Hypertrophy Flashcards
What is hypertrophy
-adaptive response to an increase in stress causing the myocardium to become thicker
Pathophysiology of hypertrophy
-increased afterload causes concentric hypertrophy= reduced filling
-increased pre load leads to eccentric hypertrophy= dilation
-this causes an impairment causing reduced cardiac output and eventually cardiac failure
Causes R atrial hypertrophy
-chronic lung disease
-tricuspid stenosis (failure)- atria has to contract harder
-congenital heart disease eg. pulmonary stenosis
-pulmonary hypertension
ECG features of R atrial hypertrophy
-enlarged peaked P wave= P pulmonale
-2.5mm in inferior leads (2,3,aVF) or more than 1.5mm in V1/V2
Left atrial hypertrophy causes
-mitral stenosis
-aortic stenosis
-HTN
-hypertrophic cardiomyopathy
ECG changes for L atrial hypertrophy
-broad, M shaped (bifid), or biphasic P wave in lead 1/2
-bifid P wave with greater than 40ms between 2 peaks
-P wave has to be more than 110ms
Causes of R ventricular hypertrophy
-pulmonary HTN
-mitral stenosis
-PE
-lung disease
-congenital heart disease
-arrhythmogenic R ventricular cardiomyopathy
ECG changes for R ventricular hypertrophy
ALL CRITERIA MUST BE MET
-R axis deviation of 110degrees or more
-dominant R wave in V1 (greater than 7mm or R wave bigger than S wave)
-dominant S wave in V5/V6 (7mm deep)
-narrow QRS (less than 120ms)
Causes L ventricular hypertrophy
-HTN
-aortic stenosis
-aortic regurgitation
-mitral regurgitation
-hypertrophic cardiomyopathy
ECG criteria L ventricular hypertrophy
BOTH CRITERIA NEED TO BE MET
Voltage criteria:
-S wave in V1 when added to R wave in V5/V6 must be greater than 35mm
Non voltage criteria:
-increased R wave peak time of greater than 50ms in V5/V6
or
-left ventricular strain pattern= ST depression and T wave inversion in V5/V6
