EKG 3 summary

Question 1

Right ventricular hypertrophy:
What type of axis deviation is most common?

Answer 1

Right axis deviation (lead I negative, lead avF positive)

Question 2

What 2 things indicate a dominant right ventricle (right ventricular hypertrophy)?

Answer 2

V1: R wave > S wave
V6: S wave > R wave

Question 3

If your right atria or ventricle has hypertrophy, what is the most likely issues?

Answer 3

Lung issue

Question 4

Left atrial enlargement usually indicates what?

Answer 4

Valve issues

Question 5

P wave amplitude > 2.5 mm in at least one of the inferior leads allows you to diagnose what?

Answer 5

Right atrial enlargement

Question 6

How do you diagnose left atrial enlargement?

Answer 6

1) 2nd portion of P wave incr. amplitude:
In V1, terminal P wave drops > 1 mm below baseline, and no axis deviation seen
OR
2) Dx = terminal portion of P wave at least 1small box (0.04 sec) in width

Question 7

Which tends to occur first, atrial enlargement or ventricular hypertrophy?

Answer 7

Ventricular hypertrophy

Question 8

Which is more likely to have axis deviation, right atrial enlargement or left?

Answer 8

Right
(not expected in left, but expected in right)

Question 9

What are the criteria for left ventricular hypertrophy (LVH)? (important)

Answer 9

1) R wave in V5 or V6 + S wave in V1 or V2 exceeds 35mm
2) R wave in aVL is 11mm
3) R wave in aVL + S wave in V3 exceeds 20mm in women and 28mm in men

4) LAD > ~15 degrees, but not useful diagnostic feature, & QRS may be slightly prolonged

Question 10

Secondary repolarization abnormalities may be caused by what?

Answer 10

Changes in ST segment and T wave related to ventricular hypertrophy

Question 11

Cardiac ischemia shows what on an EKG?

Answer 11

Symmetric T wave inversion

Question 12

What 2 leads do you need to look at for RVH?

Answer 12

V1 and V6