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The preferred technique is the trans-oesophageal approach giving a view of 4 chambers. The normal thickness of a right ventricular free wall ranges from 2-5 millimetres, with a value above 5 mm considered to be hypertrophic. [10]
The electrical axis of the heart is the net direction in which the wave of depolarization travels. It is measured using an electrocardiogram (ECG).Normally, this begins at the sinoatrial node (SA node); from here the wave of depolarisation travels down to the apex of the heart.
Specifically, an increase in Q wave size, abnormalities in the P wave, as well as giant inverted T waves, are indicative of significant concentric hypertrophy. [13] Specific changes in repolarization and depolarization events are indicative of different underlying causes of hypertrophy and can assist in the appropriate management of the condition.
Normal T wave. In electrocardiography, the T wave represents the repolarization of the ventricles. The interval from the beginning of the QRS complex to the apex of the T wave is referred to as the absolute refractory period. The last half of the T wave is referred to as the relative refractory period or vulnerable period.
According to V. Gorshkov-Cantacuzene: "The U wave is the momentum carried by the blood in the coronary arteries and blood vessels". [4] [5] [6]The resistivity of stationary blood is expressed as () = | (+), where is a coefficient, and is the hematocrit; at that time, as during acceleration of the blood flow occurs a sharp decrease in the longitudinal resistance with small relaxation times.
Normal heart (left) and right ventricular hypertrophy (right) Investigations available to determine the cause of cor pulmonale include the following: [1] Chest x-ray – right ventricular hypertrophy, right atrial dilatation, prominent pulmonary artery; ECG – right ventricular hypertrophy, dysrhythmia, P pulmonale (characteristic peaked P wave)
Peaked P waves (> 0.25 mV) suggest right atrial enlargement, cor pulmonale, (P pulmonale rhythm), [1] but have a low predictive value (~20%). [2] A P wave with increased amplitude can indicate hypokalemia. [3] It can also indicate right atrial enlargement. [4] A P wave with decreased amplitude can indicate hyperkalemia. [5]
When normal, the RV is about half the size of the left ventricle (LV). When strained, it can be as large as or larger than the LV. [5] An important potential finding with echo is McConnell's sign, where only the RV apex wall contracts; [7] it is specific for right heart strain and typically indicates a large PE. [8]