Electrocardiograms (ECGs) remain a foundational pillar of cardiovascular diagnostics, providing rapid, non-invasive diagnosis and being universally accessible to all clinicians. An ECG captures the electrical signals of the heart via a standard 12-lead configuration, offering insights into arrhythmias, conduction delays, ischemic injury, structural remodeling, and systemic pathologies with cardiac implications. This review presents a structured framework for ECG interpretation by discussing general approaches to rate, rhythm, axis, intervals, and repolarization dynamics, and by outlining both cardiac and non-cardiac conditions associated with ECG abnormalities. We explore the accelerating pace of innovations in artificial intelligence (AI) for ECG analysis. Deep learning algorithms now rival and, in select domains, surpass expert clinicians in detecting left ventricular systolic and diastolic dysfunction, hypertrophic obstructive cardiomyopathy, and acute myocardial infarction. The integration of AI-enhanced ECG interpretation enables earlier disease recognition, refined risk stratification, and optimized clinical decision-making across acute and chronic care settings. This review systematically guides readers through ECG interpretation, linking fundamental principles with nuanced clinical patterns using AI to enhance accurate diagnosis and improve patient outcomes across a wide range of cardiovascular conditions.

Background: Evidence regarding the duration of anticoagulation (AC) therapy for left ventricular thrombus (LVT) is lacking. This study aims to evaluate the rate and risk factors for LVT recurrence in patients with Anterior STSegment elevation Myocardial Infarction (STEMI) complicated by LVT. Methods: This was a retrospective analysis of patients with Anterior STEMI complicated by LVT and reduced ejection fraction (<35 %) from 2010 to 2020. Patients with atrial fibrillation and hypercoagulable state were excluded. Recurrence of LVT was defined as a new LVT on transthoracic echocardiography (TTE) after interval resolution and AC discontinuation. Demographics, comorbidities, guideline directed medical therapy, TTE, and angiographic characteristics were assessed and compared in patients with and without LVT recurrence. Results: 87 patients met the inclusion criteria. Nine (10.3 %) had LVT recurrence of which three (33.3 %) had cardioembolic events. More patients with recurrence had ventricular aneurysm/scarring (33 % vs 10.3 %) and multi-vessel disease (22.2 % vs 9 %). Conclusion: This study reveals that a portion of patients with Anterior STEMI complicated by LVT are at a higher risk of recurrence after initial resolution and AC discontinuation. Larger prospective trials are needed to readdress the appropriate duration of anticoagulation.

Background: Gastrointestinal angiodysplasia is a significant vascular anomaly characterized by dilated, tortuous blood vessels in the gastrointestinal tract. The current literature extensively documents the association between angiodysplasia and aortic stenosis, known as Heyde syndrome, characterized by the triad of aortic stenosis, GIB, and acquired von Willebrand syndrome. However, other valvular diseases, including mitral and tricuspid regurgitation, have also been implicated. This comprehensive systematic review aims to investigate the spectrum of valvular abnormalities, exploring the intricate mechanisms by which they contribute to gastrointestinal bleeding. Furthermore, it will evaluate the available surgical and nonsurgical treatment modalities, assessing their efficacy in mitigating the incidence of such bleeding. Methods: A comprehensive search of the Pubmed/MEDLINE database was conducted to identify relevant studies to retrieve relevant articles from August 2014 to August 2024. A combination of Medical Subject Heading (MeSH) terms and text words related to cardiac valvular diseases and GIB were used. MeSH terms included “gastrointestinal bleeding”, “heart valve diseases”, “hematochezia”, “heart valve prosthesis”, “bioprosthesis”, “native valve diseases”, and “mechanical valve”. Results: Forty-five papers met the inclusion criteria. Twenty-seven studies covered GIB in aortic valve disease, ten on mitral valve disease, two on tricuspid valve disease, and six on multiple valves. Conclusions: This systematic review demonstrates the association between angiodysplasia and aortic stenosis and highlights mitral regurgitation and tricuspid regurgitation as potential etiologies. Definitive management with valvuloplasty or valve replacement is vital to preventing the onset or recurrence of GIB in patients with valvular disease.

Transcatheter aortic valve replacement (TAVR) offers a minimally invasive alternative to traditional surgical aortic valve replacement (SAVR) for the treatment of severe aortic stenosis. Notably, TAVR was once reserved for patients at high surgical risk but is now a viable option even for those at low surgical risk. Despite the widespread adoption and favorable outcomes of TAVR, this technique presents several challenges, including conduction disturbances such as new-onset left bundle branch block (LBBB) and high-grade atrioventricular (AV) block, which may require permanent pacemaker (PPM) implantation. These complications arise from the close anatomical relationship between the aortic valve and the cardiac conduction system and are influenced by factors such as valve design, implantation depth, and individual anatomical variations. This review aims to explore the structural and physiological intricacies of the aortic valve and conduction system. Additionally, this review explores pre-procedural risk stratification, monitoring protocols, and emerging strategies to mitigate these complications and enhance procedural safety and long-term patient outcomes.

Background: Extracorporeal cardiopulmonary resuscitation (eCPR) is a method for initiation of cardiopulmonary bypass during resuscitation of a patient with refractory cardiac arrest to support end-organ perfusion. This retrospective study evaluates which prognostic markers are seen in patients with poor outcomes who underwent eCPR in our rural tertiary care center. Study Design/Methods: All patients who underwent eCPR at our center from May 2013 to January 2023 were analyzed in a retrospective manner. We then compared outcomes in patients who survived to discharge (survivors) versus those who did not survive to discharge (non-survivors). Demographic factors, body mass index, peak serum lactate in 24 h, initial rhythm, lowest mean arterial pressure within the first six hours, a requirement of renal replacement therapy, and the number of blood transfusions required during the hospitalization were analyzed. Results: 37 patients (24 males and 13 females) with a median age of 58 years (IQR: 48–65) were included. The overall mortality rate was 75.7%, and all survivors had good neurological outcomes, which were defined as Cerebral Performance Category (CPC) scores of 1 or 2. The most significant factors seen in non-survivors were obesity as measured by BMI more than 30 (odds ratio = 7.33; 95% CI 1.40–38.33; p = 0.02), and lowest MAP <65 within the first 6 h despite being on extracorporeal membrane oxygenation (0% vs. 74.1%; p = <0.01). Conclusions: This retrospective study demonstrates that initial presentations of patients who underwent eCPR with obesity and MAPS < 65 within the first 6 h despite ECMO support were seen in patients with higher mortality.