Hypertrophy & Bundle Branch Blocks

Question 1

Type of Ventricular Hypertrophy:

• Add mm of height to S wave in V1-V2 with the R wave in V5-V6
• If the above calculation is greater than 35 mm AND/OR
• R wave in aVL is > 11 mm

Answer 1

Left Ventricular Hypertrophy

Question 2

Describe how to determine LEFT ventricular hypertrophy

Answer 2

• Add mm of height to S wave in V1-V2 with the R wave in V5-V6
• If the above calculation is greater than 35 mm AND/OR
• R wave in aVL is > 11 mm

Question 3

Type of Ventricular Hypertrophy: The R wave is bigger than the S wave in V1 and gets progressively smaller through the precordial leads (V1-V6)

Answer 3

Right Ventricular Hypertrophy

Question 4

Describe how to determine RIGHT ventricular hypertrophy

Answer 4

The R wave is bigger than the S wave in V1 and gets progressively smaller through the precordial leads (V1-V6)

Question 5

Type of Artrial Enlargement:

• Broad [double-peaked/M shaped] p wave in lead II [or I and aVL]. OR/AND
• Diphasic p wave [sine wave +/-]in V1 with a larger terminal [neg deflected] component.

Answer 5

Left Atrial Enlargement

Question 6

Describe how to determine LEFT atrial enlargement

Answer 6

• Broad [double-peaked/M shaped] p wave in lead II [or I and aVL]. OR/AND
• Diphasic p wave [sine wave +/-] in V1 with a larger terminal [neg deflected] component.

Question 7

Type of Atrial Enlargement: A peaked p wave in II [or III, V1 and aVF] which is greater than or equal to 2.5 mm

Answer 7

Right Atrial Enlargement

Question 8

Describe how to determine RIGHT atrial enlargement

Answer 8

A peaked p wave in II [or III, V1 and aVF] which is greater than or equal to 2.5 mm

Question 9

Injury Pattern: Elevated ST segment > 1 mm

Answer 9

Injury

Question 10

Injury Pattern: Symmetrical T wave inversion > 3 mm in 2 adjacent leads OR ST segment depression > 2 mm

Answer 10

Ischemia

Question 11

Injury Pattern: Q waves that are at least 0.04 sec wide or 1/3 the entire QRS in height

Answer 11

Infarct

Question 12

Describe the injury pattern

Answer 12

Elevated ST segment greater than 1 mm

Question 13

Describe the ischemia pattern

Answer 13

Symmetrical T wave inversion greater than 3 mm in 2 adjacent leads or ST segment depression greater than 2 mm

Question 14

Describe the infarct pattern

Answer 14

Q waves that are at least 0.04 sec wide [1 small square] or 1/3 the entrie QRS in height

Question 15

Lead: Inferior LV, RA, LA

Answer 15

II, III, aVF

Question 16

Lead: High Lateral LV

Answer 16

I, aVL

Question 17

Lead: RV, RA, LA, and anteroseptal LV

Answer 17

V1-V2

Question 18

Lead: Anterior and Apical LV

Answer 18

V2, V3, V4

Question 19

Lead: Anteriolateral LV

Answer 19

V4, V5, V6

Question 20

The QRS widens with ____1____.

Answer 20

BBB [Bundle Branch Block]

Question 21

Right BBB: The more ______1_____ the more advanced/progressed the block. ___2___ fires when it should, ____3____ firing is delayed.

Answer 21

1. Separation
2. Left
3. Right

Question 22

Left BBB: Looks like _________1__________. ___2___ fires when it should, ____3____ firing is delayed.

Answer 22

1. Batman’s Hat
2. Right
3. Left

Question 23

For R BBB look at leads _________. For L BBB look at leads ___________.

Answer 23

V1-V2; V5-V6