…fraction <55%. This implies that left ventricular pumping capacity is reduced and it is synonymous with heart failure with reduced ejection fraction (HFREF ). Average ejection…

…or both. Consequently, relatively small increases in venous return can produce disproportionate increases in left ventricular and left atrial pressure. At rest, filling pressures may…

…by decreasing systemic vascular resistance (SVR). Clevidipine does not reduce cardiac filling pressure (pre load), since it has no effects on the venous capacitance vessels…

…by decreasing systemic vascular resistance (SVR). Clevidipine does not reduce cardiac filling pressure (pre load), since it has no effects on the venous capacitance vessels…

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

…suffer a sudden cardiac arrest have ventricular fibrillation prior to the cardiac arrest. Most of these have atherosclerotic heart disease (coronary artery disease) as the…

…and by the left circumflex artery in the remainder. The atrioventricular node is supplied by the right coronary artery in 90% (right dominant system) of…

…as acute STEMI cases. Management of left bundle branch block (LBBB) in patients with acute coronary syndromes (ACS) For many years, European and North American…

…coronary artery disease, left ventricular hypertrophy, dilated cardiomyopathy, hypertrophic cardiomyopathy, degenerative disease, hypertension, hyperkalemia, myocarditis, and amyloidosis may all cause LAFB. Prognosis of left anterior…

…ST segment elevations on the conventional 12 lead ECG. These situations are as follows: Transmural ischemia located in the posterolateral portion of the left ventricle …

…Frank's leads etc). Note that in some situations it is appropriate to connect additional electrodes in order to detect right ventricular infarction (leads V3R…

…in the setting of chronic or acute coronary artery disease. All types of ischemia– chronic, acute, or subacute –lead to regional abnormalities in contractile function…

…the left main coronary artery (LAD) or 2 epicardial coronary arteries (Felker et al). Left ventricular dilation entails a markedly elevated risk of ventricular tachycardia…

…more coronary arteries. Epicardial spasm produces a reversible functional occlusion and usually causes transmural ischaemia. The resulting abnormalities in left ventricular function may lead to…

…transvalvular flow resistance increases. This results in increased left ventricular load, while simultaneously affecting systemic perfusion. Aortic stenosis is a serious condition with poor long…

…Other leads Greater than or equal to 1 mm These criteria for the other leads apply in the absence of left ventricular hypertrophy or left…

…one coronary artery (Coronary arteries). Chronic myocardial ischemia may also lead to left ventricular dilation, which is referred to as ischemic cardiomyopathy (Dilated Cardiomyopathy). Ventricular…

…response or ventricular arrhythmias. A fall in systolic blood pressure, particularly when accompanied by evidence of ischaemia, may indicate exercise induced global left ventricular dysfunction…

…localization, hemodynamic effects and possible impact on the coronary arteries. The tumors can be asymptomatic for a long time and be detected randomly when investigating…

…= right coronary artery. LAD = Left anterior descending coronary artery. LCX = left circumflex coronary artery. Arterial blood supply of the conduction system Figure…

…and ventricular arrhythmias were observed in the fifth decade of life in several family members. Imaging studies did not reveal structural cardiac abnormalities, nor coronary…

…and improved left ventricular function. Accelerated ventricular rhythm (idioventricular rhythm) This rhythm has been discussed previously in this article. Briefly, accelerated ventricular rhythm (also called…

…significant atherosclerotic disease affecting two or more major epicardial coronary arteries. It frequently coexists with left main coronary artery disease, diabetes mellitus, left ventricular dysfunction…

…been associated with exertional angina, myocardial ischaemia, myocardial infarction, ventricular arrhythmias, impaired left ventricular function, myocardial stunning, and sudden cardiac death. It may also be…

…This results in electrical instability which explains why ventricular tachycardia may progress to ventricular fibrillation. Left untreated, ventricular fibrillation leads to asystole and cardiac arrest…

…systemic microvascular inflammation paradigm" [9] . In this model, systemic comorbidities (obesity, hypertension, diabetes) induce a chronic, systemic proinflammatory state. This circulating inflammation leads to coronary…

…specifically classified by the 2022 AHA/ACC/HFSA and 2021/2023 ESC guidelines as HF with a left ventricular ejection fraction (LVEF) of ≤40% [14…

…performed. Note that troponins may be elevated but the elevation is typically discrete and not on a par with the degree of left ventricular impairment…

…V6 (left ventricle): ≥45 milliseconds 1 Romhilt Este's score system ECG changes in left ventricular hypertrophy (LVH) Large R waves in left sided leads…

…is actually a complicated and fundamental aspect of ventricular function. Impaired diastolic function (i.e diastolic dysfunction ) may lead to diastolic heart failure (i.e…

…and less pronounced. This ultimately leads to increased diastolic pressure in the left ventricle. Impaired relaxation results in increased ventricular diastolic pressure. Myocardial stiffness Myocardial…

…combination—systemic venous hypertension with relatively modest left sided congestion—is an important clinical clue. Haemodynamic severity The presentation may range from mild right ventricular…

…left atrial enlargement (P mitrale) and right atrial enlargement (P pulmonale) The atria may become dilated and/or hypertrophic during pathological circumstances. As for ventricular…

…efficient atrial and ventricular activity. The conduction system includes the sinoatrial (SA) node, atrioventricular (AV) node, Bundle of His, bundle branches (left and right bundle…

…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…

…complex. Brugada's algorithm If there is no RS complex in any chest lead (V1–V6) a diagnosis of ventricular tachycardia can be made. Otherwise…

…PVR). This parameter is of utmost interest in investigating right ventricular load. Pressure in the right atrium (right atrial pressure) With the PA catheter (Swan…

…a critical marker of arrhythmogenic risk, particularly in the setting of ischemic heart disease or reduced left ventricular ejection fraction (LVEF). Sustained VT: Defined as…

…lead to the following hemodynamic effects: Tachyarrhythmia results in reduced preload, diminished stroke volume, and subsequently lower blood pressure and reduced organ perfusion. Left ventricular…

Procedurer The oesophagus runs directly behind the left atrium. An electrode placed in the oesophagus at the right level therefore records atrial depolarisation with an…

…ventricular depolarization (e.g sinus tachycardia with simultaneous left bundle branch block). P wave and PR interval Checklist P wave is always positive in lead…

…the vector of the ventricular free wall is directed to the left (and downwards). Lead V5 detects a very large vector heading towards it and…

…the left ventricle and left atrium. Chronic aortic regurgitation leads to dilatation and hypertrophy of the left ventricle. Cardiac remodeling Ventricular dilatation and hypertrophy lead…

…inhibitors stabilize left ventricular remodeling, improve patient symptoms, prevent hospitalization, and prolong life. Furthermore, because ACE inhibitors also inhibit kininase II, they may lead to…

…QRS complex. Axis deviation: right axis deviation (RAD) and left axis deviation (LAD) Causes of right axis deviation Normal in newborns. Right ventricular hypertrophy. Acute…

…II. Heart axis deviation: right axis deviation (RAD) and left axis deviation (LAD) Causes of right axis deviation Normal in newborns. Right ventricular hypertrophy. Acute…

…at least one lead (males and females). Differentiating posterolateral ischemia from right ventricular hypertrophy (RVH) It is occasionally difficult to differentiate right ventricular hypertrophy (RVH…

…a ventricular rate slower than 50 beats per minute. P waves with constant morphology preceding every QRS complex. P wave is positive in limb lead…

…resistant to resolution. Known predictors of cardiac arrest The only risk biomarker in genuinely widespread use is left ventricular ejection fraction (LVEF), measured by echocardiography…

…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…

…or even invisible spikes (at least in some leads). Pacemaker stimulated beats display wide QRS complexes and a left bundle branch block pattern on ECG…

…ventricular hypertrophy P wave in II 2.5 mm tall Right atrial enlargement P wave in V1 Terminal negative component 1 mm × 40 ms Left…

…clinicians. Perfusion defects are categorized by their size, encompassing: Small defects : <10% of the left ventricular myocardium. Medium defects : 10–20% of the myocardium. Large…

…in the left ventricle and consequently reduced cardiac output. A substantial reduction in pulmonary perfusion and the subsequent reduction in left ventricular preload lead to…

…a central venous catheter — coagulopathy, infection at the puncture site, known thrombosis in the target vein. With a mechanical tricuspid prosthesis the lead must not…

…from the left ventricle. However, these impulses propagate slowly as they travel partially or entirely outside the specialized conduction system. This slow propagation leads to…

…sinus bradycardia (<30 beats/min or sinus pauses ≥3s) C: Increased QRS voltage (isolated QRS voltage criteria for left ventricular hypertrophy or right ventricular hypert

…Left Axis Deviation (LAD) LAD is a recognized diagnostic component of left ventricular hypertrophy (LVH). Specifically, the Romhilt Estes point score system for diagnosing LVH…

…be estimated with echocardiography. The PASP is an independent predictor of survival and for elevated left ventricular filling pressures (Lam et al). PASP is elevated…

…the left ventricle a D shaped appearance in short axis views. The increased pressure may also propagate back to the right atrium and venous system…