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The Cornell voltage criteria [13] for the ECG diagnosis of LVH involve measurement of the sum of the R wave in lead aVL and the S wave in lead V 3. The Cornell criteria for LVH are: S in V 3 + R in aVL > 28 mm (men) S in V 3 + R in aVL > 20 mm (women) The Romhilt-Estes point score system ("diagnostic" >5 points; "probable" 4 points):
Given the demographics of SCAD, it is important to maintain a high index of suspicion for the condition in otherwise low-risk women presenting with symptoms of acute coronary syndrome. Initial evaluation may show ECG changes of ST elevation, like heart attacks due to other causes. SCAD comprises 2-4% of all cases of acute coronary syndrome.
In lead V 1, the QRS complex is often entirely negative (QS morphology), although a small initial R wave may be seen (rS morphology). In the lateral leads (I, aVL, V 5-V 6) the QRS complexes are usually predominantly positive with a slow upstroke last >60ms to the R-wave peak. [4] Notching may be seen in these leads but this is not universal.
[10] Traditionally, "ECG" usually means a 12-lead ECG taken while lying down as discussed below. However, other devices can record the electrical activity of the heart such as a Holter monitor but also some models of smartwatch are capable of recording an ECG. ECG signals can be recorded in other contexts with other devices.
Athletic heart syndrome (AHS) is a non-pathological condition commonly seen in sports medicine in which the human heart is enlarged, and the resting heart rate is lower than normal. The athlete's heart is associated with physiological cardiac remodeling as a consequence of repetitive cardiac loading. [ 3 ]
The TIMI risk score can identify high risk patients in ST-elevation and non-ST segment elevation MI ACS [30] [31] and has been independently validated. [ 32 ] [ 33 ] Based on a global registry of 102,341 patients, the GRACE risk score estimates in-hospital, 6 months, 1 year, and 3-year mortality risk after a heart attack. [ 34 ]
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There are more women than men with hypertension, [19] and, although men develop hypertension earlier in life, [20] hypertension in women is less well controlled. [21] [22] The consequences of high blood pressure in women are a major public health problem and hypertension is a more important contributory factor in heart attacks in women than men ...