Glossary Of Terms - E
Echocardiogram or echocardiography, also called cardiac ultrasound, uses ultrasound waves to give a picture of the inside of the heart, its chambers, valves, and main arteries.
See separate factsheet on Echocardiogram.
An echocardiogram is a painless procedure that uses ultrasound to produce a moving image of the inside of your heart. It is a useful test for checking the structure of your heart and to see how well it is functioning– eg look at its chambers, valves, and main arteries, but not the coronary arteries, which are too small. Your care will be adapted to meet your individual needs and may differ from what is described here.
An echocardiogram uses an ultrasound probe, which is run over your chest to get a moving picture of your heart. Harmless high-frequency sounds are produced near the skin. You will not feel anything and the sound waves will not affect your body in any way. They go through the skin, bounce back from part of the heart, and produce an echo that comes back to the probe. The procedure is carried out in hospital by a cardiologist or a technician trained in the procedure. Possible reasons why you may have an echocardiogram include the following:
● to check whether your heart doesn’t pump as well as it should
● to check for complications after a heart attack
● to look for damage to the heart valves if you have symptoms of heart valve disease
● to check for heart disease in newborn babies and young children
● to look for heart defects in unborn babies – fetal echocardiogram.
When you are reclining comfortably a clear gel is applied to the skin on the left side of your chest. The probe, called a transducer, emits ultrasound waves. The sound waves are reflected back from the surfaces outside and inside your heart. It reveals any abnormalities of your heart valves and shows the size and shape of the chambers of your heart. Echocardiography also shows up any abnormal communications between two heart chambers. This is especially important for diagnosing babies and children. Ultrasound scanning can be used on fetuses in a womb before a baby is born.
Economy class syndrome means deep vein thrombosis caused by travel in a cramped position, particularly on a long flight.
Ectopic (adjective) and ectopia (noun) mean a congenital displacement (= out of place = abnormal position) of an organ or a part of an organ in a body. See Junctional ectopic tachycardia.
Ectopic pregnancy is the abnormal development of a fertilised egg wrongly outside the uterus – usually in a fallopian tube.
Eggs – eating eggs is OK There is no evidence linking egg consumption and heart disease – this applies to almost everyone*. *The only people advised not to eat too many eggs are those with familial hypercholesterolaemia - too high cholesterol, which is a metabolic disease from a congenital defect in the LDL receptor gene resulting in dysfunctional or absent receptors. In the UK it affects about 1 in 500 people. Familial here means with family history, ie inherited.
A British Egg Information Service poll found that 45% of UK adults did not know that the former guidance of maximum three eggs a week was wrong.
EF = ejection fraction, the percentage of the maximum full volume of a ventricle that is being pumped out at each heartbeat. In healthy adults this is about 55%-70%. With heart failure it may be 35%-40% for example or sometimes lower. See Heart failure terms.
Elbow. The joint in each arm. The inside has easily visible veins that are suitable for taking a blood sample. Also called cubitus.
The bone in the upper arm is called the humerus. A knock on the elbow end produces a funny sensation – hence funny bone.
The forearm = lower arm bones are the radius on the thumb side, and the ulna on the little finger side.
The elbow joint is essentially a hinge. The lower arm and hand can rotate about its axis – if you think of the ulna as the centre, then the radius is like a radius of a circle, a line from the centre to a point on the circumference.
Tennis elbow is an inflammation of the tendons near the elbow.
Elective means not compulsory, ie by choice – eg elective surgery.
Electrocardiogram, ECG. An electrocardiogram or electrocardiograph records the rhythm and electrical impulses that your heart produces every time it beats, obtained from electrodes connected to the chest.
See separate factsheet on ECG.
You may need to have an ECG if you have a problem with your heart – such as palpitations, dizziness or chest pain – to find out what the problem is. The test can detect whether you have an abnormal heart rhythm, whether you have had a heart attack, and/or if your heart is working under strain.
If you are about to have an operation, you may have an ECG beforehand to check how well your heart is functioning. You may have an ECG after surgery to help decide how much exercise you can do. An ECG can also form part of a routine health check-up. GPs are often able to do the ECG in their surgery; but sometimes you will need to be referred to a hospital.
The ECG results indicate whether or not the heartbeats are normal; abnormalities such as damage to heart muscle from a past heart attack; and/or that some part is enlarged, damaged, or working under strain – eg from high blood pressure.
The normal pattern has five waves – denoted by P, Q, R, S, T. The P-wave is the left and right atrial muscles pumping blood into the ventricles. The QRS is the ventricle muscles contracting to pump blood out into the aorta to go round the body. The T-wave is the ventricles relaxing. The various differences from the normal pattern outside certain allowances may indicate various heart conditions, abnormalities, or diseases – but not all heart abnormalities or diseases show on an ECG. The rhythm is generated by the sino-atrial node, also called sinus node.
See also Event monitor, Finometer tilt testing, MIBI. An Echocardiogram and ECG may be done together.
ECG Procedure
Small metal adhesive discs – called electrodes – will be stuck onto your skin – one on each arm and/or leg and several on the front of your chest. The tiny voltages at each electrode are amplified and either connected to a pen producing a wavy line on paper, or the same pattern on a screen. The equipment gives a record of the electrical impulses that your heart produces each time it beats – by amplifying the tiny differences in the voltages at the electrodes. The results, on paper or on a computer screen, show whether the electric signals of each heartbeat are normal; or abnormalities such as from damage to heart muscle from a past heart attack; and/or that some part is enlarged, damaged, or working under strain – eg from high blood pressure.
The procedure is harmless, safe, and completely painless and the machine will not give you an electric shock or affect your heart in any way. It is your own heart that produces the electrical signals. The machine merely records them.
To specialists the graphs indicate whether or not the heartbeats are normal; abnormalities such as damage to heart muscle from a past heart attack; and/or that the left ventricle is enlarged, damaged, and/or working under strain – eg from high blood pressure.
Other tests
For some patients, full diagnosis may need other tests as well. The ECG is a valuable diagnostic tool, but the standard test with the patient resting has some limitations. Some so-called abnormalities indicated by an ECG can have a trivial and innocent cause. On the other hand, a patient can have a normal ECG and still be suffering from some form of heart disease.
Better information is gained by recording the ECG with the patient under exertion – called an Exercise stress test. The patient walks at varying speeds on the level and then on an upward slope while the recording is taken. See also tilt test under Collapse, Event monitor, Finometer tilt testing, MIBI. An Echocardiogram and ECG may be done together.
Long P-R on ECG. The P-R interval is the total time on the ECG from the start of the P wave to the start of the R wave or the QRS complex. It's normally 120 to 200ms. It is the time the electrical impulse takes to travel from the sinus node through the atrio-ventricular node where it enters the ventricles. So it indicates good or poor AV function. Long P-R over 200ms may indicate a first degree heart block as below, or various other conditions. Short P-R may indicate a pre-excitation leading to early activation of the ventricles. Normally the atria and the ventricles are electrically isolated, and the only electrical flow is through the atrio-ventricular node. In pre-excitation the electrical impulses can flow along some other shorter path and arrive earlier than they should.
First degree heart block means the impulse from the atria to the ventricles is delayed by going slower than usual. It occurs in about 6-11 per 1000 children and about 1 per 1000 adults. The causes include: myocardial infarction, myocarditis, and effects of some drugs - such as calcium channel blockers, betablockers and other drugs that can slow the electrical conduction.
Long Q-T on ECG. The Q-T interval is the total time on the ECG from the start of the QRS to the end of the T-wave, corresponding to the left and right ventricles contracting. Long QT syndrome is an inherited defect in the heart rhythm caused by a mutation in a gene that regulates the heart's electrical system. Beta-blockers can help maintain a normal heart rhythm in 90% of cases.
In the US, 4,000 children and young adults die yearly of Long QT syndrome. The first sign may, unfortunately, be that the heart muscle abruptly goes into fibrillation – beating too fast and so ineffectively that the blood stops circulating. The heart has to be defibrillated (shocked back into a normal rhythm) within a few minutes if the person is to survive.
Types of ECG
The standard ECG test, sometimes called a resting ECG, is taken while you are not doing any activity. There are also other types of ECG your doctor may suggest you have, if a standard resting ECG won’t provide all the necessary information. These tests are normally done in a hospital.
Resting ECG
The standard, resting ECG, is very simple and only takes a few minutes – you’ll be able to sit or lie down while having it. You will have a number of small metal plates or sticky patches called electrodes stuck or strapped to you (one on each arm and leg and six on your chest). The electrodes are attached to a recording machine by wires. When your heart beats, it produces electrical signals that are picked up by the electrodes and transmitted to the recording machine. The machine then prints out your heartbeat onto a paper strip.
See also Exercise stress test.
Click here for ECG.
Electrode. In pacemaking, an electrode is the electrically active portion of the lead that delivers a stimulus to the heart to get the heart beating properly.
For an electrocardiogram, an electrode is an electrical connection patch touching the skin that detects the heart's electrical signals.
Electrolyte. Electrolyte has three meanings. 1 It is a compound that conducts electricity. 2 An ion in such an electrolyte. 3 an ion in a material such as a cell or blood. Some body salts are electrolytes.
Electron See electron under Organic chemistry.
Element. See trace elements needed for health under Minerals, or element under Organic chemistry.
Elixir is a clear sweetened liquid forming the base of eg cough medicine. It often contains some alcohol.
Eluting, elution, means chemical purification or separation by washing. See under Stent.
Embolus. An embolus or embolism is a part of a blood clot that breaks away and flows in the blood to somewhere else. A pulmonary embolism is such a clot that flows to and stops in a pulmonary artery near the lungs. See Blood clot.
Emergency means the patient needs immediate treatment for a condition that has occurred suddenly or unexpectedly or by accident. Emergency operations are operations whose occurrence could not have been scheduled in advance – though the hospital may have made plans and arrangements so that such operations can be done immediately, without significant delay. Contrast with elective operations that are planned and scheduled in advance – eg when the patient comes to an outpatient appointment.
Emetic is something to make a patient vomit. It irritates the stomach lining and/or stimulates the part of the brain that controls vomiting.
Emulsion is a mixture of two liquids that don't normally mix but in the presence of a third substance (an emulsifying agent) can be mixed. The final mixture may behave as drops of one liquid in the other if shaken.
Endocarditis is inflammation of the membrane around the heart and heart valves. Such patients may be unable to take some antithrombotic medicines. Bacteria that have entered the bloodstream somehow - eg usually from the mouth such as bad teeth, or sometimes from some other part of the body, cause an infection of the valves and/or lining of the heart. It is fatal if not treated.
It can come on suddenly. The symptoms include chronic illness for several weeks, night sweating, fevers, weight loss, aches and pains; and bacteria in the blood - which need to be identified. The hospital treatment is antibiotics - usually given directly into a vein close to the heart for up to six weeks; and occasionally heart surgery - eg to replace a valve.
Endocrine gland. The endocrine glands, also called ductless glands, secrete the hormones directly into the blood. They include pituitary, pineal, thyroid, parathyroid, adrenal, testes, ovaries, and the islets of Langerhans in the pancreas that produce insulin. See under Hormone.
Endorphin is a natural painkiller released from the brain.
ENDO-MIDCAB = Endoscopy assisted minimally invasive direct coronary artery bypass surgery. A new approach to heart bypass surgery at King’s College Hospital, London, is helping to speed up patients’ recovery, cut infection rates, and minimise scarring from surgery.
Cardiac surgeons at King’s College Hospital, London, are confident the procedure will radically change the treatment of selected patients with coronary artery disease.
Previously for CABG, surgeons made large incisions over the breastbone to access the heart and the blocked vessel.
In the new technique, the surgery uses a much smaller incision 3-5 cm wide over the side of the chest. The surgeon inserts a special surgical camera (endoscope) through the incision so he can see pictures of the heart. Using specialised instruments, the bypass surgery enables blood to flow better.
Endothelial tissue is tissue lining the blood vessels, heart, and some other cavities.
Energy conservation in a heart-related context is a way of making a satisfactory arrangement of activities and rest so you do not become overtired. This may be useful for anyone whose medical condition causes breathlessness, or fatigue.
Eg avoid actions that put too much stress on your heart or lungs or make you breathless; save effort where possible; use equipment aids if you need to; wear comfortable clothing; use a dishwasher, washing machine, dryer; perhaps order shopping online to save having to go to shops and supermarkets.
Maybe find a slightly different way that is less stress or physical exertion; maybe sit for some activities that you previously used to stand for.
Continue activities that you enjoy; continue to keep in touch with other people; and accept offers of help and/or ask for help when you need it.
Enteric coating means a drug has a coating so after being taken by mouth it passes through the stomach without affecting the stomach, and affects the intestine.
Enzyme is a protein that controls the rate of some chemical process in the body. Each type of cell produces a particular group of enzymes – so a person's body has thousands of enzymes. Eg cells in the liver have enzymes that control the breakdown of various body nutrients.
Epicatechin See epicatechin under Apple a day.
Epiglottis A flap attached to the back of the tongue. See under Larynx.
Epinephrine is a neurotransmitter produced in the medulla (innermost centre) of the adrenal glands, hence its original name adrenaline. Synthetic drugs have been made since 1990. Brand names are: Ana-Guard, Ana-Kit, Anapen, EpiPen, and Minijet.
The drug is given in an emergency to stimulate heart activity and raise low blood pressure. It narrows blood vessels in the skin and intestine. Epinephrine is injected to counteract cardiac arrest or to relieve severe allergic reactions (anaphylaxis) to drugs, food, or insect stings.
When anaphylaxis strikes, life is at risk. So time is critical. Patients at risk of anaphylaxis should carry a prefilled syringe for immediate self-injection at the start of an attack – the syringe dose is 0.3ml. The onset of the effect of the injected dose is within about five minutes, and lasts up to about four hours.
As epinephrine narrows blood vessels it can also be used to control bleeding and/or to slow the dispersal of local anaesthetics – and so prolong their effect.
Erythropoietin is a hormone needed for red blood cell production. See Kidney.
Erythrocyte sedimentation rate (ESR) and blood test. See polymyalgia.
ESBL = Extended Spectrum Beta Lactamase.
ESPRIT. Efficacy and Safety of PRescribing In Transplantation. The BCPA and other related organisations support them.
ESR = Erythrocyte sedimentation rate and blood test. See polymyalgia.
Esters. An ester is any of a group of compounds produced by a reaction between acids and alcohols and with elimination of water. Fats are solid esters. See under Lipids, triglycerides.
Etexilate means it turns a drug into the active form in the patient’s body. See Dabitran.
EUROSCORE stands for European System for Cardiac Operative Risk Evaluation. It dates from 1998. It is a method of calculating predicted operative mortality for patients undergoing cardiac surgery, ie the risk of death from a cardiac operation. Operative mortality is a good measure of quality of cardiac surgical care, as long as patient risk factors are taken into consideration.
Nearly 20,000 consecutive patients from 128 hospitals in eight European countries were studied. Information was collected on 97 risk factors in all the patients. The outcome (survival or death) was related to the preoperative risk factors. The most important, reliable and objective risk factors were then used to prepare a scoring system. For each of about 20 factors a score from 1 to 4 is added. The total then gives the estimated percentage risk of death for the proposed operation on that patient. Eg for age per 5 years or part thereof over 60, score 1; Gender: if female score 1; … if previous MI in the last 90 days score 2; … if emergency operation score 2; …
Event monitor. An event monitor takes a continuous recording of the electrical impulses produced by the patient's heart – like an ECG over 24 hours or a week. Holter monitor means the same.
A patient can wear the monitor all day and night, and walk about unhindered. It typically has three or four electrodes picking up signals from the chest and a small portable recorder for recording the signals – eg a box clipped to your clothing. It is usually done as an outpatient procedure and is particularly useful if you have symptoms that only occur intermittently – such as palpitations, dizzy spells or faints.
See separate factsheet on Event Monitoring.
It gives a record of how your heart behaves as you go about your normal daily life. Recording your ECG in this way is very valuable as it may show that you would benefit from a heart pacemaker, or from drug therapy, or from some other further treatment.
The technician will stick electrodes to your chest in the same way as for a simple ECG, and connect the wires to the recorder.
Before you leave the hospital you will be given a diary and asked to use it to note down the time of day when any symptoms occur. Your entries in this log will draw attention to the times when you have experienced symptoms.
You should come back to the hospital as arranged so that the technician can remove the recorder, and you hand in your diary.
The recording can be played back at up to 60 times speed – eg an hour played back each minute. The playback can be even faster if the operator knows from your diary when to concentrate on and can skip playback of your sleeping hours for example.
Newer event monitors available since 2001 or 2002 use better computer technology and can run for up to a week. They are much smaller and lighter than earlier monitors.
Event monitoring by Implantable loop recorder - ILR
An implantable loop recorder ILR is a small, slim device that is inserted just under your skin in the front of your chest. You will have a local anaesthetic for this, so won’t feel any pain. The device can continuously monitor your heartbeat and can be activated whenever you experience symptoms – such as dizziness or a blackout.
Knowledge gained
Problems with the heart often show up on the ECG display or printout, which shows the electrical activity in your heart as it beats. An ECG recording looks like a wavy line, with a series of bumps and spikes that relate to the different phases of your heartbeat. Everyone's normal heartbeat pattern is similar.
However if you have a problem with your heart, the bumps and spikes may look abnormal. They may be too big or too small; too close together or too far apart; or some of the bumps may be missing. Thus the ECG recording usually gives some detail of how your heart is functioning and what seems to be the problem. You may need further tests to confirm this.
Afterwards
After looking at your ECG results, your doctor will be able to advise you on the best course of action and/or decide that some further test may be needed. Although an ECG is useful and simple to do, it only shows certain conditions.
If your ECG is normal, your doctor may suggest other tests to find out more about what is causing your symptoms. While a normal ECG can sometimes mean that there isn’t anything wrong with your heart, it is also possible that you have something that does not show on an ECG, so other tests may be needed.
If your ECG is abnormal, it doesn’t necessarily mean that you definitely have a problem with your heart. You may need other tests that doctors can do to get more information on the structure of your heart and how it’s functioning. These include:
- an echocardiogram – this uses ultrasound to create a moving image of your heart
- a chest Xray
- a cardiac magnetic resonance imaging MRI scan, which uses radiowaves to see how the pattern of how the heart muscles are working, and if not working properly should show what is wrong.
Abnormal ECG
An abnormal ECG does not necessarily mean you have a heart disease. It is possible to have an abnormal ECG recording when there’s actually nothing wrong with you – the results may have a trivial and innocent cause.
Various things can cause an abnormal ECG, including certain heart conditions and other factors. These include:
- abnormal heart rhythms (arrhythmias), such as atrial fibrillation, atrial flutter, ventricular tachycardia and heart block
- heart valve disease
- heart failure or coronary heart disease – causing the heart to work under strain
- diseases of a heart muscle – cardiomyopathy
- certain drugs, including beta-blockers and digoxin.
Exercise. See also under Stress, Exercise stress test, and Exercise plan after a heart attack.
In April 2004 the UK Chief Medical Officer, Sir Liam Donaldson, said that most* adults should take at least 30 minutes of moderate** physical exercise on five or more days per week, and children should take 60 minutes of moderate physical activity every day.
*Here 'most' obviously excludes those training for a sport and those who are ill or not fit enough to take such exercise.
**Moderate physical activity here means causing an increase in breathing rate, higher pulse rate, and feeling warm. The increases may be slight and should be easily within what the person can do without any breathlessness or pain.
This does not mean going to a gym. The adult quota can be achieved by eg three ten-minute bouts such as vacuuming or mowing a lawn. Even dusting and ironing need about twice the rate of physical energy that sitting needs. See also Walking.
Two-thirds of UK men and three-quarters of UK women are not active enough to benefit their health. Exercising cuts the risk of premature death by a third - see death rates.
Because of the way the circadian rhythm works, people should not do physical exercises immediately before going to sleep, as this may tend to trigger increased temperature, heart rate, breathing and brain activity, and keep one awake.
The British Heart Foundation National Centre for Physical Activity and Health, BHFNC, has found the following.
● 37% of CHD deaths are related to inactivity; as compared to only 19% of CHD deaths being related to smoking.
● Inactivity is the most prevalent risk factor for CHD, with 70% of women and 60% of UK men not active enough to achieve the health benefits from physical activity.
● 9% of UK deaths from CHD could be avoided if people who are currently sedentary or have a light level of physical activity increased their activity to a moderate level.
Burning calories continues after vigorous exercise
Research published in 2011 found that after vigorous exercise one's body continues to burn calories for some hours afterwards. Vigorous here means one is sweating, body temperature raised, and fast heartbeat - ie intense activity such as a game of football, or swimming, running, biking or similar. In the trials volunteers aged 22 to 33 used an average of 19 Kcal; and used a further 190 Kcal afterwards.
Exercise plan after a heart attack – Do's and don'ts
When you are recovering in the first four to six weeks after a heart attack, you should not do anything that requires lifting, pulling, pushing, or a sudden burst of energy. If you are unsure about an activity, ask.
It is OK to do: light housework, dusting, cooking, washing dishes, making tea, light hand washing, shopping (but someone else should carry heavy loads), light gardening (weeding, planting out, trimming, watering with a hose).
It is OK to experience: slight breathlessness, feeling your muscles working, slight sweating, and/or tiredness that soon passes.
Avoid: heavy housework, vacuuming, scrubbing, sweeping, washing windows, driving a car, running upstairs or for a bus, lifting heavy items, painting and decorating, heavy gardening, mowing, digging, watering involving carrying a heavy can.
Stop immediately if you experience any of the following warning signs: pains in the chest, sickness or nausea, excessive sweating, excessive shortness of breath.
If these symptoms are not quickly relieved, do not hesitate to seek medical advice.
Walking is an ideal exercise for your rehabilitation. It is relaxing, non-strenuous exercise – free, easy, and safe.
To build up your stamina follow these five stages. Remain in each stage until you can complete it comfortably – at least three days. Move on to the next stage only when you feel ready.
Stage 1. Climb stairs and take a short walk 2 to 3 times a day
Stage 2. Take a continuous walk for ten minutes each day
Stage 3. Increase walking time to 20 minutes
Stage 4. Increase walking time to 45 minutes
Stage 5. Keeping the same distance, try to do it in less time while still feeling comfortable.
Exercise stress test. This is performed to assess how the patient’s heart copes when exercising – walking at increasing speeds and perhaps jogging on a treadmill simulating level ground and/or going uphill. During this, an electrocardiogram monitors the heart. Any symptoms experienced will be recorded and your blood pressure and pulse will be monitored. These help diagnose angina, distinguish stable angina from unstable angina, and diagnose other CHD.
The Bruce Treadmill Test, also called the Bruce cycle, is an exercise stress test on a treadmill with a standard pattern of speeds and slopes at 3-minute intervals. The patient starts walking at 2.74km/hr on a slope upwards of 10%. After 3 minutes the slope and speed are increased to 4.02 at12%. There are a total of ten such 3-minute stages taking it up to 12.07 at 28% starting after 27 minutes. Even a fit athlete is not expected to be able to do all stages so the test stops when the athlete cannot continue.
For heart patients, as an aid to diagnosis, the test is conducted with a doctor and/or other medic present for safety, and continuous recording of the patient's electrocardiogram ECG.
Fitness can be measured by the volume of oxygen an athlete can consume while exercising at maximum capacity.
VO2 max is the maximum amount of oxygen in millilitres used in one minute per kilogram of body weight. Those who are more fit have higher VO2 max values and can exercise more intensely. One can increase one's VO2 max by working out at an intensity that raises one's heart rate to 65% to 85% of one's heart rate maximum for at least 20 minutes three to five times a week. The original research paper is by Bruce, RA: Multi-stage treadmill test of maximal and sub maximal exercise (1972).
Extended Spectrum Beta Lactamate is an enzyme produced by certain bacteria and that breaks down certain antibiotics - making the bacteria difficult to treat. It can be produced by some strains of bacteria that normally live in the bowel eg E. coli. Infection from the bacteria occurs mainly in the urine, and may affect wounds, lungs and blood. It can be spread from one person to another via contamination with faeces eg on hands or other objects and thus into a person's mouth.
Despite ESBL being resistant to normal antibiotics, washing hands thoroughly with soap and water after using the toilet and before eating reduces the risk of ESBL. Also try to avoid touching wounds, catheters and drips.
Extra corporeal membrane oxygenation, ECMO is a way of providing oxygen to patients whose heart and/or lungs cannot properly serve their functions. It is a 24/7 system where blood is circulated through an external pump and machine for adding oxygen and returned to the patient.
Ezetimibe See Ezetimibe under Lipid-lowering agents.
Copyright
This information was created and edited by Richard Maddison for the BCPA.
Copyright © 1997-2013 The British Cardiac Patients Association, and/or Richard Maddison.
BCPA Head Office: 15 Abbey Road, Bingham, Nottingham NG13 8EE
Reg Charity 289190. Email: Admin@BCPA.co.uk
First published in this form 2002, and updated 2005, 2007, 2008, 2011, 2012, 2013.
All rights reserved. No part of this work may be reproduced, stored in a retrieval system or transmitted, in any form or by any means, without written permission from the BCPA Head Office.
We give permission for copies to be stored and made within the BCPA and any UK hospital; and these hospitals may give printed but not electronic copies to patients provided the source and copyright is acknowledged on the copies – eg include the page footer.
Authors, sources and acknowledgements
The main sources are BCPA Journal published articles, other information from authors, and publicly available documents and websites. In many cases the journal articles give sources and further information than the Glossary entries.
Parts of the wordings under ECG and Echocardiogram are adapted with permission from BUPA's health information resources, available at www.bupa.co.uk/health-information.
We hope we have thanked everyone.
Richard Maddison