatening
Baseline ECG: May reveal predisposing
features
24 hour ECG
Event recorder
68. SVT in children
Common Arrhythmia in children
Can be asymptomatic
Adenosine mainstay for acute attacks
Chronic SVTs can lead to poor LV function
69. SVT
Long term treatment
No treatment
Vagal manoeuvres
Drugs
Beta Blockade: Propranolol, Atenolol
Flecanide, Amiodarone
Radiofrequency Catheter Ablation