Hemiblocks - EKGs Flashcards

1
Q

2 types of hemiblocks

A
  • Left anterior hemiblock (ant/superior division)

- Left posterior hemiblock (post/inferior division)

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2
Q

More common hemiblock

A

LAH

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3
Q

Causes of hemiblocks

A
LAH = LAD occlusion (anterior infarct)
LPH = RCA occlusion (posterior/inferior infarct)
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4
Q

LAH vs. LPH - EKG

A
LAH = left axis deviation (free wall supplied from L only)
LPH = right axis deviation (free wall supplied from R only)
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5
Q

What causes the axis deviations to not occur without a hemiblock?

A

The free wall of the LV is normally simultaneously innervated by each division in opposite directions, cancelling each other out in the EKG

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6
Q

LAH - EKG

A
  • Left axis deviation ( > -60º)
  • Big S in 2, 3, F
  • (Q in 1 and L) - not as apparent
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7
Q

LPH - EKG

A
  • Right axis deviation (> +120º)
  • Big S in 1 and L
  • (Q in 2, 3, F) - not as apparent
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8
Q

How to differentiate hemiblock from ventricular hypertrophy?

A

Hemiblock = no sign of RVH or LVH (giant QRS complexes)

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