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Decoding Axis Deviation: Unraveling RBBB vs. LPFB on the ECG

How to differentiate whether right axis deviation is due to right bundle branch block or left posterior fasicular block? Differentiating between right axis deviation due to a right bundle branch block (RBBB) or a left posterior fascicular block (LPFB) can be challenging but can involve several key points: QRS Duration: RBBB often causes a widened QRS complex (>0.12 seconds) while LPFB typically doesn't cause as much widening. Presence of R/S Ratio in Lead I: In RBBB, Lead I often shows an R/S ratio less than 1, whereas LPFB displays an R/S ratio greater than 1. QRS Morphology in V1 and V6: In RBBB, V1 often shows an rSR' pattern (bunny ears) and V6 shows a wide, slurred S wave. In LPFB, V1 can show a qR pattern and V6 often has a small r wave followed by a deep S wave. Prolonged R-wave peak time in avF: Time from onset of the QRS to the peak of the R wave in aVF > 45 ms suggests LPFB. Associated Findings: RBBB is frequently associated with ST-T changes and a slurred S wav...

Normal & Abnormal Hepatic Vein Doppler Patterns on Echocardiography

Understanding Normal and Abnormal Waves of Hepatic Vein Doppler on Echocardiography Echocardiography, particularly the Doppler assessment of the hepatic veins, provides valuable insights into the functioning of the heart and liver. By analyzing the hepatic vein Doppler waves, clinicians can evaluate conditions related to right-sided heart function, heart failure, and hepatic congestion. Normal Waves of Hepatic Vein Doppler: In a healthy individual, hepatic vein Doppler shows characteristic waveforms reflecting the normal flow of blood from the liver back to the heart. There are three main phases: 1. S Wave (Systolic Flow): This initial positive wave occurs during ventricular systole, indicating the forward flow of blood towards the right atrium. 2. D Wave (Diastolic Flow): Following the S wave, there's a transient reversal or cessation of flow during early diastole. It signifies the closure of the tricuspid valve and cessation of the blood flow. 3. A Wave (Atrial Contraction): The ...

Management of Hyperkalemia

  How to manage Hyperkalemia? SIMPLE approach and methods of managing high serum potassium levels.

Success - Its the courage to continue that counts !!!

MOTIVATIONAL QUOTES: "Success is not final; failure is not fatal: It is the courage to continue that counts." — Winston S. Churchill "It is better to fail in originality than to succeed in imitation." — Herman Melville "The road to success and the road to failure are almost exactly the same." — Colin R. Davis “Success usually comes to those who are too busy looking for it.” — Henry David Thoreau “Develop success from failures. Discouragement and failure are two of the surest stepping stones to success.” —Dale Carnegie "Nothing in the world can take the place of Persistence. Talent will not; nothing is more common than unsuccessful men with talent. Genius will not; unrewarded genius is almost a proverb. Education will not; the world is full of educated derelicts. The slogan 'Press On' has solved and always will solve the problems of the human race." —Calvin Coolidge “There are three ways to ultimate success: The first way is to be kind. Th...

ECG abnormalities in patients with Cardiomyopathies

  ECG abnormalities in patients with Cardiomyopathies

Easy Approach to ECG

  Simple and easy approach to interpretation of ECG

Resistant Hypertension Diagnosis & Management

Simple approach to diagnosis and management of resistant Hypertension