Deck 18: Atrial Enlargement and Ventricular Hypertrophy

Question 1

Which of the following are true regarding hypertrophy?

A) It is a condition in which the ventricular muscular wall(s) become flaccid and weak.
B) It results from the ventricle having to pump against abnormally low resistance within the cardiovascular system.
C) It occurs when the chamber dilates to accommodate the increased blood.
D) Causes of hypertrophy include systemic hypertension and aortic stenosis.

Answer 1

Causes of hypertrophy include systemic hypertension and aortic stenosis.

Question 2

An enlarged heart chamber:

A) is most often seen with certain types of valvular disease.
B) occurs as the result of having to pump against increased systemic vascular resistance.
C) cannot hold as much blood as a normal chamber.
D) is smaller inside the chamber than a normal chamber.

Answer 2

is most often seen with certain types of valvular disease.

Question 3

Changes in the _________ are used to identify hypertrophy.

A) P wave
B) ST segment
C) QRS complex
D) PR interval

Answer 3

QRS complex

Question 4

Changes seen in the ECG that indicate the presence of enlargement or hypertrophy include:

A) a decrease in duration of the waveform.
B) an increase in the amplitude of the waveform.
C) axis deviation.
D) b & c

Question 5

The duration of the normal P wave is _______ seconds, while its amplitude should not exceed _______ mm.

A) 0.04 to 0.12, 2.0
B) less than 0.10, 2.5
C) 0.06 to 0.10, 2.5
D) 0.06 to 0.08, 3.5

Question 6

An indicator of right atrial enlargement is a/an:

A) negative or downward deflecting P wave.
B) inverted P wave.
C) increase in the width of the P wave.
D) increase in the amplitude of the first part of the P wave.

Question 7

The P wave changes in right atrial enlargement are termed:

A) P mitrale
B) P pulmonale
C) P mega
D) P delta

Question 8

A/an __________ is an indicator of left atrial enlargement.

A) negative or downward deflecting P wave
B) increase in the amplitude of the terminal portion of the P wave
C) decrease in the duration of the P wave
D) increase in the amplitude of the first part of the P wave

Question 9

The P wave changes in left atrial enlargement are termed:

A) P mitrale
B) P pulmonale
C) P mega
D) P delta

Question 10

Normally, in lead V1 the QRS complexes:

A) have very short R waves with much larger S waves.
B) have a tall R wave and a short S wave.
C) are biphasic.
D) are mostly upright and notched.

Question 11

Moving from the right to the left chest leads the R waves

A) go from smaller to larger
B) remain about the same size
C) go from smaller to biphasic
D) go from larger to smaller

Question 12

Moving from the right to the left chest leads the S waves

A) go from smaller to larger
B) remain about the same size
C) go from smaller to biphasic
D) go from larger to smaller

Question 13

The QRS complex is normally ______ seconds in duration and the mean QRS axis lies between __________.

A) greater than 0.12, +90F $\degree$ and +180 $\degree$
B) less than 0.10, 0 $\degree$ and +90 $\degree$
C) less than 0.10, 0 $\degree$ and +30 $\degree$
D) between 0.12 and 0.20, 0 $\degree$ and +90 $\degree$

Question 14

In the precordial leads, right ventricular hypertrophy causes the R waves to be equal to or ________ than the S waves in the leads that lie closer to lead ____.

A) larger, V1
B) larger, V6
C) smaller, V3
D) smaller, V1

Question 15

In right ventricular hypertrophy the QRS axis falls between ____ and ______ degrees

A) 0, + 90
B) + 90, - 180
C) 0, -90
D) -90, - 180

Question 16

In the precordial leads, left ventricular hypertrophy causes the R waves to be ________ in the leads that lie closer to lead ____.

A) larger, V1
B) larger, V6
C) smaller, V3
D) smaller, V1

Question 17

Increased S wave amplitude in V1, V2 along with increased R wave amplitude in V5, V6 indicate:

A) preexcitation syndrome.
B) left bundle branch block.
C) right ventricular hypertrophy.
D) left ventricular hypertrophy.

Question 18

Secondary repolarization abnormalities seen with severe hypertrophy include:

A) elevated ST segments.
B) T wave inversion.
C) down-sloping ST segment depression.
D) b and c

Question 19

Secondary repolarization abnormalities associated with severe left ventricular hypertrophy are best seen in leads:

A) V1, V2
B) V3, V4
C) V5, V6
D) I, II, and III

Question 20

Left atrial enlargement can result from mitral insufficiency.

Question 21

Enlargement and hypertrophy often exist together as both are ways in which the heart tries to increase its cardiac output.

Question 22

The ECG is a useful tool for distinguishing between hypertrophy and enlargement.

Question 23

Leads I and aVF provide the necessary information to assess atrial enlargement.

Question 24

The term biphasic means that a waveform has both a positive and negative deflection.

Question 25

In lead V1, normal P waves can have both a positive and negative deflection.

Question 26

Right ventricular hypertrophy is far more common than left ventricular hypertrophy.

Question 27

It is the limb leads that are mainly used to identify ventricular hypertrophy.

Question 28

In the limb leads, the most common characteristic seen with right ventricular hypertrophy is left axis deviation.

Question 29

Both the right and left ventricles can be hypertrophied in some patients.