Hypertrophy Flashcards
What is hypertrophy of the heart?
- Increased in thickness of muscular layers of the heart walls
*caused by pressure overload
What is (atrial) enlargement?
- Dilation of the chambers of the heart
*caused by volume overload
What is one of the main causes of ventricular hypertrophy?
- HTN, the left ventricle has to work harder to move blood through the aortic valve
What are the normal P wave intervals?
Height: <2.5mm in lead II
Width: <0.11 sec in lead II
When assessing for hypertrophy on an EKG what are you looking for?
- P waves
*RAE/LAE - QRS complex
*PVH/LVH
When looking for atrial enlargement what leads should you be looking at?
- Lead II
*P wave - Lead VI
*biphasic p wave
What does the first part of the p wave represent in a biphasic p wave?
- Right atrial depolarization
What does the second part of the p wave represent in a biphasic p wave?
- Left atrial depolarization
What will RAE look like in lead II?
- > 2.5 boxes in height
*called P-pulmonale
*COPD common cause
What will RAE look like in lead VI?
- > 2.5 boxes in height (right atrial depolarization)
What will LAE look like in lead II?
- Notched P wave
*called p-mitrale
*common cause is mitral stenosis
What will LAE look like in V1?
- Terminal portion (negative component) of the P wave is larger and wide
*needs to decend >1mm below the isoelectric line
Why is the QRS complex mainly negative in V1?
- B/c ventricular depolarization moves downward and to the patients left side and posteriorly
- Therefore moving away from the positive electrode of v1
What should you look for when assessing for RVH?
- Large R waves in v1
*b/c the right ventricles are thick so the vector is moving towards the positive electrode of V1
*so the QRS complex is more positive - S wave will be smaller than R wave (V1)
- Will be persistent S waves in V5 and V6
What will be the R wave arrangement of the precordial leads in RVH?
- V1 (large)
- V2 (large)
- V3 (medium)
- V4 (smaller)
- V5 (smallest
*Descending
What are some causes of RVH?
- Pulmonary hypertension
- Mitral valve disease
- Pulmonary stenosis
What will the EKG show in LVH?
- V1 deep S wave
- V5 large R wave
**there will be largerrrr QRS deflections in the chest leads
What is the criteria used for diagnosing LVH while using the precordial leads?
- The R wave amplitude in lead V5 or V6 PLUS the S wave amplitude in lead V1 or V2 exceeds 35mm
What is the criteria used for diagnosing LVH while using the limb leads?
- The R wave amplitude in lead aVL exceeds 13mm
What are some causes of LVH?
- Systemic arterial hypertension
- Aortic stenosis
- mitral insufficiency
When a patient has LVH what else might be present?
- An inverted T wave
*Strain pattern
*The cardiac patients has a higher risk of cardiovascular related morbidity and mortality
Where are hemiblocks located?
- Either the anterior or the posterior divisions of the LEFT bundle branch
What is the common cause of hemiblocks?
- Blood supply loss to either the anterior or posterior division of the left bundle branch
*Occlusion of the anterior descending coronary artery
If there is a anterior hemiblock what is the axis deviation?
LAD
What is the EKG pattern of an anterior hemiblock?
- Q1S3
*Q wave in I
*Deep S wave in III
If a patient has a shift in axis from normal to -60 degrees what should be suspected?
Anterior Hemiblock
What type of axis deviations do posterior hemiblocks cause?
RAD
What is the EKG pattern of an posterior hemiblock?
S1Q3
*Wide S in I
*Q in III
