Hypertrophy

Question 1

criteria for LAE

Answer 1

• P wave > 0.12 sec w/ terminal portion > 0.04 sec
• Terminal portion of P wave in V1 > 1 mm below

Question 1

criteria for RAE

Answer 1

• P wave > 2.5 mm in Inferior lead (II, III, aVF)
• Normal P wave: < 0.12 sec and < 2.5 mm

Question 2

what makes a normal QRS?

Answer 2

• Axis between 0 and 90
• R wave progression in precordial leads

Question 3

criteria for RVH

Answer 3

1. Limb Lead Criteria:
   - RAD
   - Negative QRS in L leads (I, aVL)
2. Chest Lead Criteria:
   - V1 - R wave > S wave
   - V6 - S wave > R wave

Question 4

criteria for LVH

Answer 4

1. Limb Lead Criteria:
   - aVL - R >11 mm
2. Chest Lead Criteria:
   - (V5/V6) R + (V1/V2) S = >35 mm

Question 5

what is the exception with LVH?

Answer 5

• Not accurate in < 35 y/o
• Only changes amplitude of ventricular depolarization, not timing
• Can also present with secondary repolarization abnormalities - Downsloping ST segment depression, T-wave inversion
• If pt presents with abnormal repolarization with LVH = GET ECHO

Question 6

how does an abnormal repolarization look like?

Answer 6

asymmetrical, downslope of T wave