Tag Archives: electrocardiogram (ECG)

Introduction Fabry disease is a rare X-chromosome-linked disorder that results from alpha-galactosidase A enzyme deficiency. It is broadly divided into classical (earlier onset, low enzyme activity) and non-classical (milder, later-onset and some residual activity). It is underdiagnosed despite the availability of diagnostic tests, such as blood (plasma or leucocyte alpha-galactosidase A enzyme) and genetic testing. Due to its heterogeneous nature as a multi-system disorder, Fabry disease (FD) is rarely considered. Patients often present with non-specific symptoms, such as fatigue and gastrointestinal symptoms akin to irritable bowel, taking

Introduction In late 2019, the first case of a patient with pneumonia of unknown cause was reported in Wuhan, China. The disease, called coronavirus disease 2019 (COVID-19), spread rapidly and caused a pandemic. The virus that causes this infection is called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).1 Besides respiratory tract disease, which is considered the main and most common clinical manifestation of COVID-19, other systems, including the cardiovascular system, could also be affected. Factors, such as tissue hypoxia, which results as the pneumonia progresses, and inflammation of the vessel walls, have been suggested a

Background Some paroxysmal arrhythmias are either too short in duration, or result in symptoms too severe, to allow patients to be able to activate and record an electrocardiogram (ECG) on a portable patient-activated monitor. Non-sustained ventricular tachycardia, sinus pauses and transient high-grade atrioventricular block can be examples of this. Many paroxysmal arrhythmias, however, have a duration of at least a few minutes during which, a patient familiar with the use of a personal ECG-recording device, can activate the device and record an ECG that is of sufficient quality for a cardiologist to review the recording and determine the di

We recorded an ECG (figure 1) in a 50-year-old Caucasian woman when she attended our clinic for atypical chest pain and a history of familial hypercholesterolaemia. Her medication included atorvastatin and ferrous sulphate only. Cardiovascular examination was unremarkable. The ECG shows a very large U-wave, but was otherwise normal. Because of the disproportionally large U-wave, she underwent extensive investigations. Her echocardiogram, exercise stress echocardiogram and 24-hour Holter monitor were all normal. Her blood tests showed normal thyroid function, normal serum potassium (4.4 mmol/L) and calcium (2.4 mmol/L). Figure 1. A 12-lead ele

Introduction The significance of the frontal QRS-T angle (QTA), the difference between the QRS-axis and T-axis, has not been widely recognised in clinical practice, though it is widely available on 12-lead ECGs recorded by a modern electrocardiograph.1,2 An abnormally wide QTA represents an abnormality of ventricular depolarisation or repolarisation, and is known to be an independent predictor of cardiovascular mortality secondary to ischaemic events, sudden death, death from arrhythmia, increased incidence of congestive heart failure, as well as all-cause mortality.2-5 It has even been considered as a stronger predictor of poor prognosis tha

Introduction Due to the asymmetry of the heart, it has long been described in what is known as the ‘Valentine’ position, in which the heart is oriented vertically downwards. It defines the heart as a solitary organ and provides no reference point for its location within the chest. This description has since been found to be inaccurate, as we know the heart is positioned in a direction extending from the right shoulder to the left hypochondrium. The in vivo orientation of the heart takes into account its surrounding bony structures and is the best definition of true anatomical heart position.1,2 Figure 1. Pathway of cardiac electrical acti