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ECG of the Enlarged Heart. The Cardiac Cycle. Know this. During examination V follows S2 and should be Visible with elevated JVP. Mitral Regurg. Aortic Regurg. Mitral Stenosis. Aortic Stenosis. What are the features of this ECG. Relations of ECG leads. aVR RV.
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Know this During examination V follows S2 and should be Visible with elevated JVP
Relations of ECG leads aVR RV
Characteristics of normal QRS complex • Width : 3 small squares or less • In Lead V1, the depth of S wave is > than the height of R wave • In Lead V5,V6, the height of R wave is always < 25mm • In the left ventricular leads (V5, V6), presence of a septal Q wave is normal
Features of Left Ventricular Hypertrophy • Left axis deviation (look at inferior leads III or AVF) • Tall R waves in lateral LV leads (aVL, V, VI - but not V/VI in a grossly enlarged heart) • Deep S in septal/RV leads(III, V1 & V2) • Delayed intrinsicoid deflection> 0.05s • Strain pattern • ST-T abnormalities
ESTES Criteria for LVH ("diagnostic", >5 points; "probable", 4 points) ESTES Criteria for LVH ("diagnostic", >5 points; "probable", 4 points)
RV Hypertrophy • Right axis deviation • Tall R-waves in RV leads (look at aVR) • Deep S-waves in LV leads • ST-T changes