atrial and ventricular enlargement课件

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1、AtrialandVentricularEnlargementChapter6WebSiteInstructionhttp://www.madsci.com/manu/ekg_hypr.htmhttp://library.med.utah.edu/kw/ecg/ecg_outline/Lesson7/index.htmlhttp://library.med.utah.edu/kw/ecg/ecg_outline/Lesson8/index.htmlCardiacEnlargementDilationstretchede.g.congestivehe

2、artfailureHypertrophyincreasesizeofheartmusclefiberse.g.aorticstenosisCardiacEnlargementIncreaseamount/areaofcardiactissueHowwouldthisaffectdepolarization?HowcouldthataffectanECG?RightAtrialAbnormalityOverloadoftherightatriadilationhypertrophyalsoknownasPpulmonaleHowwouldthisc

3、hangethePwave?RightAtrialAbnormalityRightAtrialAbnormalityNormalPwaveislessthan2.5mmtalland0.12secondswide.Withrightatrialhypertrophy,Pwavesaretypicallytallerthan2.5mmbutnotwiderthan0.12sec.RightAtrialAbnormalityCriteriaTallPwavesinleadII(orIII,aVFandsometimesV1)RightAtrialAbn

4、ormalityCauses:PulmonarydiseaseCongenitalheartdiseaseLeftAtrialAbnormalityAlsoknownasPmitraleLeftatrianormallydepolarizesaftertherightatria.HowwouldthisaffectthePwave?wider;leftatrialenlargementshouldprolongthePwave>0.12sec.LeftAtrialAbnormalityLeftAtrialAbnormalityII:widePwav

5、eV1:negativePwaveis“1boxwide,1boxdeep”AtrialEnlargementLeftAtrialAbnormalityLeadII(andI)showwidePwaves(secondhumpduetodelayeddepolarizationoftheleftatrium)(Pmitrale:mitralvalvedisease)V1mayshowabi-phasicPwave1boxwide,1boxdeep(biphasicsincerightatriaisanteriortotheleftatria)Lef

6、tAtrialAbnormalityCauses:Valvedisease(mitralandaortic)HypertensiveheartdiseaseCardiomyopathiesCoronaryarterydiseaseVentricularHypertrophyFrontalPlaneTransversePlane12LeadsV1?V1?V6?V6?Fig.4-6NormalQRSNormalQRSRightVentricularHypertrophyWhatdoyouthinkwillhappentotheECGwithventri

7、cularhypertrophy?RightVentricularHypertrophyConsiderrightventricularhypertrophyandV1HowwouldV1bedifferent?NormalHypertrophyRightVentricularHypertrophyRightVentricularHypertrophyCriteriaInV1,RwaveisgreaterthantheSwave-or-RinV1greaterthan7mmRightaxisdeviationInV1,Twaveinversion(

8、reasonunknown)SwavesinV5andV6RightVentricularHypertrophyCause