The electrocardiogram (ECG) is the most commonly performed cardiac investigation in the world. It has been estimated that in Europe alone, up to 300 million ECGs may be recorded annually ( World Health Organisation, 1981 ). The test is fundamental to many cardiac diagnoses, and it is recorded in a wide range of healthcare settings. Despite the clinical importance and ubiquity of the ECG, until very recently there has not been any nationally recognised qualification in the UK to certify competence either in carrying out the procedure or interpreting the result. The only professional group who have had to undergo formal training and assessment in ECG recording and interpretation in order qualify are cardiac physiologists, yet once they are qualified cardiac physiologists record very few ECGs, devoting their time instead to more specialist procedures such as echocardiography and the follow-up of implanted devices. Most ECGs are probably recorded by healthcare practitioners who have not undergone formal training and assessment in practical electrocardiography and who do not hold a recognised qualification in the technique.
The incidence of regurgitant flow velocities were determined using colour flow mapping and pulse Doppler in 107 pregnant women, 55 of whom were less than 28 weeks gestation. The results were compared with 51 non-pregnant controls. The incidence of tricuspid regurgitant velocities increased from 42% in the control group to 67% at greater than or equal to 28 weeks gestation with a median peak regurgitant velocity of 1.7 ms-1. The incidence of pulmonary regurgitant velocities increased from 50% in the control group to 96% at greater than or equal to 28 weeks gestation with a median peak regurgitant velocity of 1.1 m s-1. Mitral and aortic regurgitant velocities were recorded in 27% and 2% of non-pregnant controls respectively. No statistically significant increase in left sided regurgitant velocities was evident during pregnancy. The increase in incidence of right heart regurgitant velocities may be secondary to the dilatation of the respective value orifices due to the volume loading of pregnancy.
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