EKG review 2

EKG review 2 - Chap 2 Hypertrophy- increase in muscle mass,...

Info iconThis preview shows pages 1–3. Sign up to view the full content.

View Full Document Right Arrow Icon
Chap 2 Hypertrophy - increase in muscle mass, the wall of hypertrophied ventricle is thick and powerful, caused by pressure overload- heart is forced to pump blood against an increased resistance (patients with systemic hypertension or aortic stenosis) Enlargement - dilation of a particular chamber, enlarged ventricle can hold more blood, caused by volume overload- chamber dilates to accommodate an increased amount of blood (in valvular diseases) Enlargement and hypertrophy coexist (both ways heart tries to increases cardiac output) EKG can’t distinguish between Enlargement and hypertrophy P wave for atrial enlargement QRS for ventricular hypertrophy How EKG wave changes due to Enlargement and hypertrophy 1. Chamber longer to depolarize increase duration 2. Chamber generate more current increase in amplitude 3. Electrical axis shifts Axis Normal- QRS up in V1 and aVF LAD/left- QRS up in V1 and down in aVF RAD/right- QRS down in V1 and up in aVF NML/no man’s land- QRS negative in V1 and aVF Right ventricular hypertrophy less common, occurs in severe chronic obstructive pulmonary disease or uncorrected congenital heart disease with profound volume or pressure overload Atrial Enlargement- to assess , look at lead 2 and V1 Right Atrial Enlargement- Tall P waves in 2,3 AVF (>2.5mm), possible right axis deviation of P wave. Left Atrial Enlargement - amplitude of terminal negative component of the p wave may be increased and descend at least 1 mm below isoelectric line in V1. Duration of P wave is increased and terminal negative portion of p wave must be 1 small block in width. No significant axis deviation b/c left atrium is normally electrically dormant. Left Ventricular Hypertrophy- more common, caused by systemic hypertension and valvular disease R1 and S3 > 25mm S V1/2 + R V5/6 > 35mm R AVL > 13mm Precordial leads
Background image of page 1

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
R wave amplitude in lead V5 or V6 plus S wave amplitude in lead V1 and V2 exceeds 35mm R wave amplitude in lead V5 exceeds 26 mm R wave amplitude in lead V6 exceeds 18 mm R wave amplitude in lead V6 exceeds R wave amplitude in lead V5 Limb Leads R wave amplitude in lead AVL exceeds 13mm R wave amplitude in lead AVF exceeds 21mm R wave amplitude in lead 1 exceeds 14mm R wave amplitude in lead 1 plus the S wave amplitude in lead 3 exceeds 25mm Right Ventricular Hypertrophy Tall R wave in V1 (>s wave in V1) Tall S wave in V6 (>R wave in V6) T wave inverted inV1 Right axis deviation If both ventricles hypertrophied, left ventricle affects more dominant All enlargement or hypertrophy findings on EKG must be verified by echocardiogram proof Secondary Repolarized Abnormalities of Ventricular Hypertrophy 1. ST segment Depression 2. T wave inversion (no longer aligned with QRS axis) Caused by inadequate blood flow in capillary beds Referred to as strain Right ventricular changes in leads V1 and V2
Background image of page 2
Image of page 3
This is the end of the preview. Sign up to access the rest of the document.

Page1 / 6

EKG review 2 - Chap 2 Hypertrophy- increase in muscle mass,...

This preview shows document pages 1 - 3. Sign up to view the full document.

View Full Document Right Arrow Icon
Ask a homework question - tutors are online