Hypertrophy Flashcards
Right atrial hypertrophy ECG changes
Peaked P wave (P pulmonale) of 2.5mm in inferior leads (2, aVF and 3) and 1.5mm in V1/V2
Left atrial hypertrophy ECG changes
Broad bifid P wave (m shaped) with >40ms between two peaks or total P wave >110ms
Biphasic P wave with terminal negative >40ms duration
Biphasic P wave with terminal negative > 1mm deep.
Right ventricular hypertrophy ECG changes
Right axis deviation of 110 or more.
Dominant R wave in V1 (over 7mm tall or R/S>1)
Dominant S wave in V6 (over 7mm or R/S<1
Narrow QRS
Right ventricular strain pattern = ST depression and T wave inversion in V2/3
Left ventricular hypertrophy ECG changes
S wave in V1 and R wave in V5/6 = >35mm
Increased R wave peak time (slurred) in V5/6
Left ventricular strain pattern = ST depression and T wave inversion in V5/6
What is hypertrophy
A compensatory mechanism in response to pressure, volume or stress changes. An increase in cell size at the cellular level resulting in an increase in myocardial thickness.
Pre-load
The amount of blood in the ventricles at the end of diastole. Increase in preload results in eccentric hypertrophy
Afterload
the resistance the left ventricles must overcome to circular blood. Increase in afterload results in concentric hypertrophy.
Right atrial hypertrophy causes
chronic lung disease
tricuspid stenosis
congenital heart disease
primary pulmonary hypertension
Left atrial hypertrophy causes
Mitral stenosis
Aortic stenosis
Systemic hypertension
Hypertrophic cardiomyopathy
Right ventricular hypertrophy
Pulmonary hypertension
Mitral stenosis
PE
chronic lung disease
congenital heart disease
arrhythmogenic right ventricular cardiomyopathy
Left ventricular hypertrophy
Hypertension
Aortic stenosis
Hypertrophic cardiomyopathy
mitral/aortic regurgitation
cortication of the aorta
