A system determines fractal values, a nonlinear fractal ratio and fractal data patterns in a heart and maps determined fractal values to medical conditions. A system for heart performance characterization and abnormality detection includes an interface for receiving sampled data representing an electrical signal indicating electrical activity of a patient heart over at least one heart beat cycle. A signal processor calculates, a first signal characteristic value comprising a first fractal dimension value derived from the sampled data over at least a portion of a heart beat cycle, a second signal characteristic value representing a computed derivative of the first fractal dimension value and a ratio of the first and second signal characteristic values. A comparator compares the calculated ratio with a threshold value to provide a comparison indicator. A patient monitor, in response to the comparison indicator indicating the calculated signal characteristic value exceeds the threshold value, generates an alert message associated with the threshold.