Presentation
Presentation See also the separate Heart Auscultation and Heart Murmurs in Children articles. Detection requires careful evaluation, as it is almost always associated with left-sided valve lesions that dominate the presentation. [patient.info]
Medical therapy, including oral anticoagulation for atrial fibrillation, was initiated, with good response, and the patient’s condition remained stable 1 year after presentation. [nejm.org]
In line with these results, in the present study, patients with HCM who presented with AF at initial diagnosis showed the most pronounced LA dilatation. [medsci.org]
Furthermore, patients presenting with RAE often demonstrate ECG changes associated with right ventricular hypertrophy as well. [meds.queensu.ca]
A prominent left parasternal heave was present. His 12-lead electrocardiogram is shown in Figure 1. Figure 1. [mdedge.com]
Entire Body System
- Amyloidosis
Pericardium Pericarditis Acute Chronic / Constrictive Pericardial effusion Cardiac tamponade Hemopericardium Myocardium Myocarditis Chagas disease Cardiomyopathy Dilated Alcoholic Hypertrophic Tachycardia-induced Restrictive Loeffler endocarditis Cardiac amyloidosis [en.wikipedia.org]
[…] hormone副腎ホルモン adrenaline (= epinephrine)アドレナリン(=エピネフリン) adverse effect副作用、有害効果、逆効果 aerobic metabolism好気性(的)代謝 afterload後負荷 air embolism空気塞栓[症] akinesia[s]壁運動消失、アカイネジア(シス) aldosteroneアルドステロン alkalosisアルカローシス ambulatory blood pressure monitoring携帯型血圧記録 amyloidosis [tokyo-med.ac.jp]
- Leg Swelling
Other symptoms may include wheezing, bluish-colored or clammy skin, rapid or irregular heartbeat, fainting or feeling lightheaded, leg swelling, sweating excessively and weak pulse. [healthguideinfo.com]
Respiratoric
- Pleural Effusion
Fluid also leaks into the pleural spaces, causing pleural effusions. [radiologymasterclass.co.uk]
CXR: shows marked cardiomegaly with right heart enlargement, and pleural effusions. Ascites with diaphragmatic elevation may be present. Pulmonary arterial and venous hypertension are common. [patient.info]
- Pneumonia
I had pneumonia x 4 in 2002, and was diagnosed with Chronic Asthmatic Bronchitis. I went into respiratory failure twice, and had CHF with septicemia once. [allnurses.com]
[…] image to show/hide findings Click image to align with top of page Consolidation of the lingula Poorly defined left heart border due to consolidation in the adjacent lingula Clinical information Productive cough Raised white cell count Diagnosis Lobar pneumonia [radiologymasterclass.co.uk]
Cardiovascular
- Heart Disease
Heart Diseases Also called: Cardiac diseases If you're like most people, you think that heart disease is a problem for others. But heart disease is the number one killer in the U.S. It is also a major cause of disability. [icdlist.com]
Take look here for more information about your heart: http://www.cardiac-risk-assessment.com/heart-information/anatomy-of-heart http://www.cardiac-risk-assessment.com/heart-disease-diagnosis/heart-disease-tests Some of the causes thus include: ASD (Atrial [cardiachealth.org]
ICD-10-CM Codes › I00-I99 Diseases of the circulatory system › I30-I52 Other forms of heart disease › I51- Complications and ill-defined descriptions of heart disease › Cardiomegaly 2016 2017 2018 2019 Billable/Specific Code I51.7 is a billable/specific [icd10data.com]
Following are common causes of LAE: Congestive heart failure associated with all causes including ischemic heart disease and cardiomyopathy Valvular heart disease: Aortic stenosis, aortic regurgitation, and mitral stenosis Hypertensive heart disease [humankinetics.com]
- Tachycardia
Ventricular Pre-excitation syndrome Lown–Ganong–Levine Wolff–Parkinson–White Flutter / fibrillation Atrial flutter Ventricular flutter Atrial fibrillation Familial Ventricular fibrillation Pacemaker Ectopic pacemaker / Ectopic beat Multifocal atrial tachycardia [en.wikipedia.org]
An electrocardiogram showed sinus tachycardia, right atrial enlargement, and left ventricular hypertrophy. Chest radiographs revealed mild cardiomegaly with a normal pulmonary vascular pattern. [ispub.com]
Atrial arrhythmias, such as supraventricular tachycardia (SVT), atrial flutter, or atrial fibrillation may also occur. [merckmanuals.com]
View/Print Table Table 1 ECG Findings for Which Cardiology Consultation Is Recommended Category ECG findings Comment A (normal or normal variant ECG reading) Sinus bradycardia, arrhythmia, or tachycardia These ECGs do not require further work-up unless [aafp.org]
(PSVT)発作性上室性頻拍 paroxysmal ventricular tachycardia (PVT)発作性心室頻拍 patent ductus arteriosus (PDA) 動脈管開存[症] percardial friction rub心膜摩擦音 percussion 打診[法]、叩打法〈マッサージの一法〉 percutaneous transluminal coronaryangioplasty (PTCA)経皮的冠[状][動脈]形成[術] percutaneous transluminal [tokyo-med.ac.jp]
- Hypotension
症] hypertensive heart disease高血圧性心疾患 hypertrophic cardiomyopathy (HCM) 肥大型心筋症 hypertrophic nonobstructive cardiomyopathy(HNCM)非閉塞性肥大型心筋症 hypertrophic obstructive cardiomyopathy(HOCM)閉塞性肥大型心筋症 hypertrophy肥大(厚) hypoplastic left heart syndrome 左心低形成症候群 hypotension [tokyo-med.ac.jp]
Neurologic
- Dizziness
Symptoms Of Right Atrial Enlargement a reduced ability to practice physical exercise; weakness and fatigue; feeling lightheaded or faint; dizziness and confusion; tightness or pressure in the chest; shortness of breath. [yourhealthremedy.com]
The history should include questions about the following: history of fainting or dizziness, high blood pressure, heart murmur, or other heart problems; seizures; rheumatic fever; chest pain or shortness of breath with exercise; changes in exercise tolerance [aafp.org]
Workup
Axis
- Right Axis Deviation
Wolff-Parkinson-White syndrome Left axis deviation Right axis deviation, especially in patients older than 8 years Right atrial enlargement and right axis deviation Right ventricular conduction delay and right axis deviation Second- and third-degree atrioventricular [aafp.org]
LAE & Left axis deviation (common but not needed to call LVH) [unm.edu]
Other findings in RVH include right axis deviation, taller R waves in the right precordial leads (V1-V3), and deeper S waves in the left precordials (V4-V6). The T wave is inverted in V1 (and often in V2). [madsci.com]
axis deviation Left axis deviation QT Short QT syndrome T T wave alternans ST Osborn wave ST elevation ST depression Strain pattern Cardiomegaly Ventricular hypertrophy Left Right / Cor pulmonale Atrial enlargement Left Right Athletic heart syndrome [en.wikipedia.org]
T wave inverted in V1 without bundle branch block 3. right axis deviation (by the hexaxial method) 4. deep S wave in V5 and V6 5. reverse transition (start positive in V1 and end up negative in V6) cannot have bundle branch block you can't tell if it [quizlet.com]
T Wave
- T Wave Inversion
60 ms); Right ventricular hypertrophy: R/S (QRS complex) ratio >1 in lead V 1 (green arrow) with T-wave inversion in leads V 1 and V 2, Right axis QRS complex deviation ( 110°), Delayed R wave progression in leads V 1 –V 6 ; R in lead V 1 plus S in lead [mdedge.com]
The shallow, symmetric T wave inversion in lead aVL is not abnormal as an isolated finding. Isolated T wave inversion may be normal in one or more of the following leads: III, aVR, aVL, aVF and lead V1 ( See Figure 4 in ECG Blog #9 ). [ecg-interpretation.blogspot.com]
LVH Criteria #3: Typical ST and T abnormalities: ST depression or T wave inversion (or both) in the “lateral” leads (I, L, V4-V6) LVH Criteria #4: Large leftward voltage: R wave in lead L greater than 11 mm. [madsci.com]
Abnormalities of S-T Segment and T Wave : In LVH the LV is under strain due to ischaemia and is manifested by S-T segment depression and T wave inversion in leads V5, V6, aVL and lead I. [yourarticlelibrary.com]
P Wave
- P Pulmonale
Such a P-wave is called P pulmonale because pulmonary disease is the most common cause (Figure 1). The P-wave amplitude is >2.5 mm in P pulmonale. [ecgwaves.com]
In general, left atrial enlargement is used as a synonym for p mitrale, right atrial enlargement for p pulmonale, and biatrial enlargement for p biatriale. [link.springer.com]
[…] by: Tricuspid stenosis/ pulmonary valve disease Chronic lung disease Pulmonary hypertension, primary RAH on ECG P pulmonale Inferior leads: >2.5mV V1, V2 >1.5mV P pulmonale displays as a tall, peaked wave and can often be seen throughout whole trace [thephysiologist.org]
[…] by, last update January 29, 2019 ECG Criteria of Right Atrial Enlargement Right atrial enlargement produces a peaked P wave ( P pulmonale ) with amplitude: > 2.5 mm in the inferior leads (II, III and AVF) > 1.5 mm in V1 and V2 Also known as: Right Atrial [lifeinthefastlane.com]
Traditional ECG criteria for right atrial enlargement, such as P pulmonale, have been increasingly criticized as insensitive and nonspecific. [onlinejacc.org]
- P Mitrale
This is called P mitrale, because mitral valve disease is a common cause (Figure 1). The duration of the P-wave will exceed 120 milliseconds in lead II. [ecgwaves.com]
In general, left atrial enlargement is used as a synonym for p mitrale, right atrial enlargement for p pulmonale, and biatrial enlargement for p biatriale. [link.springer.com]
Wave On EKG Right Ventricular Enlargement EKG Right Ventricular Hypertrophy ECG Right Heart Strain EKG Right Atrial Enlargement Prognosis Left Anterior Fasicular Block Work Up and Right Atrial Enlargement EKG P Mitrale ECG Hocm EKG Atrial Hypertrophy [thepinsta.com]
Left Atrial Hypertrophy, P Mitrale The P wave in lead II; The left atrial component is increased. The P wave in lead ll in left atrial hypertrophy is notched and broad. The second component may be tall. [vatandar.com]
The delayed depolarization can result in a humped or notched P wave commonly termed P mitral (this term technically refers only to a humped or notched P wave that is the result of mitral valve stenosis). [humankinetics.com]
Jugular Venous Pressure
- Prominent A-Wave
The S waves are prominent in leads V5 and V6. The amplitude of R wave is more than 5 mm in lead VI. [yourarticlelibrary.com]
For example, positioning leads V1 and V2 too high ( by 1 or 2 interspaces ) on the chest — may result in prominent P wave negativity, that in lead V1 might falsely suggest LAA ( Please see My Comment at the bottom of the page on Dr. [ecg-interpretation.blogspot.com]
Pleura
- Pleural Effusion
Fluid also leaks into the pleural spaces, causing pleural effusions. [radiologymasterclass.co.uk]
CXR: shows marked cardiomegaly with right heart enlargement, and pleural effusions. Ascites with diaphragmatic elevation may be present. Pulmonary arterial and venous hypertension are common. [patient.info]
Treatment
In the case of pulmonary diseases affecting the heart, the treatment depends on the individual disease. The general aim of treatment is to reduce the load on the heart. [wisegeekhealth.com]
If an individual suffers from atrial enlargement, then there may often be many questions regarding the causes, treatment as well as possible cures. [justanswer.com]
Treatment depends on the underlying cause and may require an operation to fix the abnormality. [cardiachealth.org]
Management Treatment of the underlying condition - eg, antibiotics for infective endocarditis. Treatment of associated arrhythmias. Management of heart failure. [patient.info]
David McManus, director of the Atrial Fibrillation Treatment Program at UMass Memorial Health Care in Massachusetts, wrote in their report. Indeed, previous studies have suggested that alcohol may be associated with atrial fibrillation. [livescience.com]
Prognosis
Prognosis Prognosis is generally good but dependent on the prognosis of the underlying disease, associated other heart abnormalities and associated arrhythmias. Tricuspid regurgitation [ 1 ] The incidence of TR is less than 1%. [patient.info]
Atrial Enlargement Electrocardiogram Right Atrial Enlargement EKG Single Hypokalemia EKG RVH EKG Left Atrial Enlargement P Wave On EKG Right Ventricular Enlargement EKG Right Ventricular Hypertrophy ECG Right Heart Strain EKG Right Atrial Enlargement Prognosis [thepinsta.com]
Moreover, both are independent estimators of worse prognosis.[ 6 ]. [en.ecgpedia.org]
The prognosis for patients whose VSDs either closed spontaneously or through surgery before the development of pulmonary vascular disease is excellent, with no exercise restrictions and normal life expectancy. [pted.org]
[…] emission tomography (PET)ポジトロン放射計断層撮影[法] potential(1)潜在性 【形】 (2)電位 precordial pain前胸[部]痛 preload前負荷 premature beat期外収縮 premature ventricular contraction心室期外収縮 pressure overload圧負荷 prevalence有病率、頻度 primary一次、原発[性] 【形】 proarrhythmia催不整脈 procedure 手技、手順、処置方法 prognosis [tokyo-med.ac.jp]
Etiology
[…] with a predominance of the positive phase (the positive component of the P-wave in V1 primarily corresponds to the activation of the right atrium) and an amplitude > 1.5 mm; Signs of right ventricular hypertrophy are frequently also seen (depending on etiology [ecgforum.com]
Epidemiology
Association Scientific Statement from the Council on Clinical Cardiology, Heart Failure and Transplantation Committee; Quality of Care and Outcomes Research and Functional Genomics and Translational Biology Interdisciplinary Working Groups; and Council on Epidemiology [medsci.org]
Pathophysiology
right atrial abnormality is suggested by a positive P wave in V 1 greater than 0.15 mV, and a terminally negative P wave greater than 40 ms in duration and greater than 0.1 mV deep supports left atrial abnormality. 3 It is well recognized that the pathophysiology [mdedge.com]
[…] systolic volume index, LA= left atrial, LGE= late gadolinium enhancement, LV= left ventricular, LVRI= left ventricular remodeling index, MAPSE = mitral annular plane systolic excursion, PWT=posterior wall thickness, SWT=septal wall thickness So far, the pathophysiological [medsci.org]
Prevention
Prevention #1 Be Physically Active Physical exercise makes blood-vessel walls more flexible and, in turn, helps prevent hardening of the arteries. [yourhealthremedy.com]
Certain drugs, such as beta-blockers, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers have been shown to prevent or partially reverse remodeling under pathologic conditions. [cvphysiology.com]
Other non-surgical management includes oxygen therapy, prevention of bacterial endocarditis and management of heart failure. [patient.info]
Statement from the Council on Clinical Cardiology, Heart Failure and Transplantation Committee; Quality of Care and Outcomes Research and Functional Genomics and Translational Biology Interdisciplinary Working Groups; and Council on Epidemiology and Prevention [medsci.org]