…common in intravenous drug addicts). Myxomatous degeneration. Rheumatic heart disease. Dilatation of the right ventricle. Dilatation of the right atrium. Pulmonary hypertension. Left to right…

…of fraction of left ventricular volume ejected per beat and of ventricular end diastolic and residual volumes. Experimental and clinical observations with a precordial dilution…

…load (the ventricle is empty or nearly empty). In patients with an initial shockable rhythm, compressions and ventilation can extend the duration of the shockable…

…in the AV node is high grade. Causes of tachyarrhythmia with narrow QRS complexes (QRS duration < 0.12 s): sinus tachycardia, inappropriate sinus tachycardia…

…lead to ventricular dilation. However, the term dilated cardiomyopathy (DCM) refers to idiopathic or genetic dilation of the left ventricle . Patients with DCM typically develop…

…mitral valve separates the left atrium and the left ventricle. The valve is attached to the mitral annulus , which is continuous with annulus fibrosus (the…

…wall stress, which can be alleviated by ventricular hypertrophy and dilation: Wall stress = (Pressure LV × radius LV ) / (2 × WT LV ) LV = left ventricle;…

…the left ventricle hypertrophic? Is left ventricular ejection fraction (LVEF) normal? A normal sized ventricle with hyperdynamic contractility suggests acute aortic regurgitation. The severity of…

…TAD on the electrocardiogram. Echocardiography in ARVC Echocardiography shows global right ventricular dilation. The left ventricle and the septum are generally spared. Regional wall motion…

…causes increased right ventricular load, which results in increased oxygen demand and dilatation of the right ventricle. Despite the dilation, myocardial ischemia will develop if…

…hypertension and atherosclerotic coronary disease In patients with heavy alcohol use, left ventricular dilation may precede the development of increased left ventricular hypertrophy and mass…

…The duration of the P wave will exceed 120 milliseconds in lead II. Biatrial abnormality/enlargement Biatrial abnormality implies that the ECG indicates both left…

…into the left ventricle during diastole. The flow of blood into the ventricle causes volume overload, which exhausts the ventricle and ultimately leads to dilatation…

…duration exceeding 140 msec in males and 130 msec in females , along with slurring or notching of the mid QRS in at least two left…

…left posterior fascicular block (LPFB) . In a fascicular block, the myocardium without fascicular supply will depend on impulses spreading from other parts of the ventricle…

…complexes with LBBB morphology (i.e left bundle branch block appearance). This is explained by the fact that, as in LBBB, the left ventricle receives…

…patients with reduced EF. Pathophysiology Abnormal ventricular relaxation and increased filling pressures The central hemodynamic abnormality in HFpEF is impaired diastolic function. The left ventricle…

…reflection of the electrical potentials generated by the left ventricle. QRS duration QRS duration is the time duration from the start to the end of…

…ventricle, the QRS complex is actually a reflection of left ventricular depolarization. QRS duration is the time interval from the onset to the end of…

ECG Hypertrophy and dilatation Biventricular hypertrophy Simultaneous hypertrophy of the left and right ventricle is rather common. The ECG has low sensitivity with respect to…

…1. ECG changes seen in left ventricular hypertrophy (LVH) and right ventricular hypertrophy (RVH). The electrical vector of the left ventricle is enhanced in LVH…

…and Pathophysiology Posterior myocardial infarction is myocardial necrosis involving the posterior region of the left ventricle, usually as part of an inferoposterior or posterolateral infarction…

…syringes, a three way tap. A Seldinger set with a guidewire, a dilator and a 5–8 F pigtail catheter , plus a drainage bag. Sample…

…filled normally, there is more room for the right ventricle, the filling of which increases and the septum bulges into the left ventricle. During exhalation…

…time to fill the ventricles with blood (increased ventricular filling). Persons with premature beats might perceive this as palpitations, because of the stronger ventricular contractions…

…VT]). The VF waveform is initially coarse ( i.e fibrillatory waves have large amplitudes) but as the duration of VF is prolonged, the amplitude gradually…

…normal (QRS duration < 0.12 s), unless there is a intraventricular conduction defect. The ventricular rhythm is regular (as is the atrial) with a…

…to the left and downwards ( Figure 7 ). The explanation for this is as follows: The vector resulting from activation of the right ventricle does not…

…ECG signs of left atrial enlargement 3 Left axis deviation 2 QRS duration ≥90 milliseconds 1 Prolonged R wave peak time: V1 V2 (right ventricle)…

…1. Measurement of mitral inflow velocities. Mitral E wave velocity The E wave represents passive blood flow from the left atrium to the left ventricle…

…the left ventricle partially or entirely outside the specialized conduction system. This slower conduction results in a prolonged QRS duration. The defining features of LBBB…

…the right ventricle depolarizes after the left ventricle, allowing its electrical vectors to become evident. These vectors manifest in the later part of the QRS…

…with left ventricular dilation. This type of cardiomyopathy, referred to as tachycardia induced cardiomyopathy , can be caused by any tachyarrhythmia leading to prolonged periods of…

…the left atrial appendage (LAA). The LAA is a highly trabeculated, windsock like embryonic remnant that exhibits uniquely low flow velocities during the loss of…

…prolonged duration of effect, and significant individual variations in its effect. Drug Enalaprilat Brand names Vasotec IV ® Indications Hypertension and hypertensive emergency. Acute left…

…prolonged duration of effect, and significant individual variations in its effect. Drug Enalaprilat Brand names Vasotec IV ® Indications Hypertension and hypertensive emergency. Acute left…

…a quick reference to the intravenous antihypertensive drugs used in a hypertensive emergency. It summarises the mechanism of action, the onset, the duration of effect…

…aVF (with QRS duration <0.12 seconds), provided that other causes of right axis deviation have been excluded. Causes of left axis deviation Left bundle…

…aVF (with QRS duration <0.12 seconds), provided that other causes of right axis deviation have been excluded. Causes of left axis deviation Left bundle…

…prolonged duration of effect, and significant individual variations in its effect. Drug Enalaprilat Brand names Vasotec IV ® Indications Hypertension and hypertensive emergency. Acute left…

…low risk of pneumothorax Uncomfortable for an awake patient, harder to keep the dressing clean with a tracheostomy or copious secretions Subclavian vein Most comfortable…

…hand. These are as a rule left open. Facial bites can be sutured after careful debridement because of the cosmesis, often with antibiotic prophylaxis. Deep…

…PR interval <120 ms with a delta wave and wide QRS is indicative of 'Ventricular pre excitation', and QRS duration ≥140 ms is considered 'Profound…

…as patients with reduced left ventricular function. This is because these patients are at particularly high risk of developing life threatening arrhythmias. Antiarrhythmic drugs Disopyramide…

…Symptoms of systemic venous congestion include: Peripheral edema Rapid weight gain Increasing abdominal girth Early satiety Bendopnea Abdominal ascites Older patients may present atypically, with…

…observational databases report approximately 5–10%. Only about 10% of patients who develop shock present with it at hospital admission; approximately 90% deteriorate during hospitalization…

…uterus should be manually displaced to the woman's left side (Figure 1). Additional offloading of the vena cava can be accomplished using a wedge…

…by dense collagenous scar, interspersed with surviving bundles of myocytes that form the slow conducting isthmuses critical for re entry [6] . Non ischemic dilated cardiomyopathy…

…Caution • Avoided in hypertensive emergencies with left ventricular failure (due to negative inotropic effect). • Used cautiously in patients with asthma (due to risk of bronchospasm)…

…prognosis in patients with suspected or established coronary artery disease (CAD). It combines echocardiographic assessment of left ventricular (LV) structure and function with exercise or…

…and risk assessment The evaluation of a patient with AF who may require anticoagulation should establish: Whether AF is clinical or device detected subclinical AF…

…delay is defined as “a QRS duration greater than 110 ms in adults, greater than 90 ms in children 8 to 16 years of age…

…in patients with reduced left ventricular ejection fraction (LVEF). They are also recommended in patients within one year of MI and in those with LVEF…

…contraindicated, for example in asthma Contraindicated in impaired left ventricular function and together with an intravenous beta blocker Digoxin In heart failure or hypotension, or…

…is then reserved for patients with a CHA₂DS₂ VA score of 0–1. Check what applies in your own region. Duration above the threshold or…

…vasoconstriction of one or more coronary arteries. Epicardial spasm produces a reversible functional occlusion and usually causes transmural ischaemia. The resulting abnormalities in left ventricular…

…a 60 minute occlusion of the left anterior descending coronary artery (LAD) would reduce the infarct size by 60%, as compared with directly occluding the…

…left ventricular systolic function is depressed or preserved Whether hypotension is present Whether an accessory pathway is suspected, particularly before administration of digoxin The duration…

…al. Milrinone as Compared with Dobutamine in the Treatment of Cardiogenic Shock. N Engl J Med 2021; 385:516 525 Indications Severe left ventricular failure…

…Approximately 50% of patients with unstable angina progress to myocardial infarction within 30 days if left untreated. Moreover, the pathophysiology of NSTEMI and unstable angina…