Hypertrophy Flashcards
When we say atrial enlargement, what are we referring to?
Both hypertrophy and dilation
Which lead is most accurate in diagnosing atrial enlargement and what type of wave are we looking for?
V1. Diphasic wave.
What is the next step in determining atrial enlargement and how do we go about it?
We need to determine which atria is enlarged. If the initial part of the diphasic P wave is larger of the two waves then it is most likely right atrial enlargement. If the terminal part of the diphasic wave is larger, then it is most likely left atrial enlargement.
What other lead can you look at for atrial enlargement and what will we see?
Lead 2. Same principle as V1 but both portions of the P wave are positively deflected.
So keeping this all in mind, which atria is activated first?
Right then left.
2 common causes of RAE?
TV disease and Pulmonary HTN
2 common causes of LAE?
MV disease or systemic HTN which is most common.
2 main reasons why the ventricles will become hypertrophied?
Volume overload during diastole and pressure overload during systole trying to generate pressure
3 causes of RVH?
COPD, Mitral Stenosis and Tricuspid Regurgitation
What is a hallmark clue of RVH on EKG?
Large R on V1 that gets progressively smaller on V2, V3, and V4. You could draw a sloping line down the top of the R waves.
2 other clues I will remember for RVH?
Small s in V1 and RAD.
Most common cause of LVH and one other?
Most common cause is HTN. Also, aortic valve issues.
What is the logic here as to why we are seeing the changes on EKG?
Left ventricular wall is very thick so the impulse is taking longer and we are getting more impulse, so deep S waves over RV and tall R waves over LH. Particularly V1.
What lead is over LV and Which is opposite of it? What will we see in these leads?
V5 is over LV and we will see a very tall R wave. V1 is opposite and we will see a deep S.
What is a diagnostic tool for LVH?
Sum the depth of S and the height of R and if it is greater than 35 mm is it LVH
