EKG - LVH

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Presentation Description

Gambaran LVH pada EKG sangat penting dalam penilaian klinis, sehingga LVH ini perlu dinilai dengan pemeriksaan EKG untuk menetukan langkah penatalaksanaan selanjutnya. Kemampuan dalam pembacaac EKG perlu ditingkatkan terus, dengan demikian akan mendapatkan hasil yang akurat.

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Presentation Transcript

CHAMBER ENLARGEMENT : 

1 CHAMBER ENLARGEMENT Marriott’s Practical Electrocardiography 10th Edition, 2001 And Braunwald’s Heart Disease A Texbook of Cardiovascular Medicine, 7th Edition, 2005

Chamber Enlargement : 

2 Chamber Enlargement Volume overload  diastolic overload  dilation Pressure overload  systolic overload  hypertrophy

Slide 3: 

3 Atrial Enlargement Right atrial enlargement Left atrial enlargement

Systematic approach to the evaluation of Atrial Enlargement : 

4 Examine the contour of the P wave Measure the duration of the P wave Measure the maximal amplitudo of the P wave Estimate the axes of the P waves Systematic approach to the evaluation of Atrial Enlargement

Slide 5: 

5

Slide 6: 

6 RAE is characterized by : P pulmonale in lead II Biphasic P (the initial positive portion) in lead V1

Slide 7: 

7 Diagnostic criteria for LAE : P mitrale in lead II Biphasic P (the terminal negative portion) in lead V1

Slide 8: 

8

The changes in P-wave morphology typical of atrial enlargement as they appear in leads II and V1 : 

9 The changes in P-wave morphology typical of atrial enlargement as they appear in leads II and V1

Slide 10: 

10

Slide 11: 

11 Twelve-lead ECGs from a 23-year old intravenous drug addict with tricuspid valve disease (A)

Slide 12: 

12 Twelve-lead ECGs from a 68-year-old man with aortic valve disease (B)

Systematic approach to the evaluation of Ventricular Enlargement : 

13 Examine the contour of the QRS complex Measure the duration of the QRS complex Measure the maximal amplitudo of the QRS complex Estimate the axes of the QRS complex Systematic approach to the evaluation of Ventricular Enlargement

Slide 14: 

14 Sokolow-Lyon Criteria for RVH

Butler-Leggett Formula for RVH : 

15 Butler-Leggett Formula for RVH

Slide 16: 

16 Cornell Voltage Criteria for LVH

Slide 17: 

17 Sokolow-Lyon Criteria for LVH

Romhilt-Estes Scoring System for LVH : 

18 Romhilt-Estes Scoring System for LVH LVH = 5 points Probable LVH = 4 points

Slide 19: 

19

Slide 20: 

20

Slide 21: 

21 The changes in the sizes of the right-ventricular (RV) and left-ventricular (LV) myocardium produced by increases in volume overload caused by regurgitation of some of the already ejected blood (thick upward arrow) back through a leaking outflow valve (thin downward arrow) (A); and pressure overload caused by obstruction to ejection (thin upward arrow) through a narrowed outflow valve (B)

Slide 22: 

22 The changes in the QRS complex typical of ventricular enlargement as they appear in leads I and V1. A. Normal, B. Left-ventricular enlargement (LVE), C. right-ventricular enlargement (RVE), D. Biventricular enlargement (LVE + RVE)

Slide 23: 

23 Twelve-lead ECG from a 53-year old woman with chronic obstructive lung disease

Slide 24: 

24 Twelve-lead ECG from a 59-year old man with severe chronic obstructive lung disease

Slide 25: 

25 Twelve-lead ECG from an 18-year old man with congenital heart disease and pulmonary hypertension

Slide 26: 

26 Twelve-lead ECG from a 67-year-old man with aortic valve regurgitation

Slide 27: 

27 Twelve-lead ECG from a 70-year-old man with severe aortic valve stenosis just prior to surgical replacement

Slide 28: 

28 Twelve-lead ECG from a 40-year-old man with both systemic and pulmonary hypertension

Silakan Kunjungi : : 

29 Silakan Kunjungi : http://www.jantunghipertensi.com Semua masalah jantung ada disini Dr.Edial Sanif SpJP,FIHA