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 an important clinical clue. Haemodynamic severity The presentation may range from mild right ventricular impairment to cardiogenic shock. Patients with hypotension, marked low output…

…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…

…Moderate right ventricular hypertrophy may not alter the ECG significantly. The ECG is particularly helpful in RVH because echocardiography is less sensitive with respect to…

…the presence of right ventricular load, a variety of echocardiographic parameters are used. Examination of the right ventricle with echocardiography The right ventricle is relatively…

…cells mechanically and electrically. Most mutations are inherited in an autosomal dominant manner, with variable penetrance and expressivity. Recessive forms exist, although they are rare…

…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.

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

…It should be noted that imaging of the right ventricle requires an experienced echocardiographer. Three dimensional (3D) echocardiography should be considered in laboratories with expertise…

…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…

…elevation in the right precordial leads—and a propensity for life threatening polymorphic ventricular tachycardia (VT) and ventricular fibrillation (VF) in patients with structurally normal…

…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…

…as a right dominant system (if the LCX gives off PDA, it is referred to as a left dominant system ). In patients with right dominance…

…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…

…Haemodynamics Right ventricular strain (echo or CT) Troponin Management : : : : : High Unstable Yes Often raised Reperfusion, intensive care Intermediate–high Stable Yes Raised Admission with monitoring…

…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…

…the right atrium and right ventricle are compressed, with elevation of their diastolic pressures. Right sided filling becomes increasingly dependent on the fall in intrathoracic…

…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…

…ms for females) C: Incomplete Right Bundle Branch Block (rSR' pattern in lead V1 and qRS pattern in V6 with QRS duration <120 ms) D…

…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)…

…overlap with risk factors for DVT; immobilisation, surgery, hypercoagulability, and pregnancy are common risk factors (see Risk factors below). A significant proportion of cases with…

…right ventricular outflow tract) become dilated, which further agravates the regurgitation. The proximal portion of the pulmonary artery may also be dilated in patients with…

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

…to adults in sinus rhythm, recorded at a paper speed of 50 mm/s with 1 mV = 10 mm. At 50 mm/s a…

…loud with the team, not in your head. Functioning suction within reach under the pillow or by the right shoulder. A reservoir mask with a…

…the only absolute indication, and always urgent. A large pericardial effusion with symptoms despite medical treatment. Diagnostic drainage in suspected purulent pericarditis, tuberculosis or malignancy…

Info Brugada's algorithm is the most used algorithm for distinguishing ventricular tachycardia (VT) and supraventricular tachycardia (SVT) with wide QRS complex. The algorithm entails…

…1, not 200%). Conclusion Echocardiographic calculation of Qp/Qs is a cornerstone in managing patients with intracardiac shunts. By integrating anatomical measurements and Doppler hemodynamics…

…V3). IIa B In patients with inferior myocardial infarction, consider connecting V3R and V4R to detect concomitant right ventricular infarction. IIa B Routine blood sampling…

…et al. (2003): Recommendations for evaluation of the severity of native valvular regurgitation with two dimensional and Doppler echocardiography. In Journal of the American Society…

…typically exceeding 200 beats per minute. While ECG appearances with flutter like patterns are predominantly caused by macroreentrant circuits, microreentry remains a possible alternative mechanism…

…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…

…mechanical circulatory support Refractory advanced disease Consider palliative care Right ventricular failure is characterized by increased right atrial and right ventricular pressures with systemic congestion…

…may also rise with: Left ventricular diastolic dysfunction Valvular heart disease Pulmonary hypertension Ischaemic heart disease Atrial arrhythmias Pericardial disease, including constriction Right ventricular dysfunction…

…left ventricle. This is explained by the fact that the right ventricle pumps blood against greater resistance, as compared with the left ventricle. Understanding this…

…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…

…In the specific context of perioperative care in patients with pulmonary arterial hypertension (PAH), progression of right heart failure may indicate the need for inodilator…

…with the right atrium being depolarized before the left atrium. The first half of the P wave is therefore a reflection of right atrial depolarization…

…to right shunt, tamponade, or sudden loss of effective cardiac output. Their recognition is essential because treatment often requires urgent surgical or transcatheter intervention, with…

…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…

…well as qR complex in III and aVF (with QRS duration <0.12 seconds), provided that other causes of right axis deviation have been excluded…

…well as qR complex in III and aVF (with QRS duration <0.12 seconds), provided that other causes of right axis deviation have been excluded…

…is more common (regardless of heart rate) among persons with heart disease. Alternating block (right and left bundle branch block alternating from one beat to…

…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…

…as discussed below. Atrial flutter tends to accompany atrial fibrillation, although some individuals may only present with atrial flutter. Similar to atrial fibrillation, atrial flutter…

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…

…of upper abdominal pain. An ECG recording costs approximately $10 (10€) and may reduce morbidity and mortality substantially in patients with acute coronary syndromes. Importantly…

Echocardiography Color Doppler Velocities recorded in a sample volume of the pulsed wave Doppler can be presented with a color. A color scale from blue…

…main principle behind artificial pacemakers; i.e applying an external electrical current that depolarizes cells in contact with the lead tip, and thus generate an…

…Hemodynamic effects of constrictive pericarditis Diastolic heart failure and right heart failure The rigid pericardium prevents all four heart chambers from dilating adequately during diastole…

…right bundle branch block (RBBB) in leads V1–V3, but the QRS duration is not prolonged in leads V5–V6 (which is not consistent with…

…alleviate ischemic chest pain may lead to hemodynamic collapse in patients with right ventricular ischemia or infarction. Recognizing ECG signs of right ventricular involvement is…

…cardiomyopathy (Dilated Cardiomyopathy, DCM) . Arrhythmogenic Right Ventricular Cardiomyopathy / Dysplasia (ARVC/ARVD) Restrictive Cardiomyopathy (RCM ) Takotsubo cardiomyopathy (broken heart syndrome, apical ballooning syndrome). Non compaction cardiomyopathy

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