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This functional publication presents a entire evaluate of the epidemiology and medical presentation of acute coronary syndromes (ACS). It additionally publications the reader via hazard review, chance stratification, prognosis, and remedy of ACS.

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The possibility of this pattern being secondary to a positional change (p. 29) or simply to the peripheral right ventricular block must be ruled out. The combination of more than one of these criteria increases the diagnostic possibilities. Horan and Flowers [22] published a scoring system based on the most frequently used ventricular enlargement electrocardiographic criteria. 44 Chapter 8 V1 V2 V3 V4 V5 V6 V1 V2 V3 V4 V5 V6 Figure 34 A 60-year-old patient with chronic obstructive pulmonary disease who due to a respiratory infection presented with an electrocardiographic finding of an acute overload pattern of the right chamber (A), which disappeared in a few days (B).

CHAPTER 7 Atrial abnormalities All the electrocardiographic patterns observed in patients with atrial enlargement and with atrial conduction blocks are encompassed by this term (Figures 28–30). It is convenient to bear in mind the following facts [1]: 1 The normal P wave (Figures 16, 28A and 29A) is explained by activation first of the right atrium and then of the left atrium, with an intermediate period during which both atria are depolarised together [13,14]. 2 Atria become dilated more than hypertrophied.

Observed in a small number of cases with RVE (specially congenital heart disease with systolic overload). In these cases the repolarization present depressed ST with negative and asymetric T wave – strain pattern (Figures 32, 34 and 36) – except in the newborn, which may present exclusive R wave with a positive T wave (see Case 10, p. 139). Nevertheless, other causes that may present a dominant R pattern in V1 must be ruled out (see Table 4). The rS or even QS morphology in V1, but with RS in V6, may often be observed in chronic cor pulmonale, even in advanced phases or in the early phases of RVE of other 42 Chapter 8 Table 3 Electrocardiographic criteria of right ventricular enlargement.

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