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Meharry CVS
Introductory Terms, Phrases, Equations, etc.
| Question | Answer |
|---|---|
| Normal Atria | Depolarization begins at the SA node; travels from RA to LA via the intra-atrial septum; P-wave on ECG; RA is initial portion, LA terminal; 45° - 60° axis |
| Left Atrial Enlargement (LAE) | Dx - P wave terminus in LEAD-V1 1 small box wide/deep; (time)(depth in mm) < -0.04; notched P-wave in LEAD-1 and LEAD-2 > .12 ms -> P mitrale; P-wave axis shift +15° |
| LAE Dx | Valvular DZ -> Mitral Stenosis & Regurgitation; ↓ LV Compliance -> Chronic ↑ BP; Obstructive Cardiomyopathy; Aortic Stenosis; Aortic Regurgitation; Infiltrative Heart Disease; All ↑ P or V on the atria -> hypertrophy |
| Right Atrial Enlargement (RAE) | Dx - P wave in LEADS II, II and aVf peak > 2.5 mm (P pulmonale); P wave is 75° +; Positice aspect of P wave in LEADS V1 or V2 > 1.5 mm |
| RAE Dx | Valvular DZ -> Tricuspid Stenosis & REgurgitation; Pulmonary Hypertension -> COPD, Pulmonary Emboli, Interstitial Lung DZ, Sleep Apnea, Mitral Valve DZ, LV Systolic Dysfunction; Congenital Heart DZ -> Ebstein's Anomaly |
| Biatrial Enlargement | Dx - Look @ P wave; Biphasic in LEAD V1; Beginning > 1.5 mm height; Terminus at least 1 mm depth; 0.04 s duration; P wave amplitude > 2.5 mm & > .12 s in LEAD II |
| Normal Ventricles | Depolarization shown in QRS; Normal Axis: 30° - 105° |
| Ventricular Hypertrophy | Caused by ↑ in load, pressure or volume in ventricles; ↑ in QRS voltage |
| Left Ventricular Hypertrophy (LVH) Part 1 | Dx - > 40 years; LIMB LEADS (low sen/high spec) - R wave in LEAD I and S wave in LEAD III > 25 mm; R wave aVL > 11 mm; R wave aVF > 20 mm; S wave aVR > 14 mm |
| Left Ventricular Hypertrophy (LVH) Part 2 | Dx - > 40 years; PRECODIAL LEADS (high sen/low spec) - R wave V5 or V6 > 26 mm; R wave in V5 or V6 and S wave in V1 >35 mm; Largest R wave and Largest S wave in PRECODIAL LEADS > 45 mm |
| LVH Differential Dx Part 1 | Aortic Stenosis, Aortic Regurgitation, Mitral Regurgitation, Systemic ↑ BP, Hypertrophic Cardiomyopathy; Sokolow + Lyon: V1(S) & V5(R) > 35mm; Cornell: V3(S) & aVL(R) > 28 mm (men) 20 mm (women) |
| LVH Differential Dx Part 2 | Framingham: aVL(R) > 11 mm, V4-6(R) > 25 mm, V1-V3(S) > 25 mm, V1-V2(R) & V5-V6 > 35 mm IS(R) in III > 25 mm; Romhilt & Estes: Point Score System |
| Right Ventricular Hypertrophy (RVH) | Right Axis Deviation: 110° +; R/S(V1) ration > 1; V1(R) < 7 mm; V1(S) < 2 mm; qR in V1; rSR' in V1 w/R' > 10 mm |
| RVH Differential Dx Part 1 | Pulmonary Stenosis, Mitral Stenosis, Ventricular Septal Defect, Atrial Septal Defect, Pulmonary Hypertension (COPD, Pulmonary Emboli, Sleep Apnea, Interstitial Lung Disease |
| RVH Differential Dx Part 2 | Causes large R wave in LEAD V1: Posterior Infarct, Muscular Dystrophy, Type A Wolf-Parkinson-White Syndrome, Right Bundle Branch Block |
| Biventricular Hypertrophy | Dx - One or more criteria for RVH or LVH; LVH in PRECORDIAL LEADS axis > 90° |
| Ventricular Strain Pattern |
Created by:
TreyDoc
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