Hypertrophy & Bundle Branch Blocks Flashcards
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
Left Ventricular Hypertrophy
Describe how to determine LEFT 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
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)
Right Ventricular Hypertrophy
Describe how to determine RIGHT ventricular hypertrophy
The R wave is bigger than the S wave in V1 and gets progressively smaller through the precordial leads (V1-V6)
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.
Left Atrial Enlargement
Describe how to determine LEFT atrial 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.
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
Right Atrial Enlargement
Describe how to determine RIGHT atrial enlargement
A peaked p wave in II [or III, V1 and aVF] which is greater than or equal to 2.5 mm
Injury Pattern: Elevated ST segment > 1 mm
Injury
Injury Pattern: Symmetrical T wave inversion > 3 mm in 2 adjacent leads OR ST segment depression > 2 mm
Ischemia
Injury Pattern: Q waves that are at least 0.04 sec wide or 1/3 the entire QRS in height
Infarct
Describe the injury pattern
Elevated ST segment greater than 1 mm
Describe the ischemia pattern
Symmetrical T wave inversion greater than 3 mm in 2 adjacent leads or ST segment depression greater than 2 mm
Describe the infarct pattern
Q waves that are at least 0.04 sec wide [1 small square] or 1/3 the entrie QRS in height
Lead: Inferior LV, RA, LA
II, III, aVF
Lead: High Lateral LV
I, aVL
Lead: RV, RA, LA, and anteroseptal LV
V1-V2
Lead: Anterior and Apical LV
V2, V3, V4
Lead: Anteriolateral LV
V4, V5, V6
The QRS widens with ____1____.
BBB [Bundle Branch Block]
Right BBB: The more ______1_____ the more advanced/progressed the block. ___2___ fires when it should, ____3____ firing is delayed.
- Separation
- Left
- Right
Left BBB: Looks like _________1__________. ___2___ fires when it should, ____3____ firing is delayed.
- Batman’s Hat
- Right
- Left
For R BBB look at leads _________. For L BBB look at leads ___________.
V1-V2; V5-V6
