apex

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The goats were subjected to electrocardiography in standing position on a rubber mat without any sedation using a bipolar apex-base lead system wherein the positive electrode (left arm) was placed over the cardiac apex in fifth left intercostal space at level of elbow, negative electrode (right arm) was placed in left jugular furrow at lower one third and an earth electrode (right limb) was placed at 7th dorsal spine (Fig.
Chest X-ray Postero-anterior (PA) revealed cardiac apex and aortic arch on the right side, suggesting dextrocardia.
At that time a loud systolic murmur was heard at the cardiac apex and an emergent transthoracic echocardiogram showed severe systolic anterior motion of mitral valve (SAM) and dynamic obstruction of the left ventricular outflow tract (LVOT) with a mean pressure gradient of 64 mmHg (Figure 1).

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