…first. Procedure Choice of insertion site The left lower quadrant is the first choice : the abdominal wall is thinner there than on the right, and…

…phase. Severe breathlessness in the palliative phase (at lower doses than for pain). An opioid is rarely the right choice in nociplastic or neuropathic pain…

…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…

…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…

…antihypertensives, should prompt clinical suspicion [1]. Cardiac Signs and Symptoms Patients often present with symptoms of predominant right heart failure, including lower extremity edema, ascites…

…and calcium, as well as through the direct activation of voltage sensitive calcium channels. At lower doses, dobutamine stimulates beta2 and alpha receptors, inducing vasodilation…

…or mechanical prostheses. The former is preferred due to the lower risk of thrombosis and evidence demonstrating long term durability (Filsoufi et al). Percutaneous interventions…

…Ischaemic heart disease Atrial arrhythmias Pericardial disease, including constriction Right ventricular dysfunction caused by pulmonary embolism Infiltrative cardiomyopathies, particularly cardiac amyloidosis Sepsis and other hyperdynamic…

…leads, and narrow r waves followed by broad, deep S waves in the right precordial leads [7]. Septal q waves are usually absent [7]. Stricter…

…Other causes include acute mechanical complications—particularly ventricular septal defect (VSD) and papillary muscle rupture with acute severe mitral regurgitation—predominant right ventricular (RV) infarction…

…involvement The anatomical territory, including anterior, inferoposterolateral or right ventricular involvement Pre existing abnormalities such as prior infarction, left bundle branch block, Wolff–Parkinson–White…

…their capital letters (Q, R, S), and small waves are referred to by their lower case letters (q, r, s). Figure 5 shows examples of…

…discussed in detail in the articles on left ventricular enlargement, right ventricular enlargement and atrial enlargement. Below follows a discussion on the principles and differences…

…right atrium leads to a decrease in atrial filling. Respiratory variations in E wave velocity Under normal circumstances, intrathoracic pressure decreases during inhalation, which lowers…

…exceptions. Prior to the Doppler era, hemodynamic assessments were performed by means of right heart catheterization (with Swan Ganz catheter [ pulmonary artery catheter ]). However, hemodynamic…

…cardiac arrest is 2.5%. As per data from the registry, only suicide attempts have lower survival outcomes. Nonetheless, prompt interventions can reverse cardiac arrest…

…and these are as follows: Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVC/ARVD) – ARVC also tends to manifest in young adults and the most common symptoms…

…stretch out during diastole. During IVRT the pressure in the left ventricle decreases and when it is lower than left atrial pressure, the mitral valve…

…activation of the ventricular myocardium. The ventricles should be depolarized (activated) by impulses spreading through the left and right bundle branch, which branches out into…

…a diagnosis of third degree AV block if the atrial and ventricular rate is equal and the P waves occur right before the QRS complexes…

…is preservation of adequate right ventricular preload while supporting left ventricular performance and systemic circulation. Improvement in left ventricular function also lowers pulmonary arterial and…

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…

…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…

…Likewise, the right ventricle may appear functionally and morphologically normal on echocardiography and cardiac MRI during the first two decades of life. The most common…

…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…

…BSA. Basal segments of the right ventricle (i.e parts on the atrial side of the tricuspid annulus) function as atrium and becomes dilated. The…

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…

Cardiology Introduction Since its initial description in 1992 as a syndrome of right bundle branch block, ST segment elevation, and sudden cardiac death (SCD), Brugada…

…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…

…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…

…and their relation to the ECG leads. Note that Figure 1 is a right dominant system (i.e PDA is supplied from RCA). Figure 1…

…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…

…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…

…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…

…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)…

…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)…

…flow via inferior vena cava to the right atrium and ventricle. The thrombus is pumped from the right ventricle through the pulmonary valve into the…

…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…

…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…

… it does not exclude Diastolic collapse of the right atrium and right ventricle The cardinal echocardiographic finding A dilated inferior vena cava without respiratory variation…

…4 in Brugada's algorithm) If the QRS complex in V1–V2 resembles a right bundle branch block (i.e positive QRS) V1 : Monophasic R…

…travels during systole. 3. Right Ventricular Outflow Tract (RVOT) Diameter Optimal View : Right ventricular inflow outflow (RVIO) view. Method : Under zoomed conditions, measure the RVOT…

…B In patients with inferior myocardial infarction, consider connecting V3R and V4R to detect concomitant right ventricular infarction. IIa B Routine blood sampling for serum…

…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…

…superior vena cava. A critical area of slow conduction is consistently located in the posterolateral to posteromedial inferior region of the right atrium. This circuit…

…preserved cardiac output; increased venous and intra abdominal pressures, impaired renal venous outflow and persistent right sided congestion may be important mechanisms. Diuretics relieve the…

…anatomical development during infancy & childhood In adults, the left ventricle is considerably larger than the right ventricle. This is the result of ventricular adaptation to…

…yields a positive P wave in lead II ( Figure 2 , right hand side). The P wave is always positive in lead II during sinus rhythm…

…between –30° and 90°. If the axis is more positive than 90° it is referred to as right axis deviation. If the axis is more…

…between –30° and 90°. If the axis is more positive than 90° it is referred to as right axis deviation. If the axis is more…

…disease. If such aberration occurs at normal heart rate (<100 beats/min) it is most likely to have a right bundle branch block morphology. If…