Left main trunk

The same pattern (STf in VR) in case of an NSTE-ACS with ST-segment depression in many leads suggests the incomplete occlusion of the left main trunk (LMT) (Yamaji et al, 2001) or its equivalent (very proximal LAD occlusion + LCX) in patients with previous subendocardial ischaemia (Figures 4.59-4.61). 

Figure 4.9 (A) In case of diffuse subendocardial circumferential injury due to incomplete occlusion of left main trunk (LMT) in a heart with previous important subendocardial ischaemia, the injury vector that points circumferential subendocardial area is directed from the apex towards the base, from forward to backwards and from left to right. This explains the typical morphology of...

The electrocardiographic pattern of subendocardial injury in patients with ACSs is recorded in different leads, depending on the coronary artery involved and the location of the injured area. When the ischaemia is due to left main trunk (LMT) subocclusion or equivalent, or 3 proximal vessel diseases, the involvement of the left ventricle is circumferential. In case of single vessel disease or when in presence of multivessel disease, the active ischaemia is due to a culprit artery or two distal occlusions the involvement is considered regional (Sclarovsky 1989). The correlation between these... 

Mirror image - In general, yes. - Sometimes more prominent than the direct image Vi- V3 in some cases of lateral Ml. - In general, no. - ST elevation in VR and sometimes in Vi in case of non-complete occlusion of the left main trunk or equivalent and in 3 vessel disease. 

Figure 8.40 (A) Coronary angiography of a patient with dissection of the left main trunk. (B) The ECG shows an STE-ACS with ST-segment elevation from V2 to V6,1 and VL, and ST-segment depression in inferior leads. The ECG...

Symptoms of pulmonary hypertension include dyspnea on exertion, chest pain, palpitations, syncope, ascites and lower extremity edema. Anginal symptoms may occur and are thought to be due to increased RV oxygen demand, decreased right coronary artery perfusion due to decreased pressure difference between aorta and RV end diastolic pressure, and rare instances of compression of the left main coronary artery by the dilated pulmonary trunk. Right ventricular hypertrophy (RVH) correlates with EKG findings including RV... 

Fig. 16.30 a,b. Normal tarsal tunnel, a Transverse 12-5 MHz US image obtained posterior to the medial malleolus (MM) demonstrates the tibial nerve (arrow) located close to the posterior tibial artery (a) and veins (v) and posterior to the tibialis posterior (tp) and flexor digitorum longus (fdl) tendons. All these structures lies in the tarsal tunnel and are covered by the flexor retinaculum (arrowheads), b Oblique transverse 12-5 MHz US scan at the medial heel shows the medial and lateral plantar nerves (arrows) as a result of division of the main trunk of the tibial nerve. The photographs at the upper left of the figures indicate probe positioning... 

Fig, 4.16. a Relapse of a hepatocellular carcinoma fed mainly by branches of the right hepatic artery. A common trunk (arrow) between the left hepatic artery and the left phrenic artery is also seen, b Selective catheterisation of the mentioned common trunk also shows gastric branches (arrowhead), c Superselective catheterisation demonstrates tumor uptake (arrowheads) from this artery... 

Figure 1. Main sequence of chemosensory trunk responses to a putative chemical signal. From left to right, sniff, check, place and flehmen (see also Schulte and Rasmussen, 1999). Drawing hy Mary Amaral.

The postulates constitute the foundation of quantum mechanics (the base of the TREE trunk). One of their consequences is the Schrodinger equation for stationary states. Thus we begin our itinerary on the TREE. The second part of this chapter is devoted to the time-dependent Schrodinger equation, which, from the pragmatic point of view, is outside the main theme of this book (this is why it is a side branch on the left side of the TREE). 

---