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Left ventricular hypertrophy with secondary repolarization abnormalities as seen on ECG Histopathology of (a) normal myocardium and (b) myocardial hypertrophy. Scale bar indicates 50 μm. Gross pathology of left ventricular hypertrophy. Left ventricle is at right in image, serially sectioned from apex to near base.
The clinician must therefore be well versed in recognizing the so-called ECG mimics of acute myocardial infarction, which include left ventricular hypertrophy, left bundle branch block, paced rhythm, early repolarization, pericarditis, hyperkalemia, and ventricular aneurysm. [7] [8] [9] Localisation of the occlusion in the ECG showing STEMI changes
Left Ventricular Hypertrophy. Left ventricular hypertrophy (LVH) is an increase in the thickness and mass of the myocardium. This could be a normal reversible response to cardiovascular conditioning (athletic heart) or an abnormal irreversible response to chronically increased volume load (preload) or increased pressure load (afterload).
An unusually tall QRS complex may represent left ventricular hypertrophy while a very low-amplitude QRS complex may represent a pericardial effusion or infiltrative myocardial disease. 80 to 100 ms J-point: The J-point is the point at which the QRS complex finishes and the ST segment begins. The J-point may be elevated as a normal variant.
The diagnosis of left ventricular outflow tract obstruction is usually made by echocardiographic assessment and is defined as a peak left ventricular outflow tract gradient of ≥ 30 mmHg. [37] Another, non-obstructive variant of HCM is apical hypertrophic cardiomyopathy (AHCM or ApHCM), [39] also called Yamaguchi syndrome.
Ventricular hypertrophy can result from a variety of conditions, both adaptive and maladaptive. For example, it occurs in what is regarded as a physiologic, adaptive process in pregnancy in response to increased blood volume; but can also occur as a consequence of ventricular remodeling following a heart attack .
Ventricular remodeling may include ventricular hypertrophy, ventricular dilation, cardiomegaly, and other changes. It is an aspect of cardiomyopathy, of which there are many types. Concentric hypertrophy is due to pressure overload, while eccentric hypertrophy is due to volume overload. [6]
Sgarbossa's criteria are a set of electrocardiographic findings generally used to identify myocardial infarction (also called acute myocardial infarction or a "heart attack") in the presence of a left bundle branch block (LBBB) or a ventricular paced rhythm. [1] Myocardial infarction (MI) is often difficult to detect when LBBB is present on ECG ...
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