…and left axis deviation (LAD) Causes of right axis deviation Normal in newborns. Right ventricular hypertrophy. Acute cor pulmonale (pulmonary embolism). Chronic cor pulmonale (COPD…

…the fibular artery can also be sought anterior to the lateral malleolus. Calculation: for each leg, the highest of the dorsalis pedis and posterior tibial…

…and left axis deviation (LAD) Causes of right axis deviation Normal in newborns. Right ventricular hypertrophy. Acute cor pulmonale (pulmonary embolism). Chronic cor pulmonale (COPD…

…cold periphery Almost always Pulsus paradoxus above 10 mmHg A fall in systolic blood pressure during inspiration; one of the most useful signs Low voltage…

…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…

…is subdivided into the following two fascicles: (1) the anterior (anterosuperior) fascicle , which delivers the electrical impulse to the anterior wall of the left ventricle…

…It normally consists of three leaflets (anterior, posterior and septal leaflet). The leaflets are attached to the subvalvular apparatus, consisting of the chordae tendineae and…

…a lesion proximal to the first septal perforator of the left anterior descending artery was associated with lower five year survival than a more distal…

…embolic manifestations. The source material does not provide a detailed catalogue of specific embolic syndromes. Clinical suspicion should be heightened after: Anterior STEMI. A large…

…is a rare but catastrophic manifestation of acute coronary syndromes. The LMCA supplies a large myocardial territory through the left anterior descending (LAD) and left…

…segments referred to as A1 (anterior segment), A2 (middle segment), and A3 (posterior segment) (Figure 1). The posterior leaflet of the mitral valve has a…

…right anterior (V1) to left lateral (V6), but regrettably, the limb leads are not. Instead, the limb leads are displayed in two groups of three…

…area ). The LAD supplies the large anteriosuperior wall (often referred to as the anterior wall ) and the apical part of the lateral wall . The LAD…

…to adults in sinus rhythm, recorded at a paper speed of 50 mm/s with 1 mV = 10 mm. At 50 mm/s a…

…without current symptoms, alternating bundle branch block in acute anterior infarction, and before drugs or procedures with a known risk of bradycardia. Transvenous pacing is…

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

…Myocardial bridging is an anatomical variant in which a segment of an epicardial coronary artery passes through the myocardium rather than remaining on the epicardial…

…Lathundar Differential Diagnosis of Chest Pain: A Clinical Overview The evaluation of acute chest discomfort requires a systematic differential diagnosis, as the syndrome associated with…

…the ischemic area!) [2]. Take home message: in the setting of acute coronary syndromes, be quick to administer antithrombotic medications and reperfusion. Refer to G…

…age. Female sex. Hypertension. Absence of an adequate collateral circulation. A first or anterior infarction. Single vessel disease without collateral support. Chronic kidney disease, particularly…

…indirectly as reciprocal abnormalities in the anterior precordial leads. Acute myocardial ischaemia alters the resting membrane potential and action potential duration of affected myocardial cells…

…acute, evolving or chronic The severity of ischaemia and whether infarction has occurred The extent and degree of myocardial involvement The anatomical territory, including anterior…

…devices. Electrode position (anterior posterior vs. antero lateral) does not affect success, but active compression of the pads lowers defibrillation thresholds and improves success, and…

CPR Pneumothorax Pneumothorax is characterized by the presence of free air in the thoracic cavity. While this can occasionally be benign and manifest even in…

…Detailed diagram of coronary artery segments. CT = computerized tomography. LMCA = Left main coronary artery (5) LAD = left anterior descending artery: proximal segment…

…into the bundle of His, which bifurcates into the right and left bundle branches. The left bundle branch further divides into the anterior and posterior…

…Left anterior descending coronary artery. LCX = left circumflex coronary artery. Arterial blood supply of the conduction system Figure 1 presents the components of the…

…myelodysplastic syndrome or myeloproliferative neoplasm. Work up and staging of lymphoma and myeloma. Suspected bone marrow metastasis. Assessment of treatment response and measurement of residual…

…the visual acuity before anything else is done. The second most important is to look for signs of perforation — Seidel's sign, an irregular pupil…

…L) — choose the subcutaneous route if possible, otherwise give IM with a fine needle and 5 minutes of compression. Anticoagulant treatment is not in itself…

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

…3–5 cm superior and medial to the anterior superior iliac spine and lateral to the lateral border of the rectus abdominis — this avoids the…

…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…

…or proximal left anterior descending artery are more likely to affect flow because they supply a larger myocardial territory. The response of the coronary circulation…

…is more frequently associated with anterior infarction than with inferoposterior infarction [4]. Myocardial Necrosis : The occurrence of LBBB (as a form of bifascicular block) is…

…than NSTEMI, and up to two thirds of infarctions are anterior. The risk of ACS is greatest during the third trimester and postpartum period, although…

Critical care Myocardial ischemia and infarction Definition and Pathophysiology Cardiogenic shock is a state of inadequate tissue and end organ perfusion caused by cardiac insufficiency…

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

…periods of sinus node dysfunction occur after tachyarrhythmia; the combination of tachyarrhythmia and sinus node dysfunction is referred to as tachy brady syndrome . Neurocardiogenic syndrome…

…the right bundle branch at the level of the origin of the anterior papillary muscle. A network of Purkinje fibers sprouts out from the bundle…

…cardinal symptom of coronary artery disease. It occurs when the myocardium becomes ischemic. It is typically described as a diffuse pain over the anterior chest…

…block (LBBB) in patients with acute coronary syndromes (ACS) For many years, European and North American guidelines recommended managing patients with symptoms of myocardial ischem

…of His, which bifurcates into the left bundle branch (LBB) and the right bundle branch (RBB). The left bundle branch further divides into the anterior…

…segments ( apical anterior , apical septal , apical inferior , and apical lateral ) and the apex (Table 2). Table 2. The 17 segments of the left ventricle Basal…

…The ECG grid. The x axis represents time and y axis represents amplitude of the electrical signals generated in the myocardium. The same ECG grid…

…segment depressions with prominent T waves in the majority of the chest leads may indicate an acute occlusion in the LAD (left anterior descending artery)…

…anterior , lateral and septal wall ( Figure 2 below). An inferior myocardial infarction refers to an infarction located in the inferior wall of the left ventricle…

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