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Discuss whether it is possible to have Right Atrial Enlargement (RAE) with Left Ventricular Hypertrophy (LVH)....

Discuss whether it is possible to have Right Atrial Enlargement (RAE) with Left Ventricular Hypertrophy (LVH). What is strain pattern? Show an ECG containing this finding.

Is it possible to diagnose ischemic changes in the presence of Left Bundle Branch Block (LBBB)? Why or why not?

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Answer #1

1. Right atrial enlargement is that which is classified under Right atrial hypertrophy caused either due to pulmonary hypertension, tricuspid stenosis, Fallot tetralogy etc. On Right Atrial enlargement, the amplitude of P wave is exaggerated due to close proximity to SA node. A similar pattern can be seen in Left ventricular hypertrophy also.

2. It is called as p- pulmonale which indicates acute RA strain.

3.

4. ST segments and T waves in a discordant direction and ECG - ST segment changes during ischaemia. A new LBBB is always pathological and can be a sign of myocardial infarction

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