Rajan Choudhary Today we will cover Heart axis What is axis deviation What is normal What is abnormal Trifasicular block Hear failure What is Heart Failure What are the symptoms What can you see on a CXR ID: 915292
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Heart Failure and Axis Deviation
Rajan Choudhary
Slide2Today we will cover
Heart axis
What is axis deviationWhat is normalWhat is abnormalTrifasicular block
Hear failure
What is Heart Failure
What are the symptoms
What can you see on a CXR
ABCDE
Slide3Axis
Slide4Slide5Normal depolarisation pattern to create the QRS complex
Normal depolarisation pattern to create the QRS complex
Slide6Slide7Slide8Slide9Slide10Slide11Slide12Slide13Slide14Left ventricular hypertrophy
Left anterior
fasicular block
Left bundle branch block
Inferior MI
Ventricular pacing /ectopy
Slide15Slide16Slide17Slide18Slide19Left posterior fascicular block
Lateral myocardial infarction
Right Bundle Branch Block
Right ventricular hypertrophy
Acute lung disease (e.g. Pulmonary Embolus)
Chronic lung disease (e.g. COPD)
Slide20Slide21Slide22Slide23Slide24First Degree Heart Block
Left Axis DeviationRight Bundle Branch Block
Trifascicular
Block
Slide25Heart Failure
Slide26Symptoms:
Oedema: Peripheral and Pulmonary, ascites and HSM
SOB: orthopnoea, paroxysmal nocturnal dyspnoea (only happens once or twice, very unpleasant), exertional SOBOE
Fatigue: never in isolation, commonest. Limitation on exercise tolerance
Chest pain, ischaemic basis?
Signs:
Increased JVP, HSM
Displaced apex beat
Pitting oedema
Gallop rhythm, HS 3 and 4
Aetiology
Cardiomyopathies
Ischaemia
Increased Afterload (HTN)
High output (Paget, Thyroid, AV fistula) mimics HF but due to increased CO
Valvular heart disease
Cardiomyopathies, classed by imaging
Hypertrophy
Dilated
Restricted - wont open
Unclassified
Heart Failure
Slide27Slide28Slide29A
B
CDE
Slide30A –
A
lveolar shadowingB – kerley B lines
C -
C
ardiomegaly
D – upper lobe
Diversion
E – pleural
E
ffusion
Slide31Alveolar Shadowing
Slide32Kerley B lines
Slide33Cardiomegaly
Slide34Upper lobe diversion
Slide35Pleural Effusion
Slide36