心房心室肥大解读.pptVIP

Atrial and ventricular enlargement Cardiac enlargement refers to either dilation (volume load) of a heart chamber or hypertrophy (pressure load) of the heart muscle. Because P wave and QRS complex present the activation of the atria and ventricles respectively. one predictable ECG effect of cardiac enlargement is an increase in the voltage or duration of the P wave and QRS complex. atrial enlargement Right atrial activation begins first. the first part of the P wave represents the activation of right atrium . The final section of the P wave represents the left atrial activation. Therefore, RAE is characterized by an increase in the initial deflection and LAE by an increase in the final deflection of the P wave. right atrial enlargement ECG criteria ① shape: tall and sharp ② amplitude of P wave ≥0.25mV , be seen best in leads II,III, avF. ③ P wave ≥0.15mV when P wave is upright, arithmetic sum≥0.20mV when P wave is biphasic. ④ the width of the P wave is normal. Common diseases: ① pulmonary disease ② congential heart disease left-atrial enlargement ECG criteria ①There is a wide P wave ,which is more than or equal to 0.12s in duration .Sometimes the P wave will have a distinctive humped or notched appearance. distance humped ≥0.04s. be seen best in leads I, II, avL. ②PR segment is shorter, the time of P wave/the time of PR segment 1.6. ③ Lead V1 sometimes shows a distinctive biphasic P wave, This biphasic P wave has a small ,initial positive deflection and a prominent, wide negative deflection.The prominent , wide negative deflection in V1 is called terminal force. |Ptf V1|≥ 0.04mms. Common diseases: ①valvular heart ②Hypertensive heart disease ③Cardiomyopathies ④Coronary artery disease Both atrial hypertrophy There is a tall, wide and notched P wave in ECG Ventricular Hypertrophy Normally, the left and right ventricles depolarize simultaneously, and the left ventricle is electrically predominant because i