…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…

…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…

…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…

…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…

…hypotension, or evidence of low output despite relatively limited elevation of left sided filling pressure. Evaluation and physical examination Initial assessment should establish whether the…

…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…

…are elevated. Consequently, congestion may occur across the full range of left ventricular ejection fraction and may result from systolic dysfunction, diastolic dysfunction, or both…

…worse outcomes. Pulmonary hypertension secondary to left heart disease may occur because elevated left sided filling pressures are transmitted to the pulmonary circulation. Persistent pulmonary…

…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…

…the shortest catheter, while left sided and femoral insertions require longer ones — check the length in the set against the chosen side. An ultrasound machine…

…ischemia and infarction Definition and pathophysiology Post infarction pericarditis encompasses two temporally and clinically distinct complications of acute myocardial infarction (AMI): Early infarct associated pericarditis …

…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…

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

…section (SAX, short axis view), the the ventricle is rather a crescent shaped appendage of the left ventricle. On longitudinal sections (A4C, apical four chamber…

…left side so that the fluid collects in the left flank. Have the patient empty the bladder first. Procedure Choice of insertion site The left…

…aortic stenosis As aortic stenosis progresses, pressure conditions on the left side change dramatically, including in the left ventricle, left atrium, aorta and coronary arteries…

…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)…

…left behind — which is the commonest cause of recurrence. Indications Condition Procedure : : Acute paronychia with fluctuance or visible pus Incision and drainage Acute paronychia without…

…rupture in the left ventricular free wall. Mediastinal trauma : Penetrating injuries to the mediastinum can cause tamponade. Post operative Complications : Post surgical complications following thoracic…

…emergency echocardiography, or any examination without a proper examination table, it may be difficult to acquire images in the left lateral decubitus position. This affects…

…SB at rest due to high vagal tone. These individuals have developed a highly efficient left ventricle, capable of generating sufficient cardiac output at low…

…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…

…defined as stenosis of at least 70%, while a left main coronary stenosis of at least 50% is considered significant. These thresholds describe luminal narrowing…

…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…

…anatomical location for V3R and V4R are identical to V3 and V4, but on the right side of the chest wall. Refer to Figure 2…

…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…

…Anticoagulant treatment is not in itself a bar to vaccination. Relative: Lymphoedema or previous axillary clearance on the same side. A paretic limb — poorer absorption…

…or soft tissues over the puncture site — use another approach or refrain. Bacteraemia without suspicion of joint infection (relative; aspiration can seed a sterile joint)…

…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.

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…

…notched R waves in leads I, aVL, and the left precordial leads, and narrow r waves followed by broad, deep S waves in the right…

…stenosis Distal bifurcation involvement Coexisting multivessel disease The extent of jeopardized myocardium Left ventricular systolic function Diabetes and other comorbidities Anatomical complexity and completeness of…

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…

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

…To address these challenges, researchers have developed ECG criteria designed to identify ischemia in the presence of left bundle branch block. The most widely recognized…

…the left ventricular myocardium begins to relax and ventricular pressure drops rapidly (Figure 2). The initial relaxation is isovolumetric , meaning that relaxation occurs without changes…

Echocardiography Left ventricular function and its echocardiographic assessment Cardiac function depends on a large number of parameters, including atrial function, valvular function, and ventricular function…

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…

…orient and display the heart using the long axis of the left ventricle and selected planes oriented at 90° angles relative to the long axis…

Echocardiography Methods for assessing systolic function (contractile function) Several echocardiographic measurements are available to assess left ventricular systolic function. These methods elucidate slightly different aspects…

…and lateral walls, and the posterior wall if the LCx supplies the posterior descending artery (PDA) in a left dominant circulation (i.e. 10 15…

…affected, then the left ventricle is virtually always affected due to the coronary anatomy (refer to the chapter Coronary Arteries and Localization of Infarction & Ischemia)…

…the myocardium without fascicular supply will depend on impulses spreading from other parts of the ventricle (where the fascicle is intact). Figure 1. Left anterior…

Echocardiography Myocardial relaxation and left ventricular diastolic function Diastolic function is determined by the efficiency of myocardial relaxation. The degree and velocity of relaxation are…

…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) …

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…

…defined as left ventricular volume at the closure of the aortic valve. Upon aortic valve closure, the ventricle relaxes and pressure drops rapidly, without any…

…orifice. There are many causes of mitral stenosis, the most common of which are rheumatic heart disease, congenital malformations, radiation complications, metastases, myxoma, cardiac thrombi…

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…

…speckle tracking As previously discussed, the left ventricular wall can be subdivided into three layers: the inner lining ( endocardium ), a thick muscle layer ( myocardium ) 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…

[calc_hcmrisk] Predicting Sudden Cardiac Death in Hypertrophic Cardiomyopathy (HCM) Hypertrophic Cardiomyopathy (HCM) is a genetic cardiomyopathy characterized by left ventricular hypertrophy. It is the…