Ch. 8: Hypertrophy

Question 1

hypertrophy

Answer 1

• increase in myocardium muscle
• chamber may be diagnosed on an EKG
• m wall thickened and dilated beyond norm

Question 2

Why do we see Left Ventricular hypertrophy?

Answer 2

• systemic hypertension (systolic high BP)
• aortic valve stenosis (narrowing/hardening)

Question 3

Why do we see Right Ventricular hypertrophy?

Answer 3

• pulmonary hypertension (high BP in lungs)
• asthma, COPD (MAT), pulmonary thrombosis
• pulmonary valve stenosis

Question 4

what is seen in Right Ventricular Hypertrophy?

Answer 4

• LARGE R WAVE in all of V2-V4 (may be seen in V1)
• INVERTED T WAVE V1 often present (in relation to QRS)
• R waves progressively smaller from V1-V4

Question 5

what position is the heart in with RVH?

Answer 5

• RAD
• due to mean QRS vector going to right
• rightward rotation

Question 6

What is seen in Left Ventricular Hypertrophy?

Answer 6

• has criteria to meet
• produces QRS complexes that have exaggerated amp (height and depth)
• LARGE S WAVE in V1
• LARGE R WAVE in V5
• add depth of S wave (V1) and amp of R wave (V5); >35mm
• T wave may be inverted (how is it inverted)
• gradual down slope of T wave
• very steep return to baseline of T wave
• T wave may be asymmetrical
• check V5 and V6

Question 7

What leads are we looking at for LVH?

Answer 7

• V1, with a large S wave
• V5, with a large R wave
• T wave may be inverted, have a gradual down slope, or very steep return to baseline
• check V5 and V6
• T wave may be asymmetrical

Question 8

what is a ventricular strain? *know definition

Answer 8

• ventricle straining against some kind of resistance
• ventricular hypertrophy associated w/ strain pattern
• ST segment depression and humped

Question 9

Atrial Enlargement (Hypertrophy)

Answer 9

• P wave
• look at V1 bc directly over atria
• DIPHASIC P WAVE (both + and - deflection)

Question 10

Right Atrial Hypertrophy

Answer 10

• INITIAL component of diphasic P wave in V1 LARGER
• P wave often peaked
• if height of P wave in any limb lead >2.5mm, even if not diphasic

Question 11

Left Atrial Hypertrophy

Answer 11

• TERMINAL portion of diphasic P wave in V1 LARGE AND WIDE
• enlarged due to possible mitral valve stenosis
• terminal portion of diphasic P wave usually negative

Question 12

Athletes heart

Answer 12

• sinus bradycardia
• nonspecific ST seg and T wave changes
• criteria for LVH
• some RVH
• incomplete RBBB (looks like “rabbit ears” but is smaller than 3 sm boxes)
• Various arrhythmias
• 1st degree or Wenckeback AV Block