Heart Anatomy – ECG Changes
Left Ventricular Hypertrophy (LVH)
Left Atrial Enlargement (P-mitrale)
– Biphasic P wave in V1 with negative portion > 40 ms
Right Atrial Enlargement (P-pulmonale)
– Peaked P wave in lead V1 > 1.5 mm
Right ventricular hypertrophy (RVH)
– R > S in V1, R in V1 >=6 mm
– Dominant S wave in V5 or V6, S in V5 >=10 mm, S in V6 >=3 mm
– R in aVR >=4 mm
Biatrial Enlargement
– The P wave is more than 0.04 seconds in duration
– The positive initial part of the P wave is > 1.5 mm and the negative terminal part of the P wave is > 1 mm
– Notched P waves with duration > 120 ms in limb leads, V5 or V6
– Bifid P wave in lead II with duration > 120 ms and increased amplitude of > 2.5 mm”
Left Ventricular Aneurysm
- Persistent ST elevation seen > 2 weeks after an MI
- Commonly seen in precordial leads
- Associated with Q waves indicating infarct pattern
- Inverted T waves can be seen