Chapter 8: Hypertrophy Flashcards

1
Q

Hypertrophy of a chamber of the heart implies an increase in the thickness of the chamber wall, but ____ ________ is always present also.

A

some dilation

p. 244

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2
Q

Hypertrophy may increase the ______ that the chamber contains.

A

volume

p. 244

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3
Q

Although the term “atrial hypertrophy” is commonly used, enlargement of an atrium is usually due to ________ of the ______.
The general term ______ ___________ is preferred, since it includes both dilation and hypertrophy.

A

dilation, atrium
atrial enlargement
(p. 245)

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4
Q

Because lead __ is directly over the atria, the _ ____ in __ is our best source of information about atrial enlargement.

A

V1, P wave, V1

p. 246

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5
Q

With atrial enlargement, the P wave is usually…

A

…diphasic.

p. 247

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6
Q

If the initial component of a diphasic P wave in lead V1 is the larger, then this indicates…

A

…right atrial enlargement.

p. 248

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7
Q

If the height of the P wave in any of the limb leads exceeds ___ __ (even if not diphasic), suspect right atrial enlargement.

A
  1. 5 mm

p. 248

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8
Q

If the terminal portion of a diphasic P wave in V1 is large and wide, there is…

This terminal component is usually…

A

…left atrial enlargement.

…negative
p. 249

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9
Q

Mitral stenosis can cause left atrial enlargement, but…

A

…systemic hypertension is the most common cause.

p. 249

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10
Q

In lead V1, the QRS complex is mainly ________, and therefore the R wave is usually very _____.

A

negative, short

p. 250

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11
Q

However, with Right Ventricular Hypertrophy, there is a large _ ____ in V1.

A

R wave

p. 251

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12
Q

In right ventricular hypertrophy, the S wave in lead V1 is _______ than the R wave.

A

smaller

p. 251

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13
Q

With right ventricular hypertrophy, the large R wave of V1 gets progressively smaller from __ to __ to __.
In the frontal plane, there will be _____ ____ _________, and in the horizontal plane, there is ________ ________ of the Mean Vector.

A

V2 to V3 to V4
right axis deviation, rightward rotation
(p. 252)

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14
Q

In left ventricular hypertrophy, even more depolarization is going downward to the patient’s left – away from the positive V1 electrode. Therefore, the S wave is ____ ______ in V1. In general, hypertrophy of the L ventricle produces QRS complexes of increased _________, both in height and depth, especially in the _____ leads.

A

even deeper
amplitude, chest
(p. 253)

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15
Q

With left ventricular hypertrophy, there is a large _ in V1 and a large _ in V5.

A

S
R
(p. 254)

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16
Q

Depth (in mm) of _ in V1 plus the height of _ in V5, if greater than __ __, indicates left ventricular hypertrophy.

A

S
R
35 mm
(p. 255)

17
Q

The characteristic T wave that is commonly associated with L ventricular hypertrophy is…

A

…inverted and asymmetrical, with a long and gradual downslope, then a rapid, steep return up to the baseline.
(p. 256)

18
Q

Ventricular strain is characterized by…

A

…depression of the ST segment.

p. 257

19
Q

Ventricular hypertrophy may be associated with a ______ pattern. With ventricular strain, the ST segment becomes depressed and the mid-portion of the ST segment is slightly ______ upward. Also, the T wave is usually ________.

A

strain, humped
inverted
(p. 257)

20
Q

Lead V1 provides most of the information concerning hypertrophy of the heart’s chambers.
When routinely reading a 12 lead EKG, you should check lead I to see if the P waves are ________. Next, check the R wave in V1, then the _ ____ in V1, and then the _ ____ in V5.

A

diphasic
S wave
R wave
(p. 258)