…4. Pulmonary Valve Velocity Time Integral (PV VTI) Optimal View : Short axis (SAX) view of the aortic arch, visualizing the pulmonary valve in long axis…

…failure) and arrhythmias. The annual risk of sudden cardiac arrest is <1% and median survival is 3 years. Long term prognosis in aortiv stenosis is…

…include anomalous aortic origin of a coronary artery (AAOCA), coronary fistulae, and myocardial bridging. Although many are clinically silent, some produce myocardial ischaemia, ventricular arrhythmias…

…Achieving clear echocardiographic windows during active compressions is challenging; however, subcostal windows might be feasible, particularly during brief pauses. An enlargement of the right ventricle…

…Signs and Symptoms Patients often present with symptoms of predominant right heart failure, including lower extremity edema, ascites, and hepatic enlargement [8, 10]. Atrial arrhythmias…

…lower doses, dobutamine stimulates beta2 and alpha receptors, inducing vasodilation, decreasing aortic impedance and systemic vascular resistance, reducing afterload, and indirectly increasing cardiac output. At…

…of enlargement, namely hypertrophy and dilatation. Both hypertrophy and enlargement may reduce atrial and ventricular function as well as predispose to significant arrhythmias. Typically, atrial…

…cancer). Inflammatory conditions, such as rheumatoid arthritis, systemic lupus erythematosus, scleroderma, and rheumatic fever. Aortic dissection rupturing into the pericardium. Idiopathic pericardial effusion. Renal failure…

…circumference of the mitral annulus. The aorto mitral curtain separates the aortic valve and the anterior leaflet of the mitral valve. The anterior leaflet is…

…generate cardiac electrical activity. CPP = P aortic P right atrium Cerebral perfusion pressure (CerPP) : The pressure that drives cerebral blood flow. CerPP is determined…

…cardiac output by causing obstruction or valve dysfunction. Tumors that grow invasively in the myocardium can cause arrhythmias, which in turn can cause hemodynamic effects…

…g via a persistent foramen ovale (PFO), which enables blood flow from the right to the left atrium. Echocardiography is of importance for cardioembolic stroke…

Right ventricle and pulmonary artery Normal interval Mildly abnormal Moderately abnormal Severely abnormal RV DIMENSIONS Basal RV diameter (RVD 1), cm 2.0–2.8…

…originates on the right aspect of the aortic bulb. The left main coronary artery ( LMCA ) originates from the left anterior aspect of the aortic bulb…

…function, which may be the origin of right ventricular dysfunction, must also be evaluated. The pulmonary, aortic and mitral valve must also be evaluated, particularly…

…causes of cardiac tamponade culminating in cardiac arrest include: Aortic dissection : The proximal 4 5 cm of the aortic root is covered within the pericardium…

…and clinical characteristics in left ventricular hypertrophy (LVH) The following figure shows characteristic ECG changes in left ventricular hypertrophy (LVH) and right ventricular hypertrophy (RVH)…

…the most common cause, in which scenario tricuspid stenosis is virtually always accompanied by aortic or mitral disease (most commonly mitral stenosis). Simultaneous tricuspid regurgitation…

…other than the conditions in which the procedure is the wrong treatment : Aortic dissection with haemopericardium — drainage can increase the bleeding and worsen the prognosis…

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

…within a Doppler sector. The picture on the right shows color Doppler located across the mitral valve and the left atrium. The main advantage of…

…originates on the right aspect of the aortic bulb. The left main coronary artery ( LMCA ) originates from the left anterior aspect of the aortic bulb…

…contracts and ejects blood into the aorta roughly 100,000 times daily, each time overcoming the aortic resistance, which is typically 110 mmHg or more…

…diagnoses; cardiac tamponade, aortic aneurysm and aortic dissection are common differential diagnoses which represent contraindications for thrombolysis. Venous thromboembolism is a chronic and serious condition…

…Aortic aneurysm : Aortic aneurysms may compresses the RVOT. Echocardiography in pulmonic stenosis In the setting of pulmonary valve stenosis, the pressure in the right ventricle…

…ZTime velocity integral of the tricuspid inflow (cm) 60 cm Pressure half time (T ½,ms) ≥ 190 ms Right atrium Pressure half time (T ½…

…ischaemia , particularly acute coronary syndrome (ACS). Other cardiopulmonary causes , including myopericardial disease, pulmonary embolism, aortic emergencies, and pneumothorax. Non cardiopulmonary causes , including gastrointestinal, musculoskeletal, and…

…cardiovascular cause [4]. 2. Aortic Dissection Pain Characteristics: The classic symptom is a severe, often sharp pain that characteristically radiates to the back [5]. 3…

…under acute coronary syndromes (ACS). Aortic dissection Pneumothorax Pulmonary embolism Mediastinitis (rare condition) In addition to these five conditions, there are numerous other causes of…

…aorta. Afterload affects myocardial muscle fibers during systole and diastole. Afterload is a function of the following three variables: Aortic resistance (pressure). Left ventricular volume…

…dimensions– including atrial dimensions, mitral annulus, aortic annulus, etc –are measured using the blood tissue interface (inner edge to inner edge). The blood tissue interface…

…and VTI are measured in the RVOT (Right Ventricular Outflow Tract). The measurements are made at the aortic valve plane in the parasternal short axis…

…absence or hypoplasia. Anomalous aortic origin of a coronary artery from the opposite sinus of Valsalva is associated with increased sudden death risk, particularly in…

…the following structures: Left ventricular (LV) dimension and function. Right ventricular (RV) dimension and function. RV function can be assessed using TAPSE (Tricuspid Annular Plane…

…gradient (mmHg) across a valve. Example 1 : A maximum velocity of 4 m/s is measured across the aortic valve. The pressure gradient equals: 4…

…separate catalogue of symptom patterns. The severity of right ventricular involvement should be considered when inferior infarction is accompanied by disproportionate systemic venous congestion, hypotension…

…is by definition 120 ms or longer. ECG criteria for right bundle branch block (RBBB) QRS duration ≥0,12 seconds. Leads V1 V2: The QRS…

…the most common causes. ECG changes in right ventricular hypertrophy V1 and V2 shows larger R waves and smaller S waves. The R wave may…

…behind the sternum and thus is the most anteriorly located part of the heart. The right ventricle has a complicated anatomy. In cross section (SAX…

Echocardiography Arrhythmogenic Right Ventricular Cardiomyopathy / Dysplasia (ARVC, ARVD) Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) is considered a genetic cardiomyopathy that predominantly affects the right ventricle. ARVC…

…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.

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…

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…

…as a primary inherited arrhythmia syndrome, BrS is characterized by a distinct electrocardiographic (ECG) signature—coved ST segment elevation in the right precordial leads—and…

…atrium. An electrode placed in the oesophagus at the right level therefore records atrial depolarisation with an amplitude the surface ECG can never achieve, and…

…effect varies tenfold between individuals, and the only way to find the right level is to give a small dose, wait until it has worked…

…PE) is classified according to haemodynamic status, clinical severity, evidence of right ventricular (RV) dysfunction, and myocardial injury. This classification is central to determining the…

…ECG Myocardial ischemia and infarction Left bundle branch block (LBBB) in acute myocardial infarction (AMI): clinical implications & Sgarbossa criteria Contrary to right bundle branch block…

…which causes the shoulder injury known as SIRVA. Both are avoided with the right landmark and the right needle length. Indications Route Typical drugs Absorption :…

…which needle is chosen, and that the tubes go to the right place. In suspected bacterial meningitis it is the time to antibiotics that saves…

…or cardiac arrest with suspected pulmonary embolism. Urgent bedside echocardiography, looking for right ventricular strain. If CT pulmonary angiography can be performed immediately, do it…

…steroid that cross reacts in the cortisol assay, whether the samples were taken at the right times, and whether you know which decision threshold your…

…infarction (STEMI). The principal lesions are: Ventricular septal rupture (VSR), producing an acute left to right shunt. Ventricular free wall rupture, producing haemopericardium and cardiac…

…B: Prolonged QT interval (QTc ≥ 480 ms for females) C: Incomplete Right Bundle Branch Block (rSR' pattern in lead V1 and qRS pattern in V6…

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

…exists if the ECG displays a widened QRS appearance that is neither a left bundle branch block (LBBB) nor a right bundle branch block (RBBB)…

…considered a normal finding. The regurgitation results in blood flowing back from the pulmonary artery into the right ventricle during diastole. The most common cause…

…the highest oxygen demand. The right ventricle and the atria work against much lower resistances and therefore have lower oxygen demands. The wall thickness is…

…leads ≥ 1.0 mm V7–V9 (posterior) ≥ 0.5 mm V3R–V4R (right ventricle) ≥ 0.5 mm (≥ 1.0 mm in men < 30 years…

…fibreoptic intubation. A difficult airway is anticipated in a stable patient — awake fibreoptic intubation or anaesthetic back up is then the right course, not RSI…