…P2 (middle scallop), and P3 (posterior or lateral scallop). Figure 1. Anatomy of the mitral valve The leaflets are connected to the papillary muscles via…

…or other ECG changes (see below) should lead to a suspicion of ARVC. The gradual loss of myocardium leads to ventricular dilation and right heart…

…Right ventricular infarction. Ebstein's anomaly (Figure 1). Carcinoid heart disease. Endocarditis (common in intravenous drug addicts). Myxomatous degeneration. Rheumatic heart disease. Dilatation of the…

…of catheterization) Congenital dysplasia/aplasia of the pulmonary valve Idiopathic pulmonary artery dilation Pulmonary regurgitation results in right ventricular volume overload, which gradually causes right…

…in increased intramural pressure in the right ventricle, which is counteracted by dilatation of the ventricle. Dilatation of the right ventricle results in reduced intraventricular…

…stenosis results in increased right atrial pressure, which subsequently causes right atrial dilation. Vena cava inferior may also dilate secondarily. Principles of management Medical therapies…

…of titration is abandoned — when a fixed dose is given without assessment, when a modified release preparation is started in an opioid naive patient, or…

…7 ). The explanation for this is as follows: The vector resulting from activation of the right ventricle does not come to expression , because it is…

…Hypertrophy and dilatation Atrial enlargement: left atrial enlargement (P mitrale) and right atrial enlargement (P pulmonale) The atria may become dilated and/or hypertrophic during…

…showing left and right ventricular hypertrophy. Next chapter Biventricular Hypertrophy Related chapters Overview of Hypertrophy and Dilatation Left Ventricular Hypertrophy Atrial Hypertrophy and Dilatation (P…

…left ventricular enlargement, right ventricular enlargement and atrial enlargement. Below follows a discussion on the principles and differences of dilatation and hypertrophy, as well as…

…The hallmark of both RBBB and LBBB is the QRS duration which is by definition 120 ms or longer. ECG criteria for right bundle branch…

…is 12 h, a primary PCI strategy is indicated in the presence of ongoing ischemic symptoms, haemodynamic instability, or life threatening arrhythmias. I C A…

…of the P wave depends on where the atrial lead is fixed. Typically, the atrial lead is fixed next to the right atrial appendage, or…

…deceased — in the donation register, on a donor card, or through statements made to the next of kin. Active malignancy with a risk of transmission …

…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…

…than the right ventricle, the QRS complex is actually a reflection of the electrical potentials generated by the left ventricle. QRS duration QRS duration is…

…occurs in diastole or the decompression phase during CPR). High aortic pressure and low right atrial pressure favor coronary blood flow. A CPP of approximately …

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

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

…the vector generated by the right ventricle, the QRS complex is actually a reflection of left ventricular depolarization. QRS duration is the time interval from…

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…

…in V6 with QRS duration <120 ms) D: Profound sinus bradycardia (<30 beats/min or sinus pauses ≥3 s) Explanation: Incomplete Right Bundle Branch Block…

…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…

…interfere with ongoing CPR or airway management, no risk of pneumothorax Highest risk of thrombosis and contamination, immobilises the patient The right internal jugular vein…

…Hemodynamic effects of constrictive pericarditis Diastolic heart failure and right heart failure The rigid pericardium prevents all four heart chambers from dilating adequately during diastole…

…and where no liver, lung or vessel lies in the path of the needle. Access Puncture site Direction Comment : : : : Subxiphoid 1–2 cm below and…

…Assessment should integrate the history, physical examination, laboratory data and diagnostic testing. Examination for congestion Useful bedside indicators of persistent or improving congestion include: J

…depolarization of the left ventricle is achieved by impulses spreading from the right ventricle. The electrical impulse will propagate through the left ventricle partially or…

…of the 20th century. Cardiac pacing has evolved from a hazardous experiment in the 1930s, to a routine, safe, and sophisticated treatment used worldwide. Artificial…

…duration, morphology, and hemodynamic consequences, which collectively dictate the urgency and modality of intervention [3] . By Duration: Non sustained VT (NSVT): Defined as three or…

…These require a QRS duration exceeding 140 msec in males and 130 msec in females , along with slurring or notching of the mid QRS in…

…left to right shunt, tamponade, or sudden loss of effective cardiac output. Their recognition is essential because treatment often requires urgent surgical or transcatheter intervention…

…duration: left bundle branch block. Right bundle branch block. Non specific intraventricular conduction delay. Hyperkalaemia. Class I antiarrhythmic drugs. Tricyclic antidepressants. Phenothiazines. Ventricular beats or…

…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…

…programming. The simplest pacemaker systems consist of a pulse generator and one lead, which is located either in the right atrium or the right ventricle…

…marked renal failure. Duration of treatment: at least 3 months. Extended treatment in unprovoked pulmonary embolism, a persisting risk factor, or recurrence. Special situations Situation…

…water soluble and short acting, not a depot preparation, and gives a shorter duration of effect. Lidocaine 10 mg/mL without adrenaline , 2–5 mL…

…Type 1 Brugada syndrome reminds somewhat of right bundle branch block (RBBB) in leads V1–V3, but the QRS duration is not prolonged in leads…

…duration ≥40 ms suggest ventricular tachycardia. Duration from start of QRS complex to nadir of S wave ≥60 ms suggests ventricular tachycardia. V6 : QR or…

…delivers the electrical impulse to the posterior and inferior walls of the left ventricle. Anatomical or functional block in the anterior fascicle leads to left…

…left atrial enlargement, and abnormalities of diastolic filling. Mitral regurgitation may develop through papillary muscle displacement, annular dilatation, or both; progressive ventricular remodeling may also…

…QRS duration ≥0.12 s) if there is a left or right bundle branch block. Commonly, the premature atrial impulse arrives before one of the…

…of the discomfort. Location and radiation. Onset and temporal pattern. Duration and recurrence. Provoking and relieving factors. Associated symptoms. Similarity to previous documented angina or…

…of the Pupillary Reflex in Cardiac Arrest The pupillary light reflex is controlled by a simple neural circuit: light signals travel from the retina via…

…DCM) Dilated cardiomyopathy (DCM) is defined as dilation of one or both ventricles. Dilation of the left ventricle is virtually always accompanied by impaired left…

…help determine expected normal values based on body surface area (BSA), aiding in the diagnosis of aortic root dilation. Key Formulas BSA Calculation (Mosteller formula): [ …

…syndrome), osteogenesis imperfecta typically causes prolapse of P2 (Figure 1). Myocardial ischemia affecting the papillary muscles or the connected myocardium may cause mitral prolapse, and…

…ventricular tachyarrhythmias (including recurrent episodes of ventricular tachycardia) can also cause this cardiomyopathy. The duration of the tachyarrhythmia appears to be a stronger risk factor…

…Time to onset of action 5 to 15 minutes Duration of action 1.5 to 5 hours Delivery IV Dose 5–15 mg/hour IV…

…of both thromboembolic and hemorrhagic risks. The diagnostic prerequisite for clinical AF remains the documentation of the arrhythmia via a standard 12 lead ECG or…

…prevent, or alleviate, the pressure increase in the left ventricle and left atrium. Chronic aortic regurgitation leads to dilatation and hypertrophy of the left ventricle…

…inhibitors Enalaprilat Enalaprilat is rarely used in hypertensive crisis due to its slow onset, prolonged duration of effect, and significant individual variations in its effect…

…inhibitors Enalaprilat Enalaprilat is rarely used in hypertensive crisis due to its slow onset, prolonged duration of effect, and significant individual variations in its effect…

…fluid ounces of 40% distilled spirits. Habitual heavy consumption is defined in the source material as at least eight drinks weekly in females or at…

…days duration. Vernakalant does not convert atrial flutter to sinus rhythm. Vernakalant is only administered in a monitored clinical setting appropriate for cardioversion. Administration of…

…10 mL of 100 mg/mL in hyperkalaemia, hypocalcaemia, calcium channel blocker poisoning 0.2 mL/kg Sodium bicarbonate 50 mmol in hyperkalaemia or tricyclic…

…For better or worse, ejection fraction has become virtually synonymous with left ventricular function. An obvious drawback with the use of the ejection fraction is…

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

…to measure the QT interval Measurement of the QT interval may be difficult due to T wave changes. Causes of prolonged QTc duration Antiarrhythmics (procainamide…