CMDT Media Library | AccessMedicine | McGraw Hill Medical

Skip to Main Content

1-8 of 8 Results

eFigure 13–1. Left ventricular hypertrophy. Six E C G tracings show the patterns observed in left ventricular hypertrophy.

Current Medical Diagnosis & Treatment 2024 > Approach to Hypertension

View in Context

eFigure 10–16. LVH with left (superior) axis deviation. The mean frontal plane QRS axis is –45 degrees, suggesting the possibility of coexisting left anterior fascicular block. The R wave of 24 mm in aVL, however, strongly suggests (but does not prove) the presence of LVH. ST-segment depression and T wave inversion are present in aVL, and T wave inversion is present in V4–6. Precordial lead voltage criteria for LVH are not met. This may be due to the superior axis, as a result of which the lead axes of V5–6 are far removed from the mean QRS vector. LVH was confirmed at autopsy examination. (Reproduced with permission from Goldschlager N, Goldman MJ. Principles of Clinical Electrocardiography, 13th ed. Appleton & Lange: The McGraw-Hill LLC Companies Inc, 1989.) Two electrocardiograph tracings show the patterns observed in left and right ventricular hypertrophy

Current Medical Diagnosis & Treatment 2024 > Coarctation of the Aorta

View in Context

eFigure 10–24. The ECG is from a 33-year-old man with a large ventricular septal defect and moderately severe pulmonary hypertension. The right axis deviation (+115 degrees) and the tall R waves in leads V1 and V2 reflect the RVH, while the deep S waves in leads V2 and V3 and the well preserved R waves in leads V5 and V6 reflect the LVH. This ECG pattern, with the large equiphasic QRS complexes in the mid precordial leads, is characteristic of the biventricular hypertrophy that accompanies ventricular septal defects and is referred to as the Katz-Wachtel pattern. Reproduced with permission from Leonard S. Gettes, MD. https://www.understandingecg.com. An electrocardiograph tracing from a patient with biventricular hypertrophy.

Current Medical Diagnosis & Treatment 2024 > Ventricular Septal Defect

View in Context

eFigure 10–25. LVH. The mean frontal plane QRS axis is –15 degrees. The R wave exceeds 15 mm in aVL, and the sum of the S wave in V1 and the R wave in V5 exceeds 35 mm. ST-segment depression is present in leads I and aVL, and T wave inversion is present in I, aVL, and V5-6. The deep S waves in the right precordial leads reflect the large electrical force generated by the hypertrophied LV. The ST-segment elevation in V1-2 is consistent with LVH. (Reproduced with permission from Goldschlager N, Goldman MJ. Principles of Clinical Electrocardiography, 13th ed. Appleton & Lange: The McGraw-Hill LLC Companies Inc, 1989.) Two electrocardiograph tracings show the patterns observed in left and right ventricular hypertrophy

Current Medical Diagnosis & Treatment 2024 > Patent Ductus Arteriosus

View in Context

eFigure 10–30. Aortic stenosis. A: Drawing of the left heart in left anterior oblique view showing anatomic features of aortic stenosis. Note structures enlarged: LV (thickened); poststenotic dilation of the aorta. (Reproduced, with permission, from Hammer GD, McPhee SJ. Pathophysiology of Disease, 8th ed. McGraw-Hill, 2019.) B: Drawing showing auscultatory and hemodynamic features of predominant aortic stenosis. Cardinal features include LVH and systolic ejection murmur. (EC, ejection click; SM, systolic murmur; P, pulmonary valve; A, aortic valve.) (Reproduced with permission from Cheitlin MD et al, eds. Clinical Cardiology, 6th ed. Appleton & Lange: The McGraw-Hill Companies Inc, 1993.) C: Pressure–volume loop in aortic stenosis. The LV becomes thickened and less compliant, forcing the diastolic pressure-volume curve upward, which results in elevated LVEDP (a′). Because the LV must pump against a fixed gradient (increased afterload), b increases to b′. Finally, the hypertrophy of the ventricle results in increased inotropic force, which shifts the isovolumic pressure curve leftward. A three-part illustration depicts the hemodynamic changes in aortic stenosis. A chest x ray reveals an enlargement of the heart in the lower quadrant, resulting from aortic stenosis.

Current Medical Diagnosis & Treatment 2024 > Aortic Stenosis

View in Context

eFigure 10–30. Aortic stenosis. A: Drawing of the left heart in left anterior oblique view showing anatomic features of aortic stenosis. Note structures enlarged: LV (thickened); poststenotic dilation of the aorta. (Reproduced, with permission, from Hammer GD, McPhee SJ. Pathophysiology of Disease, 8th ed. McGraw-Hill, 2019.) B: Drawing showing auscultatory and hemodynamic features of predominant aortic stenosis. Cardinal features include LVH and systolic ejection murmur. (EC, ejection click; SM, systolic murmur; P, pulmonary valve; A, aortic valve.) (Reproduced with permission from Cheitlin MD et al, eds. Clinical Cardiology, 6th ed. Appleton & Lange: The McGraw-Hill Companies Inc, 1993.) C: Pressure–volume loop in aortic stenosis. The LV becomes thickened and less compliant, forcing the diastolic pressure-volume curve upward, which results in elevated LVEDP (a′). Because the LV must pump against a fixed gradient (increased afterload), b increases to b′. Finally, the hypertrophy of the ventricle results in increased inotropic force, which shifts the isovolumic pressure curve leftward. A three-part illustration depicts the hemodynamic changes in aortic stenosis. A chest x ray reveals an enlargement of the heart in the lower quadrant, resulting from aortic stenosis.

Current Medical Diagnosis & Treatment 2024 > Aortic Stenosis

View in Context

eFigure 11–7. Classic asymmetric LVH in hypertrophic cardiomyopathy (HCM). Marked hypertrophy (*) of the interventricular septum is noted on both echocardiography (upper panel) and cardiac MRI (lower panel). (Reproduced, with permission, from Baliga RR, Abraham WT. Color Atlas and Synopsis of Heart Failure. 2018.) Echocardiography and cardiac magnetic resonance images show classic asymmetric left ventricular hypertrophy (LVH) in hypertrophic cardiomyopathy (HCM).

Current Medical Diagnosis & Treatment 2024 > Hypertrophic Cardiomyopathy

View in Context

eFigure 11–8. Cardiac amyloidosis on cardiac MRI. The axial images of the chest demonstrate the constellation of biatrial enlargement, concentric LVH and RVH, a small pericardial, and bilateral pleural effusions (green asterisk) (A). There is extensive global subendocardial late gadolinium enhancement (B), a pattern that is rarely seen in hypertrophic cardiomyopathy (HCM). (Reproduced, with permission, from Baliga RR, Abraham WT. Color Atlas and Synopsis of Heart Failure. 2018.) Cardiac magnetic resonance (CMR) images of cardiac amyloidosis.

Current Medical Diagnosis & Treatment 2024 > Restrictive Cardiomyopathy

View in Context