ECG changes in chamber

enlargement
NURSHAHIRA NADHIRAH BINTI
SHAH HIRAN
0300548

Heart chambers

Left ventricular hypertrophy

Cause: Increased in left ventricular
workload
General ECG features:
- The QRS complex becomes larger (tall Rwave in LV lead, deep S-wave in RV lead)
The Sokolow-Lyon
Criteria:
R in V5 or V6 + S in V1
>35 mm.

- strain pattern = ST depression in

lead V5-V6

- Leftward shift in frontal plane QRS

axis

Left axis
deviation

Management of LVH
1. Blood pressure control and
consultations
2. Lifestyle modifications
3. Pharmacotherapy with antihypertensive medications
4. Aortic valve repair in aortic stenosis

Right ventricular
hypertrophy
Causes: lung disease and congenital
heart disease
General ECG changes
- Right axis deviation

- Dominant R-wave
R/S ratio in V1 or V3R > 1, or R/S ratio in V5 or V6
<= 1
R wave in V1 >= 7 mm
R wave in V1 + S wave in V5 or V6 > 10.5 mm

Management of RVH
Treat the underlying cause
Medications for symptoms relief
- Drugs like beta-blockers, ACE
inhibitors, angiotensin receptor
blockers, diuretics, and digoxin may be
prescribed.

Left atrial hypertrophy

Cause: backflow of blood from LV to
LA
General ECG changes
- P wave with a broad (>0.04 sec or 1
small square) and deeply negative (>1
mm) terminal part in V1
- P wave duration >0.12 sec in leads I
and / or II

Management of LAH
Depends on the causes
- Mitral regurgitation may need
surgery to replace the valve
- Hypertension needs antihypertensive medications
- Congestive cardiac failure needs
diuretics and ACE-I

Right atrial hypertrophy

Cause: increased pressure in
pulmonary artery
General ECG changes
- P >2.5 mm in II / III and / or aVF
- P >1.5 mm in V1.

Management of RAH

Treat the underlying causes

Anti-hypertensive medications
Anticoagulants
Anti-arrhythmia

Thank you