hypertrophy/BBB/electrolytes -Sorweide Flashcards
What is the criteria for LVH?
- Voltage Criteria. (S wave in V1 or V2 + R Wave in V5 or V6= Greater than 35)
- LAD (does not have to be present)
- Left atrial enlargement=P-mitrale (limb leads I and II, P wider than .12sec, notched P wave may be seen)
- lateral “strain” pattern: V4-6 T wave inversions with concave depressed ST pattern (strain) that is asymmetric
need 1 criteria but >2–> HIGH probability
What will RVH look like on an EKG?
V1=bigger R wave, V5 bigger S waves
strain pattern seen in C1
What is the gold standard for evaluation of hypertrophy?
ECHO!!!!!
What is the treatment for hypertrophy?
lifestyle modification
BP control
- ACEI–> help with dec BP, dec after load, help CV mm restructuring
- diuretics-dec BP, dec preload and afterload
- Beta blockers-dec BP, control rate, counteract stress hormones
-treat issues causing it (e.g. valve repair, pacemaker/defibrillator)
What can a new left bundle branch block be?
acute MI!!!
What should you look for in a RBBB?
WIDE QRS >.12
rSR’ in V1 and V2
Slurred S in I
What should you look for in a LBBB?
wide QRS >.12
wide S in leads V1-2, wide R in V5-6
ST depression and inverted T waves in the same leads
What is the treatment for BBBs?
Nothing, other than treating the underlying disease
may need a pacemaker if symptomatic
What do tall, peaked, narrow T waves indicate? Is this bad?
hyperkalemia
yes, it is the most deadly cause of wide QRS –> can lead to ANY arrhythmia
What are the EKG findings in hypocalcemia?
hypo: Prolongation of ST segment portion of QT interval
hyper: short ST
What are prominent U waves, slight ST depressions, small T waves and peaked P waves indicative of?
hypokalemia
What types of things could cause hypokalemia?
Poor oral intake, GI or urine loss, mineralcorticoid excess, alkalosis, renal tubular acidosis, insulin excess, medications
