What Is Atrial Hypertrophy?

Atrial enlargement with less manifested atrial hypertrophy. Atrial enlargement causes thickening of the atrial muscle fibers, as well as the stretching and injury of the conduction beam in the room, leading to changes in the amplitude and direction of the overall vector of atrial muscle depolarization. The ECG mainly shows P wave amplitude, depolarization time and morphological changes.

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Right atrium hypertrophy

In right atrial hypertrophy, the main change of the P vector ring is a significant increase in the ring body to the front and lower right.

1.

1. PII, III, AVF0.25mV, PV1, V20.15mV.

2. P electric axis is skewed to the right, + 75 ° + 90 °.

3 The P-wave time is not extended.

4 Lead V1 R / S> 1 (without right bundle branch block). If you increase the index of lead V1 R / S> 1, the specificity of the above diagnostic indicators can be significantly increased.

1. Atrial infarction P-wave height may widen and deform during atrial infarction. However, atrial infarction is complicated by ventricular infarction, so the myocardial infarction pattern appears on the electrocardiogram. In addition, atrial infarction may show elevated PR segment or horizontal downward movement. Rare right atrial hypertrophy.

2.

ECG changes in right atrial hypertrophy must be combined with clinical considerations. If the patient has congenital heart disease (such as

Diagnosing right atrial hypertrophy according to the P wave peak and voltage increase has certain reference value. In recent years, many authors at home and abroad have made a detailed analysis and comparison of the sensitivity and specificity of right atrial hypertrophy diagnosis using echocardiography and conventional 12-lead ECG. Jeffrey equalized the comparison of 100 cases of different degrees of right atrial hypertrophy and 25 normal people in 1994, and proposed that the main ECG changes of right atrial hypertrophy should be P wave of lead V2> 0.15mV, and the QRS electrical axis on the front> + 90 ° The R / S of lead V1 is greater than 1 without right bundle branch block, with a sensitivity of 24% to 35% and a specificity of 100%. People with "pulmonary P wave" on the ECG do not necessarily have right atrial hypertrophy. In addition, when obstructive pulmonary disease (emphysema, asthma), pulmonary hypertension, congenital heart disease (atrial septal defect) and other diseases, The P wave can be normal. It can be seen that the typical "pulmonary P wave" in ECG and right atrial hypertrophy are not well correlated. Because right atrial hypertrophy is often accompanied by right ventricular hypertrophy, the diagnosis of right atrial hypertrophy should be combined with the ECG diagnosis conditions of right ventricular hypertrophy, and its sensitivity and specificity are increased.