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Clinical Patient Care 2023 > Hypertrophy > Flashcards

Hypertrophy Flashcards

1
Q

What is hypertrophy of the heart?

A
  1. Increased in thickness of muscular layers of the heart walls
    *caused by pressure overload
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2
Q

What is (atrial) enlargement?

A
  1. Dilation of the chambers of the heart
    *caused by volume overload
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3
Q

What is one of the main causes of ventricular hypertrophy?

A
  1. HTN, the left ventricle has to work harder to move blood through the aortic valve
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4
Q

What are the normal P wave intervals?

A

Height: <2.5mm in lead II
Width: <0.11 sec in lead II

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5
Q

When assessing for hypertrophy on an EKG what are you looking for?

A
  1. P waves
    *RAE/LAE
  2. QRS complex
    *PVH/LVH
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6
Q

When looking for atrial enlargement what leads should you be looking at?

A
  1. Lead II
    *P wave
  2. Lead VI
    *biphasic p wave
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7
Q

What does the first part of the p wave represent in a biphasic p wave?

A
  1. Right atrial depolarization
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8
Q

What does the second part of the p wave represent in a biphasic p wave?

A
  1. Left atrial depolarization
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9
Q

What will RAE look like in lead II?

A
  1. > 2.5 boxes in height
    *called P-pulmonale
    *COPD common cause
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10
Q

What will RAE look like in lead VI?

A
  1. > 2.5 boxes in height (right atrial depolarization)
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11
Q

What will LAE look like in lead II?

A
  1. Notched P wave
    *called p-mitrale
    *common cause is mitral stenosis
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12
Q

What will LAE look like in V1?

A
  1. Terminal portion (negative component) of the P wave is larger and wide
    *needs to decend >1mm below the isoelectric line
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13
Q

Why is the QRS complex mainly negative in V1?

A
  1. B/c ventricular depolarization moves downward and to the patients left side and posteriorly
  2. Therefore moving away from the positive electrode of v1
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14
Q

What should you look for when assessing for RVH?

A
  1. 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
  2. S wave will be smaller than R wave (V1)
  3. Will be persistent S waves in V5 and V6
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15
Q

What will be the R wave arrangement of the precordial leads in RVH?

A
  1. V1 (large)
  2. V2 (large)
  3. V3 (medium)
  4. V4 (smaller)
  5. V5 (smallest
    *Descending
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16
Q

What are some causes of RVH?

A
  1. Pulmonary hypertension
  2. Mitral valve disease
  3. Pulmonary stenosis
17
Q

What will the EKG show in LVH?

A
  1. V1 deep S wave
  2. V5 large R wave
    **there will be largerrrr QRS deflections in the chest leads
18
Q

What is the criteria used for diagnosing LVH while using the precordial leads?

A
  1. The R wave amplitude in lead V5 or V6 PLUS the S wave amplitude in lead V1 or V2 exceeds 35mm
19
Q

What is the criteria used for diagnosing LVH while using the limb leads?

A
  1. The R wave amplitude in lead aVL exceeds 13mm
20
Q

What are some causes of LVH?

A
  1. Systemic arterial hypertension
  2. Aortic stenosis
  3. mitral insufficiency
21
Q

When a patient has LVH what else might be present?

A
  1. An inverted T wave
    *Strain pattern
    *The cardiac patients has a higher risk of cardiovascular related morbidity and mortality
22
Q

Where are hemiblocks located?

A
  1. Either the anterior or the posterior divisions of the LEFT bundle branch
23
Q

What is the common cause of hemiblocks?

A
  1. Blood supply loss to either the anterior or posterior division of the left bundle branch
    *Occlusion of the anterior descending coronary artery
24
Q

If there is a anterior hemiblock what is the axis deviation?

A

LAD

25
Q

What is the EKG pattern of an anterior hemiblock?

A
  1. Q1S3
    *Q wave in I
    *Deep S wave in III
26
Q

If a patient has a shift in axis from normal to -60 degrees what should be suspected?

A

Anterior Hemiblock

27
Q

What type of axis deviations do posterior hemiblocks cause?

A

RAD

28
Q

What is the EKG pattern of an posterior hemiblock?

A

S1Q3
*Wide S in I
*Q in III

Clinical Patient Care 2023 (33 decks)

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