it all begins with knowing the foundation.
This is your conduction system of the heart
no need for me to go into this in greater
detail apart from the fact that there is the
SA node. Pay attention to that, right atrium.
What wave? P. I want you to go next to the
AV node. The time that it takes
to go from SA to AV, what interval is this?
PR interval. What time have you memorized?
0.12 to 0.2 seconds. Good. From this, I want you to take
a look at the bundle branches. You tell me.
All I am doing is pointing out things that
we have discussed already and now you can
actually visualize it. Tell me about the
left bundle and right bundle branch, which
depolarizes first physiologically? Left
bundle branch. How can you confirm that? Second
heart sound. What is it? A2, P2. What does
that mean? Aortic followed by pulmonic. Are
you putting things together? Good. I want
you to give you a patient a disease such as
left bundle-branch block. If it is a left
bundle-branch block, then you tell me what
kind of split of S2? Good. Paradoxical split.
What if it was the right bundle-branch block?
Is it a fixed split or widened split? Widened
split. If you don't know the difference, that
is okay. That's a lot of information. Go back and
review the difference between a fixed split
most common diagnosis there, atrial septal
defect. This is widened split with the right
bundle-branch block. If you are good with
those conduction systems, we are good. The only thing
that I wish to point out to you? EC versus
the AV node there. That AV node and on that
wall. If you are passing an impulse anywhere
apart from that AV node, then this would be
known as what? An acessory pathway. Welcome
to WPW. Okay. And we will walking through these
later as well. So every single slide, every
single piece of information that you are going
to work with me here, you give it a clinical tag.
If you don't, maybe perhaps you let it go
for another time.