Hypertrophy - EKGs

Question 1

Hypertrophy vs. Dilation on EKG

Answer 1

NO DIFFERENCE

Question 2

Atrial enlargement…best leads?

Answer 2

1, 2, 3, V1

Question 3

Normal P wave

Answer 3

Rounded,

Question 4

RAE vs. LAE

Answer 4

RAE = tall, pointed (more in 3)
LAE = wide, notched (more in 1)

Question 5

Name of RAE P wave

Answer 5

P-pulmonale

Question 6

Name of LAE P wave

Answer 6

P-mitrale

Question 7

LAE P wave…1, 2 vs. 3, V1

Answer 7

1, 2 - notched, MONOPHASIC (both up)

3, V1 - notched, SECOND HALF DOWN (diphasic)

Question 8

P wave in V1

Answer 8

Diphasic (always)

Question 9

Causes of RAE

Answer 9

• Tricuspid disease

- Pulmonary hypertension

Question 10

Causes of pulmonary HTN that cause RAE

Answer 10

• COPD
• Pulmonary embolism
• Mitral stenosis
• Mitral regurgitation

Question 11

RAE P-waves

Answer 11

2, 3, F – > 2.5 mm
V1, V2 – > 1 mm
Tall, pointed, peaked

Question 12

LAE P-waves

Answer 12

2, 3, F – notched (“m”) wider than 0.12s (3 small boxes)

V1 – prominent terminal negative component (sine wave)

Question 13

Causes of LAE

Answer 13

Mitral disease (stenosis or regurg)

Question 14

Causes of LVH

Answer 14

• HYPERTENSION
• Aortic stenosis/insufficiency
• Hypertrophic caridomyopathy
• Coarctation of aorta

Question 15

General QRS changes in LVH

Answer 15

Over RV - deeper S waves (higher voltage in LV wall)

Over LV - taller R waves (higher voltage in LV wall)

Question 16

Can you determine LVH from LV dilation on an EKG?

Answer 16

NO - determined by total muscle mass only

Question 17

Criteria for Dx LVH lacks ____ but has high ____

Answer 17

Sensitivity; specificity

Question 18

Sokolow Lyon Criteria (LVH)

Answer 18

• (R in 1) + (S in 3) > 25 mm (5 big boxes)
• R in AVL > 11 mm
• R in V6 > 26 mm

Question 19

LVH w/ strain

Answer 19

ST depression (opposite of QRS)

Question 20

Other common finding for LVH besides QRST changes

Answer 20

L axis deviation (AVF negative/down)

Question 21

Causes of RVH

Answer 21

• Chronic lung disease (COPD)
• Pulmonary stenosis
• VSD
• Congenital stuff
• Mitral stenosis
• Tricuspid regurgitation

Question 22

General QRS changes in RVH

Answer 22

• Prominent R waves in right precordial leads

- Prominent S waves in left precordial leads

Question 23

RVH = R:S ratio _____

Answer 23

> 1 in right leads

Question 24

Other things that can be seen with RVH

Answer 24

• ST-T strain
• Late intrinsicoid inflection (V1)
• Incomplete RBBB
• P-pulmonale

Question 25

What can be heard with RVH?

Answer 25

S3 (children)