…2. Inspect the eyelids, conjunctiva, cornea and anterior chamber. Note the pupil size, shape and reaction to light. A teardrop shaped or peaked pupil suggests…

…The intramyocardial segment is termed the tunnelled artery. The left anterior descending artery (LAD) is most commonly involved. The reported prevalence depends substantially on the…

…These three planes correspond to the parasternal short axis view (PSAX), apical two chamber view (A2C), and apical four chamber view (A4C), respectively (Table 1)…

…ventricle in the thorax. It is localized immediately behind the sternum and thus is the most anteriorly located part of the heart. The right ventricle…

…Step 3 — anterior packing A compressed nasal tampon: 1. Coat the tampon with antibiotic ointment and trim it to the length of the nasal cavity…

Conduction defects ECG Fascicular block (hemiblock): left anterior fascicular block & left posterior fascicular block Fascicular blocks were previously referred to as hemiblocks, but the latter…

Echocardiography Tricuspid regurgitation The tricuspid valve separates the right ventricle and the right atrium. It normally consists of three leaflets (anterior, posterior and septal leaflet)…

…bifurcation involvement Disease in the left anterior descending and left circumflex arteries The number of additional diseased vessels Lesion morphology and technical feasibility of PCI…

…endocardium, typically overlying an akinetic or dyskinetic myocardial segment after myocardial infarction (MI). It is particularly associated with extensive anterior or transmural infarction, apical dysfunction…

…acute coronary syndromes. The LMCA supplies a large myocardial territory through the left anterior descending (LAD) and left circumflex (LCx) arteries (Figure 1). Acute obstruction…

…annular circumference. The posterior leaflet generally has two distinct indentations which divide it into three scallops, P1 (anterior or medial scallop), P2 (middle scallop), and…

…For example, if there is acute ischemia located in the anterior wall and there is ST segment elevation in lead V3, then there should also…

…left ventricle. Figure 2. Assignment of the 17 myocardial segments to the territories of the left anterior descending (LAD), right coronary artery (RCA), and the…

…must not be included. Electrical axis Electrical axis Interpretation : : −30° to +90° Normal −30° to −90° Left axis deviation — left anterior fascicular block, inferior infarction…

…newly discovered complete heart block without current symptoms, alternating bundle branch block in acute anterior infarction, and before drugs or procedures with a known risk…

…atrium is activated passively. The upper boundary of this circuit may be located either anterior or posterior to the superior vena cava. A critical area…

…2], [5]. Localization: While often retrosternal, the pain may be localized to the left anterior chest and can radiate to the neck, shoulders, and arms…

…tissues and organs. A few decades later Cohnheim demonstrated that ligation of the left anterior descending artery in dogs resulted in myoardial infarction. An important…

…Predisposing features Risk features vary by lesion but include: Older age. Female sex. Hypertension. Absence of an adequate collateral circulation. A first or anterior infarction…

…Instead, the infarct related electrical changes may be recorded indirectly as reciprocal abnormalities in the anterior precordial leads. Acute myocardial ischaemia alters the resting membrane…

…has occurred The extent and degree of myocardial involvement The anatomical territory, including anterior, inferoposterolateral or right ventricular involvement Pre existing abnormalities such as prior…

…can immediately and safely restore sinus rhythm, obviating slow drug titration and rendering the supraventricular versus ventricular distinction less critical. Performance involves sedation (e.g…

…should be utilized. The cannula is inserted into the 4th or 5th intercostal space along the anterior axillary line. Thoracostomy This method is generally deemed…

…de Winter's sign, widespread ST segment depressions) that point to the left anterior descending artery (LAD) as the culprit. The coronary arteries: a brief…

…into the right and left bundle branches. The left bundle branch further divides into the anterior and posterior fascicles. Both the right bundle branch and…

…and the vascular supply. RCA = right coronary artery. LAD = Left anterior descending coronary artery. LCX = left circumflex coronary artery. Arterial blood supply…

…Preparation: The patient must have rested lying down for at least 10 minutes in a room at a comfortable temperature — a cold foot gives falsely…

…into the mediastinum. The anterior superior iliac spine is a second line alternative in marked obesity or when the supine position is necessary. After previous…

…which causes the shoulder injury known as SIRVA. Both are avoided with the right landmark and the right needle length. Indications Route Typical drugs Absorption :…

…landmark — the posterior corner of the acromion — is easy to palpate even in a large patient. The anterior approach, just lateral to the coracoid process…

…Scars, hernia or visible abdominal wall collaterals (caput medusae) Puncture at least a few centimetres away from them Full bladder Have the patient void, or…

…status, the ASA class and the airway beforehand. Procedure Anterior shoulder dislocation The commonest of all dislocations. There is a hollow beneath the acromion, the…

…some lesions with apparently lesser narrowing are physiologically important. Lesion location also matters: stenoses in the left main stem or proximal left anterior descending artery…

…130 msec in females , along with slurring or notching of the mid QRS in at least two left facing leads [7]. These stricter parameters correlate…

…STEMI is more frequent than NSTEMI, and up to two thirds of infarctions are anterior. The risk of ACS is greatest during the third trimester…

…rupture with tamponade, and less common causes such as severe pre existing valvular disease or excessive beta blocker or calcium channel blocker exposure. The incidence…

…Left anterior fascicular block is diagnosed if the axis is between 45° and 90° with qR complex in aVL and QRS duration 0,12 s…

…Left anterior fascicular block is diagnosed if the axis is between 45° and 90° with qR complex in aVL and QRS duration is 0,12…

…repeatedly to the circumflex artery before a 60 minute occlusion of the left anterior descending coronary artery (LAD) would reduce the infarct size by 60…

…cause permanent bradycardia, particularly anterior infarctions). Viral myocarditis. Lyme disease. Rheumatic fever. Endocarditis. Heart surgery (can cause permanent bradycardia). Hypothyroidism. Medullar lesion. Increased intracranial pressure…

…the septum. Purkinje fibers are branched off from the right bundle branch at the level of the origin of the anterior papillary muscle. A network…

…occurs when the myocardium becomes ischemic. It is typically described as a diffuse pain over the anterior chest wall. The pain may be experienced as…

…such as heart failure, structural heart disease, fibrosis of the conduction system and acute myocardial infarction (particularly anterior STEMI). Hence, an acute myocardial infarction may…

…and the right bundle branch (RBB). The left bundle branch further divides into the anterior and posterior fascicles. The bundle branches and fascicles play a…

…V4. V4: placed on the left medioclavicular line between rib 5 and 6. V5: placed on the anterior axillary line, on level with V4. V6…

…Current guideline criteria for ischemic ST segment depression: New horizontal or downsloping ST segment depressions ≥0,5 mm in at least two anatomically contiguous leads…

…For this purpose, the left ventricle is subdivided into 4 walls: inferior , anterior , lateral and septal wall ( Figure 2 below). An inferior myocardial infarction refers…

…prepared. The patient is positioned semi recumbent, at 30–45 degrees — the fluid then collects anteriorly and inferiorly, which makes it easier to reach subxiphoid…