…osteoarthritis related joint disease. Contraindications Infection of the skin or soft tissues over the puncture site — use another approach or refrain. Bacteraemia without suspicion of…

…the nasal bone instead of the soft part, and lets go after two minutes. Management is a ladder — compression, cautery, anterior packing — and each step…

…perforation — Seidel's sign, an irregular pupil, a soft globe — because a perforated eye must never be instrumented, have its pressure measured, or be palpated…

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)…

…narrowing of the left main coronary artery, which supplies the left anterior descending and left circumflex coronary territories. Because these vessels perfuse a large proportion…

…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…

…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…

…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…

…reduction of blood flow to tissues and organs. A few decades later Cohnheim demonstrated that ligation of the left anterior descending artery in dogs resulted…

…Papillary muscle rupture, producing acute severe mitral regurgitation (MR). These complications result from transmural myocardial necrosis and subsequent tissue disruption. Infarct expansion and, in some…

…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…

…Thrombotic debris may worsen microvascular obstruction, while cardiomyocyte swelling, interstitial oedema and tissue inflammation produce extravascular compression. In the most severe form, termed no reflow…

…due to superior efficacy over monophasic devices. Electrode position (anterior posterior vs. antero lateral) does not affect success, but active compression of the pads lowers…

…absence of sounds on the affected side. Ultrasonography can reveal pneumothorax (highlighted by a lack of lung tissue) and its impact on cardiac function. Clinically…

…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…

…leg. If the signal is uncertain or borderline, the fibular artery can also be sought anterior to the lateral malleolus. Calculation: for each leg, the…

…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…

…Slow, local effect Contraindications Absolute: Infection, a wound, scar tissue, a tattoo or skin disease at the injection site. Known hypersensitivity to the preparation. Intramuscular…

…The site lies about 3–5 cm superior and medial to the anterior superior iliac spine and lateral to the lateral border of the rectus…

…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…

…location also matters: stenoses in the left main stem or proximal left anterior descending artery are more likely to affect flow because they supply a…

…complication of myocardial infarction (MI) [5]. It is more frequently associated with anterior infarction than with inferoposterior infarction [4]. Myocardial Necrosis : The occurrence of LBBB …

…dysplasia (FMD), which may produce arterial wall abnormalities and intramural haematomas. Inherited connective tissue disorders, including Marfan syndrome and Ehlers–Danlos syndrome. FMD may be…

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…

…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…

…Methyldopa. Reserpine. Clonidine. Conditions Myocardial ischemia, myocardial infarction (can cause permanent bradycardia, particularly anterior infarctions). Viral myocarditis. Lyme disease. Rheumatic fever. Endocarditis. Heart surgery (can…

…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…

…segments of the left ventricle Basal Segments Mid cavity Segments Apical Segments 1. basal anterior 7. mid anterior 13. apical anterior 2. basal anteroseptal 8…

…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…

…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)…

…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…

…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…

…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…