Term
| Hypertrophy summary: Check __ wave in V1 for atrial hypertrophy. Check __ wave in V1 for right ventricular hypertrophy. Check __ __ _ in V1 and __ __ __ in __ for Left ventricular hypertrophy. |
|
Definition
- p wave: atrial hypertophy
- R wave: right ventricular hypertrophy
- S wave depth in V1, R wave height in V5: left ventricular hypertrophy |
|
|
Term
| The __ wave represents the depolarization and contraction of both atria. Since electode __ is directly over the atria this we examine the __ __ in __ to look for atrial enlargement. |
|
Definition
- p wave
- V1
- p wave in V1 for atrial enlargement |
|
|
Term
| With atrial enlargement, the __ __ in lead __ is usually __. |
|
Definition
- p wave in lead V1
- diphasic (positive and negative) |
|
|
Term
| In a diphasic p wave in lead V1, if the __ __ part is greater than the down part, it is Right Atrial Enlargment. |
|
Definition
|
|
Term
| If the height of the P wave in any limb leads exceeds __ __, even if its not diphasic, suspect __ __ __. |
|
Definition
- 2.5 mm
- right atrial enlargement |
|
|
Term
| In a diphasic P wave in lead V1, if the __ __ is greater, it is Left Atrial Enlargement. |
|
Definition
|
|
Term
| __ valve stenosis may lead to left atrial enlargement. But the most common cause of left atrial enlargement is __. |
|
Definition
|
|
Term
| V1 is a positive electrode, and the ventricles normally polarize downward and to the left (away from V1), thus the QRS complex is normally __ in lead V1. |
|
Definition
|
|
Term
| In right ventricular hypertrophy, the QRS in V1 is ___ since the right side is thicker causing more depolarization to go towards V1 instead of away from V1. |
|
Definition
|
|
Term
| With RVH, the QRS is __ and the large __ wave gets progressively __ from V2, to V3, to V4, etc. |
|
Definition
- positive
- R wave
- smaller |
|
|
Term
| If patient has Right Ventricular Hypertrophy they probably also have __ __ __. |
|
Definition
|
|
Term
| If patient has LVH, they probably also have __ __ _. |
|
Definition
|
|
Term
| With Left Ventricular Hypertrophy, the QRS complexes will have __ ___ in all the __ __. |
|
Definition
- exaggerated amplitudes
- chest leads |
|
|
Term
| With Left Ventricular Hypertrophy, lead V1 will have a huge __ wave and lead V5 will have a huge __ wave. |
|
Definition
- lead V1 huge S wave (Downgoing)
- lead V5 huge R wave
SIDE NOTE; remember R WAVE IS ALWAYS UPGOING AND S WAVE IS ALWAYS DOWNGOING. DON'T MISNAME THE WAVES IN QRS. SEE PAGE 254. |
|
|
Term
| Lead __ is over the left ventricle, that is why with LVH you see an even bigger __ wave in this lead. |
|
Definition
|
|
Term
| EVEN WHEN SOMETHING IS WRONG IN THE EKG, R WAVE IS GOING UP AND S WAVE IS GOING DOWN. |
|
Definition
|
|
Term
| If the sum (mm) of S in __ and R in __ is greater than __ mm, there is __ ___ __. |
|
Definition
- V1
- V5
- 35 mm
- Left Ventricular Hypertrophy |
|
|
Term
| The T wave in __ and __ may also show signs of __ __ __. If the T wave is __ and __ in these leads it may indicate __. |
|
Definition
- V5 and V6
- Left Ventricular Hypertrophy
- inverted and asymmetrical (gradual downslope, rapid upslope)
- LVH |
|
|
Term
| Ventricular hypertrophy often also has a strain pattern. STrain is characterized by a __ and __ ST segment. |
|
Definition
|
|
Term
| Of all the leads, lead __ reveals most information about hypertrophy of the heart. |
|
Definition
|
|
Term
| Basic Characteristics in Considering a Dysrhythmia |
|
Definition
What are the atrial and the ventricular rates and what is their association?
Is the rhythm regular or irregular?
Are there any AV conduction delays?
Are there any bizarre-looking QRS or P-wave complexes?
Is the rhythm dangerous or life-threatening? |
|
|
Term
| Dilatation is __ cardiac muscle with or without hypertrophy. It is __ likely to cause voltage increase. |
|
Definition
|
|
Term
|
Definition
Increase in size of the cardiac muscle wall, usually a result of excessive and prolonged work against resistance (e.g., uncontrolled hypertension)
Size of fibers (cells)increase, NOT the number of fibers with concurrent metabolic demands
Increased size results in increased voltage
frequently hypertophy and dilatation occur together |
|
|
Term
| P waves in a normal heart should be upright in leads __, __, and __. |
|
Definition
|
|
Term
| P waves in a normal heart are usually downgoing on lead __. |
|
Definition
|
|
Term
| Best leads to look at to detect P wave abnormalities: |
|
Definition
|
|
Term
Causes of Right Atrial Hypertrophy:
KNOW THIS |
|
Definition
- Pulomonary Disease (COPD, pulonary HTN, etc.)
- Congenital Heart Disease
(think increased vena cava preassure/resistance, chronic disease?) |
|
|
Term
| The tall P waves seen in leads __, __, __,and __ associated with __ __ __are called __ __. |
|
Definition
- II, III, avF, and V1
- Right atrial abnormality
- P pulmonale |
|
|
Term
| Two characeristics of Right atrial abnormality according to powerpoint: |
|
Definition
- tall pointed p waves (p pulmonale) (NORMAL P WAVE DURATION)
- loss of R wave progression |
|
|
Term
| With Left Atrial Abnormalities the P wave height may be normal or increased, but the duration of the p wave is ___ to be greater than __ or __. The p wave with this condition often appears humped in leads I and II, and may be biphasic in lead V1 |
|
Definition
- increased
- 3 small boxes or 0.12 secods |
|
|
Term
| Right atrial abnormality __ p wave duration. Left atrial abnormality __ p wave duration. |
|
Definition
|
|
Term
| Left Atrial Abnormality Causes: |
|
Definition
- Uncontrolled Hypertension
- Coronary Artery Disease
- Left sided valvular disease
- HTN secondary to LVH
- Cardiomyopathies |
|
|
Term
Left sided voltage is normally dominant
In LVH, this is exacerbated
In RVH, voltage is increased on the right side |
|
Definition
|
|
Term
| Right Ventricular Hypertrophy causes: |
|
Definition
- Pulmonic stenosis
- ASD (usually with RBBB)
- severe COPD
- Pulmonary HTN
- Congenital Heart Disease |
|
|
Term
| With Right Ventricular Hypertrophy, the normally downgoing QRS in V1 becomes __ , there is a loss of __ __ __, and the is a prominent __ _ in lead I. |
|
Definition
- upgoing
- R wave progression
- S wave (down) |
|
|
Term
|
Definition
- ischemic heart diseae
- congestive heart failure
- atrial arrhythmia
- ventricular arrhythmia |
|
|
Term
|
Definition
- HYPERTENSION IS BIGGEST CAUSE
- ischemic heart disease
- hypertrophy of ventricles can be seen normally
- genetic |
|
|
Term
| With LVH, __ is common but too hard to assess so won't have to on EKG. |
|
Definition
LBBB
SO IF HAVE AN EKG WITH LBBB, FORGET ABOUT TRYING TO FIGURE OUT HYPERTROPHY, JUST PUT LBBB. |
|
|
Term
| Causes of flipped T waves: |
|
Definition
- hypertrophy
- bundle branch blocks
- ischemia
- digitalis
- epinephrine effect
- metabolic disturbances (electrolytes)
- cerebral hemorrhage
A single flipped t wave is okay, but if consistently found= bad news. |
|
|
