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Are you wondering whether your smartwatch can detect atrial fibrillation (AF) or rythm disorders? Or whether you might actually need an ILR (implantable loop recorder)? This guide gives you a clear, updated overview of what smartwatches can  and cannot  do when it comes to heart rhythm - and when a Holter monitor, patch monitor or ILR is the right choice. The article is written for patients, but is also relevant for GPs and healthcare professionals. Are ILR useful in assessin

Chest pain and ST-segment abnormalities on ECG are among the most alarming findings in the emergency department. However, this case underscores an important principle: neither ST elevation nor widespread ST depression is synonymous with acute coronary occlusion. A thorough assessment of underlying physiology is essential to avoid misdiagnosis and inappropriate management. Case Presentation A man in his 70s with known peripheral arterial disease presented with chest discomfort

A pacemaker is a small electronic device that keeps the heart beating at a safe and stable rhythm when the body’s own electrical system fails. In this complete, clinically accurate guide, you’ll learn exactly how a pacemaker works , when it is used , and what healthcare professionals should look for during a pacemaker check - including sensing, capture thresholds, and lead impedance. Whether you’re a clinician, student, or simply curious, this article provides a clear and re

Case Presentation An 80-year-old man with hypertension and type 2 diabetes was found confused and somnolent at home. On EMS arrival, his blood pressure was 73/46 mmHg and heart rate fluctuated between 25 and 50 beats per minute. The ECG demonstrated a wide-complex bradycardia (rate 26). Atropine had no effect. He received intravenous adrenaline. On hospital arrival, the patient appeared pale, cold and hypotensive, with clinical signs of pulmonary edema and acute kidney injury

Palpitations are a very common symptom that most people experience at least once in their lifetime.They can feel like your heart is beating fast, irregularly, skipping a beat - or suddenly pounding harder than usual. Most of the time, this is completely harmless. But in some cases, palpitations can be a sign of an underlying heart rhythm disorder that should be evaluated by a doctor. How Are Palpitations Evaluated? When you see a doctor for palpitations, the most important te

Acute Chest Syndrome and Right Ventricular Failure in a Patient with Sickle Cell Disease Case Presentation A man in his 40s from West Africa was admitted with diffuse pain throughout his body, including the chest. He had recently completed a long flight from Africa to Norway. On admission, he appeared clammy, in significant pain, and somnolent but easily arousable. Physical examination revealed no specific findings, but the patient appeared acutely ill and required supplement

Heart Failure with Reduced Pump Function (HFrEF) When people hear the word “heart failure,” this is often the type they imagine – when the heart’s pump has become too weak to deliver enough blood to the body. In medical terms, this is called heart failure with reduced ejection fraction (HFrEF) . A related condition is HFmrEF , or heart failure with moderately reduced ejection fraction. For most patients, the distinction between these two is less important – the principles of

A 62-year-old man with a history of deep vein thrombosis and known factor V Leiden mutation was admitted with exertional, squeezing chest pain. The chest pain subsided, but the dyspnea persisted. On admission he was hemodynamically stable with a heart rate of 90/min and a blood pressure of 130/90 mmHg. He was asymptomatic at rest but became clearly dyspneic when walking to the bathroom. Sinusrythme. T-inversions in leads V1-V3. T-inversion i lead III. S-wave in lead 1. The EC

What Is Heart Failure with Preserved Ejection Fraction (HFpEF)? This is Part 2  in the series “What Is Heart Failure?” In Part 1 , we explained what heart failure actually means - that the heart is unable to pump enough blood to meet the body’s needs. But did you know that about half of all the people with heart failure have a preserved  pumping function? So, what does that really mean? Echcardiography of a heart with HFpEF When the heart pumps normally - but still fails When

Case Presentation A woman in her 20s was admitted with sudden-onset palpitations lasting approximately three hours before arrival. On admission, she was clammy, cold, and diaphoretic, and reported pre-syncopal episodes. Blood pressure was 137/95 mmHg, and heart rate approximately 200 bpm. The admission ECG showed a wide-complexed, irregular tachycardia. Irregular wide-complexed tachycardia - Pre-excited AF Same ECG - More complexes (Standard leads) Same ECG - more complexes (

Heart failure is a common but often misunderstood condition. Many people think it means the heart has “stopped,” but that’s not the case. Heart failure means the heart is pumping less efficiently than before, and it can affect anyone, often without obvious symptoms in the early stages. Heart failure sounds dramatic — but it doesn’t mean that the heart has “stopped.”It means that the heart is not able to pump enough blood  to meet the body’s needs, either because the pumping f

A man in his 70s with a history of myocardial infarction was admitted with progressive dyspnea and findings consistent with heart failure. On admission, he had a regular tachycardia at approximately 116 bpm. ECG showed atrial tachycardia, and echocardiography revealed reduced left ventricular function with an ejection fraction (EF) of about 30%. Atrial tachycardia, 116 beats/min Apical 4-chamber view - The septal wall and apex are thin after previous myocardial infarction and

Atrial fibrillation (AF) is an increasing public health challenge — but prevention is absolutely possible. Good control of blood pressure, body weight, blood sugar, and alcohol intake , along with appropriate management of heart failure and diabetes , can significantly reduce the risk of developing AF and its serious complications. Much has been written about what  atrial fibrillation is and how  it is treated. But far too little attention is given to how it can actually be p

Many people take Aspirin (Albyl-E)  “just to be safe” , but research shows it can do more harm than good. Here’s a clear overview of the different types of blood thinners, how they work, and who actually  benefits from them. Blood Thinners - Two Types, One Important Difference Not all “blood thinners” actually thin the blood Many people think blood thinners make the blood thinner . That’s not quite true. These medications affect how the blood clots , not how thick it is. Th

A previously healthy man in his 40s was admitted with chest pain considered atypical. The ECG showed ST elevations in aVL and in leads V2–V3, as well as ST depression in II, III, and aVF. T-wave inversions were also present in V3–V6. Despite these striking changes, the patient had preserved and tall R waves in the precordial leads. Echocardiography revealed no regional wall motion abnormalities, and troponin was as low as 4 ng/L. Because of the pronounced ECG changes and ches

When the heart beats in atrial fibrillation , the upper chambers (atria) lose their normal, coordinated contraction. As a result, blood doesn’t flow efficiently through the atria but tends to swirl and stagnate . When blood stands still, the risk of forming a blood clot  increases. If such a clot breaks loose, it can travel through the bloodstream to the brain and cause a stroke  – one of the most serious complications of atrial fibrillation.A clot can also travel to the legs

“Why does my heart rate graph look so messy when I work out?” That’s what Kari , who lives with permanent atrial fibrillation , asked me recently. She often trains with her friend Lise , whose heart rhythm is normal — sinus rhythm . They do the same workout, yet their heart rate graphs look completely different: Kari’s curve is irregular and jagged, while Lise’s is smooth and predictable. 💡 Read more about permanent atrial fibrillation 📊 The Heart Rate Graphs: Kari vs. Lise

🫀 What Is Atrial Fibrillation? Atrial fibrillation (AF) is a chaotic rhythm that starts in the heart’s upper chambers; the atria. Instead of beating in a steady rhythm, the heart fires off many small, irregular electrical signals that make it “fibrillate.” Typical symptoms include: 💢 Palpitations (a fast or fluttering heartbeat) 😮‍💨 Shortness of breath 🪫 Fatigue or reduced exercise tolerance The pulse can vary greatly, often around 150 beats per minute, but it’s differen