EASY WAY TO REMEMBER : RIGHT VENTRICULAR HYPERTROPHY (RVH)

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RIGHT VENTRICULAR HYPERTROPHY BASICS


ECG CHANGES IN RIGHT VENTRICULAR HYPERTROPHY (RVH)

SIMPLE CONCEPT:

1. RIGHT AXIS DEVIATION.

2. TALL R-WAVE IN RIGHT VENTRICLE LEADS.

3. DEEP S-WAVE IN LEFT VENTRICLE LEADS.










OVERVIEW:

RVH IS BEST SEEN IN THE RIGHT VENTRICULAR LEADS (ESPECIALLY V1).

SINCE, THE LEFT VENTRICLE DOES NOT HAVE ITS USUAL DOMINANT EFFECT ON THE QRS SHAPE, THE COMPLEX IN LEAD V1 BECOMES UPRIGHT ( i.e. THE HEIGHT OF THE R-WAVE EXCEEDS THE DEPTH OF THE S-WAVE) . THIS IS NEARLY ALWAYS ABNORMAL. 

THERE WILL BE A DEEP S-WAVE IN LEAD V6. 

RIGHT VENTRICULAR HYPERTROPHY IS USUALLY ACCOMPANIED BY RIGHT AXIS DEVIATION, BY A PEAK P-WAVE ( RIGHT ATRIAL HYPERTROPHY), AND IN SEVERE CASES BY INVERSION OF THE T-WAVES IN LEADS V1-V4 AND LEADS 2,3 AND aVf.



NOTE: 1) SINUS RHYTHM , RIGHT AXIS DEVIATION .

             2) DOMINANT R-WAVES IN LEAD V1.

             3) DEEP S-WAVES IN LEAD V6.

             4) INVERTED T-WAVES IN LEADS 2,3 aVf, AND V1-V3

             5) FLAT T-WAVES IN LEADS V4-V5.



             

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