…and often notched R wave. Leads I and aVL: Similar to V5 and V6. ST T changes : Left sided leads (V5, V6, I and aVL)…

…hypertrophy (RVH). The electrical vector of the left ventricle is enhanced in LVH, which results in large R waves in left sided leads (V5, V6…

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

…I and aVL displays smaller R waves than normal. Along with larger R waves in right sided leads, the R wave progression may be opposite…

…occurs when intrapericardial pressure equals or exceeds right atrial pressure. The haemodynamic consequences are progressive impairment of right and left sided filling, reduced stroke volume…

…by elevation of pulmonary arterial pressure. It may arise from pulmonary vascular disease, left sided cardiac disease, chronic lung disease or hypoxia, chronic thromboembolic obstruction…

…modest left sided congestion—is an important clinical clue. Haemodynamic severity The presentation may range from mild right ventricular impairment to cardiogenic shock. Patients with…

…solely as an isolated coronary event. SCAD predominantly affects the left sided coronary circulation and may involve multiple vessels. Pregnancy associated SCAD can occur at…

…pressures with systemic congestion. Interventricular dependence may impair left ventricular filling and reduce systemic output. In this setting, venous congestion is generally treated initially with…

…of mitral regurgitation is associated with worse outcomes. Pulmonary hypertension secondary to left heart disease may occur because elevated left sided filling pressures are transmitted…

…tendineae . Thickened leaflet tips. Reduced leaflet mobility. Left sided rheumatic valvular disease is virtually always present. Carcinoid heart disease Short, thick and rigid leaflets. Echocardiography…

…line set with a triple lumen catheter, usually 7 Fr. Catheter length: the right internal jugular vein requires the shortest catheter, while left sided and…

…worsen with inspiration, coughing, lying supine, or swallowing and typically improves when the patient sits up and leans forward. Pain may be retrosternal or left…

…volume of the ventricle (EDV) is reduced. Constrictive pericarditis also leads to right sided heart failure, which is explained by the fact that high pressure…

…off PDA, it is referred to as a left dominant system ). In patients with right dominance the RCA supplies the atrioventricular (AV) node . In 60…

… Is the left ventricle dilated? Is the left ventricle hypertrophic? Is left ventricular ejection fraction (LVEF) normal? A normal sized ventricle with hyperdynamic contractility suggests…

…familiarize yourself with the principles of hemodynamics and conditions prevailing on the right side. Echocardiography is the first choice for assessing the right side of…

…The patient lies supine, preferably with slight rotation towards the left side so that the fluid collects in the left flank. Have the patient empty…

…aortic valve with three cusps (RCC, NCC and LCC). The right coronary artery (RCA) departs from the right coronary cusp (RCC), and the left main…

…supine position. Parasternal Windows PLAX Parasternal Long Axis view The parasternal long axis view (PLAX) is located on the left side of the sternum. It…

…directed downwards and to the left in the frontal plane and this yields a positive P wave in lead II ( Figure 2 , right hand side)…

…of the phalanx, 2–3 mL on each side, with the needle tip directed volarly until a weal forms over the volar nerve. Wait 10…

CPR Tamponade and cardiac arrest Cardiac arrest associated with tamponade has an exceptionally poor prognosis. In the vast majority of these cases, the tamponade develops…

…are obtained with the patient positioned in the left lateral decubitus position. In this position, the heart comes closer to the thoracic wall, with less…

…is likely due to drug side effects, it is necessary to weigh the risk of terminating the medication as compared with implanting a permanent pacemaker…

…on manufacturer and user settings) circle next to the transducer; this is the side indicator that assists the examiner to identify left and right in

…6. Repeat on the left side. A positive test in the posterior canal is characterised by: A latency of 1–5 seconds before the nystagmus…

…the fundal height surpasses the umbilicus, the uterus should be manually displaced to the woman's left side (Figure 1). Additional offloading of the vena…

…the left anterior aspect of the aortic bulb. The LMCA is short and branches into the two arteries supplying the anterior and left side of…

…is associated with increased sudden death risk, particularly in individuals younger than 35 years during or after vigorous exercise. Anomalous origin of the left coronary…

…interventricular) septum The ventricular septum receives Purkinje fibers from the left bundle branch and therefore depolarization proceeds from its left side towards its right side…

…the left medioclavicular line between rib 5 and 6. V5: placed on the anterior axillary line, on level with V4. V6: placed on level with…

…3A). If activation starts on one side, for example from right to left, then the wavefront will be directed to the left (Figure 3B). If…

…vaccination. Relative: Lymphoedema or previous axillary clearance on the same side. A paretic limb — poorer absorption. Injection into an arm with a dialysis fistula. Preparation…

…highest accuracy for palpation guided aspiration. Press the fluid from the medial towards the lateral side with your free hand. The needle is inserted directed…

…m2 22 ± 6 29–33 34–39 40 22 ± 6 29–33 34–39 40 ​BSA, Body surface area; LA, left atrial; RA, right atrial.

…1–2 <1 1–1.5 (not reversed with Valsalva maneuver) 1.5 1.5–2.0 (not reversed with Valsalva maneuver) Deceleration time (DT)…

Visual assessment of regional wall motion (left ventricle) TYPE OF MOTION DEFINITION WALL MOTION SCORE Normal Normal thickening (typically 30% thickening from end diastole to…

…conduction delay within the left bundle system in the case of incomplete LBBB [7]. In more severe forms, LBBB is associated with the following: Myocardial…

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

Echocardiography Myocardial ischemia and infarction Definition and pathophysiology Left ventricular (LV) thrombus is an intracavitary clot attached to the LV endocardium, typically overlying an akinetic…

…could expect, low sensitivity but high specificity with respect to detecting atrial enlargement. Left atrial enlargement is also referred to as P mitrale , and right…

…Implications of left bundle branch block in myocardial ischemia and infarction A summary of the issues that arise when facing a patient with left bundle…

…an intuitive basis. Consider the fact that the left ventricle contracts and ejects blood into the aorta roughly 100,000 times daily, each time overcoming…

…ejection fraction has become virtually synonymous with left ventricular function. An obvious drawback with the use of the ejection fraction is that it only assesses…

Echocardiography Size and mass of the left ventricle Left ventricular mass is a flawed proxy for ventricular systolic function and load. The mass is, however…

…heart using the long axis of the left ventricle and selected planes oriented at 90° angles relative to the long axis. With regards to echocardiography…

…with left ventricular systolic function. EAT = v max /time Fractional shortening (FS) Fractional shortening (FS) is calculated by measuring the change (% reduction) in left…

…LCx supplies the posterior descending artery (PDA) in a left dominant circulation (i.e. 10 15% of cases). Clinically, patients present with severe chest pain…

…lower oxygen demands. The wall thickness is considerably thinner in the atria and right ventricle, as compared with the left ventricle. Indeed, the atrial myocardium…

…rS complexes. Causes of left anterior fascicular block (LAFB) LAFB may occur in persons who are otherwise healthy. The majority of those with LAFB, however…

…Also, the load on individual fibers is positively correlated with left ventricular volume, meaning that load on the muscle fibers increases as ventricular volume increases…

…is derived by measuring flow velocities across the mitral valve using pulsed Doppler. Estimating left ventricular filling pressure via e' . Measurement of deceleration time (DT) …

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

…rises rapidly with further volume increases. This is explained by the existence of an upper limit for ventricular compliance. The greater the left ventricular compliance…

…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…

Echocardiography Structure and contractile function of myocardial fibers The left ventricular wall can be subdivided into several layers. These layers are similar to those seen…

…are organized into several sheets wrapping around the ventricle with varying orientation. This organization allows the left ventricle to contract in a highly sophisticated and…

Echocardiography Cardiomyopathy caused by tachycardia A prolonged tachycardia can cause cardiomyopathy with left ventricular dilation. This type of cardiomyopathy, referred to as tachycardia induced cardiomyopathy…

…and left ventricular function. The HCM Risk SCD score aims to identify individuals with a high risk of SCD and determine whether an implantable cardioverter…