EKG Page

Cardiac Hypertrophy: EKG Characteristics

General Characteristics of Hypertrophy
1. Increased amplitude of waves (positive or negative)
2. Axis shift: towards greater amount of muscle mass
3. Increased duration of waves

*Right atrial enlargement (RAE)
p-wave amplitude
tall, peaked p-waves in II, III, aVF
amplitude of p-wave > 2.5 mm
QRS vector shifted down

*Left atrial enlargement (LAE)
biphasic p-wave in V1
notched OR long p-waves (any lead)

*Right ventricular hypertrophy (RVH)
Remember that each small box is 1 mm
R-wave in V1 (equal or > 7 mm)
RAE is present
R wave progression is different
Right axis deviation is common

*Left ventricular hypertrophy (LVH)
-QRS voltage
1. R in Lead I + S in Lead III equal or > 25 mm
2. S in V1 + R in V5 or V6 equal or > 35 mm
3. ST and T-wave abnormalities
4. LAE & Left axis deviation (common but not needed to call LVH)

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