Hypertrophy & Enlargement of the Heart

Question 1

What is hypertrophy and what causes it

Answer 1

Increase in muscle mass

from pressure overload

Question 2

What is enlargement and what causes it

Answer 2

Dilation of a chamber

from fluid overload

Question 3

Normal QRS axis lies between

Answer 3

+90 and 0

Question 4

Normally the p wave is (+/-) _____ in lead 1 & _____ in lead aVF

Answer 4

Positive in I and positive in aVF

acceptable to be positive in one and biphasic in another

Question 5

Axis lying between +90 and +180 is considered

Lead aVF will be ____ & Lead I will be _____

Answer 5

Right Axis Deviation
aVF +
I -

Question 6

Axis lying between 0 and -90 is considered

Lead aVF will be ____ & Lead I will be _____

Answer 6

Left Axis Deviation
aVF-
I+

Question 7

Axis lying between -90 and +180 is considered

Lead aVF will be ____ & Lead I will be _____

Answer 7

extreme right axis deviation

Both leads will be negative

Question 8

T wave axis is ________ should approximated QRS within __________

Answer 8

variable

within 50-60 degrees of QRS

Question 9

Normal P wave axis is between

Answer 9

0 and 70 degrees

Question 10

Atrial enlargement is best seen/most sensitive in

Answer 10

Lead II

Question 11

Separation of atrial p waves is best seen in

Answer 11

Lead V1

-biphasic

Question 12

Right atrial enlargement have p waves with amplitudes __________ in leads ________

Answer 12

greater than 2.5mm

in leads II, III, and aVF (inferior leads)

Question 13

Left atrial enlargement

Answer 13

terminal portion of P wave drops more than 1mm below the isoelectric line in lead V1

Question 14

Diagnoses of LAE requires terminal portion of P wave to be _______ in width

Answer 14

1 small block (.04seconds)

Question 15

Left atrial enlargement is also called______ because it can occur in_____

Answer 15

P mitrale

valvular heart diseases, hypertensive heart disease, cardiomyopathies, and CAD

Question 16

Most common causes of right ventricular hypertrophy are

Answer 16

pulmonary disease and congenital heart disease

Question 17

Increased R wave amplitude in leads overlying the LV and increased S wave amplitude in leads overlying the RV are diagnostic of

Answer 17

Left Ventricular Hypertrophy

Question 18

Leading causes of left ventricular hypertrophy are

Answer 18

systemic hypertension and valvular disease

Question 19

Right ventricular repolarization abnormalities will be seen in leads ____

Answer 19

V1 and V2

Question 20

Left ventricular repolarization abnormalities will be seen in leads_____

Answer 20

I, aVL, V5, and V6ed by

Question 21

What parts of the EKG are affect by ventricular hypertrophy?

Answer 21

=Secondary repolarization abnormalities

ST segment & T wave changes

Question 22

Secondary repolarization abnormalities include:

Answer 22

Down sloping ST segment
T wave inversion
RVH-right precordial T wave inversions
LVH- left precordial T wave inversions ( V5, V6)

Question 23

________ repolarization abnormalities are more common

Answer 23

Left ventricle