SlideShare una empresa de Scribd logo
1 de 22
Descargar para leer sin conexión
BY DR.UZMA TALIB


Defination:



Left ventricular hypertrophy is defined as an increase in the
mass of the left ventricle, which can be secondary to an
increase in wall thickness, an increase in cavity size, or both



Causes:



Hypertension
Hypertrophic cardiomyopathy
Aortic stenosis
Athelitic training














Risk factors for left ventricular hypertrophy include the
following:
Age
Gender
High blood pressure, a blood pressure reading greater than
140/90 mm Hg, is the greatest risk factor.
Aortic stenosis, narrowing of the main valve through which
blood leaves the heart, may increase the left ventricle's
workload.
Obesity can cause high blood pressure and increase your
body's demand for oxygen, factors that may lead to left
ventricular hypertrophy.
Genetic factor


 The development of LVH is a relatively early response to
hypertension,



Ambulatory BP monitoring has suggested that there may be two additional
risk factors for LVH:
The daily BP load (the percentage of pressures above 135/85 during the day
and 120/80 mmHg at night
Nocturnal hypertension (in which the expected nighttime reduction in BP is
not seen)



maximal daytime blood pressure or peak exercise blood
pressure are most predictive of the level of hypertrophy .
There is also evidence that left ventricular mass may be
increased prior to the development of overt hypertension.


High BP → ↑ LV wall stress
Wall stress ∝ 1/ wall thickness
LV wall thickening → ↓ wall stress
Myocyte hypertrophy and ↑ collagen matrix


.The same factors, such as angiotensin II, norepinephrine,
epinephrine, increased peripheral and cardiac sympathetic
drive and endothelin, promote both hypertension and LVH.
The tendency to LVH may be an inherited trait that
predisposes to the development of hypertension
› To diagnose LVH you can use the following criteria*:

 avL

R in V5 (or V6) + S in V1 (or V2) > 35 mm, or
R > 13 mm
Symptoms:










Shortness of breath
Chest pain
palpitations
Dizziness
Fainting
Rapid exhaustion with physical activity
Fatigue
Syncope
Some time patient shows no symptoms
Signs:







•
•
•

systolic murmur best heard between the apex and
left sternal border
- increases in intensity with maneuvers that
decrease preload (Valsalva, squatting to
standing position).
- does not radiate to the carotid arteries
sustained apical impulse
S4
bisferiens pulse (carotids, femoral arteries)







Complications that can occur as a result of these problems
include:
Inability of your heart to pump enough blood to your body
(heart failure)
Abnormal heart rhythm (arrhythmia)
Insufficient supply of oxygen to the heart (ischemic heart
disease)
Interruption of blood supply to the heart (heart attack)
Sudden, unexpected loss of heart function, breathing and
consciousness (sudden cardiac arrest)
Defination:



right ventricular hypertrophy is the enlargement of heart’s
right ventricle
Right ventricular hypertrophy, or simply RVH, is considered to
be one of the rare diseases of the heart. Unlike the left
ventricle, which tends to overwork itself when it detects
abnormalities, the right ventricle dilutes itself. This is the
reason why left ventricular hypertrophy is way more common
than right ventricular hypertrophy.








Pulmonary hypertension
Fallot tetralogy
Pulmonary valve stenosis
Ventricular septal defect (VSD)
High altitude
Cardiac fibrosis
Chronic obstructive pulmonary disease (COPD)







Chest pain and tightness
Palpitation
Dizziness
Loss of consciousness
Light headedness
Edema of feet,leg,ankle
To diagnose RVH you can use the following criteria:

 V1

Right axis deviation, and
R wave > 7mm tall





POTASSIUM
MAGNESIUM
CALCIUM


Hyperkalemia
Hypokalemia



Hyperkalemia: affects Na channels and causes



depolarizaion .
Na channels inactivate and refractory.
Ventricular fibrillation and asystole.
At the same time increases activity of potassium
channels and increases memb. repolarization.

Causes:
Renal insufficiency
Medication
Blood transfusion, Massive hemolysis
Addison's disease
congenital adrenal hyperplasia
Burns,necrosis,tumor lysis syndrome
Potassium containg dietary supplements
Hyperkalemia:causes hyperpolarization of RMP.
Greater than normal stimulus is required to generate A.P.
 Opposite in case of heart and it become hyperexcitable. Lower A.P in
atria may cause arrhythmias.

Causes:

Inadequate intake
Postemetic,Diarrhea
Diuretic
Alkalosis
Renal artery stenosis
Tumors of adrenal gland


Hypermagnesemia
Hypomagnesemia



Hypomagnesemia



required for Na/K ATPase. Normal Mg inhibits
release of K . In hypo more K is released so cells depolarize
causing tachyarrhythmias


Causes:



Alcohol abuse
Delirium tremens
Ch.Diarhea
Thiamine deficiency
Diuretics
Aminoglycoside
Gentamycin,tobramycin
Cisplatin,cyclosporin





















Hypermagnesemia: Acts as physiological Ca channel
blocker. Causes arrhythmias such as A/F, interventricular
conduction delay.
Causes:
Antacids
Vitamins
Acute renal failure
Maternal eclampsia
Tumor hypoparathyoidism
Iatrogenic
Sis syndrome
Milk alkali syndrome
Hypothyroidism



Hypercalsemia
Hypocalsemia



Hypercalsemia:



rarely too high to effect heart but may cause heart to fail to
relax during diastole and eventually stops in systole(Ca rigor).
Causes:












Hyperparathyroidism
Sarcoidosis
Iatrogenic
Breast cancer
Phaeochromocytoma
Hyperthyroidism
Post renal transplant
Adrenal insufficiency












Hypocalsemia:
exact mech. nt known but ECG changes are seen.
Cause :
Hypoparathyroidism
Sepsis
Alcoholism
Renal failure
Pacreatitis
Hyperphosphatemia
Phosphate enemas
Malnutrition


THANK YOU

Más contenido relacionado

La actualidad más candente

La actualidad más candente (20)

Ventricular Septal Defect
Ventricular Septal DefectVentricular Septal Defect
Ventricular Septal Defect
 
Ventricular tachycardia
Ventricular tachycardiaVentricular tachycardia
Ventricular tachycardia
 
Aortic Aneurysms
Aortic AneurysmsAortic Aneurysms
Aortic Aneurysms
 
Mitral stenosis
Mitral stenosisMitral stenosis
Mitral stenosis
 
Aortic regurgitation
Aortic regurgitationAortic regurgitation
Aortic regurgitation
 
Hypertrophic cardiomyopathy
Hypertrophic cardiomyopathyHypertrophic cardiomyopathy
Hypertrophic cardiomyopathy
 
Aortic anurysm
Aortic anurysmAortic anurysm
Aortic anurysm
 
dialated cardiomyopathies
dialated cardiomyopathiesdialated cardiomyopathies
dialated cardiomyopathies
 
SVT
SVTSVT
SVT
 
Aortic regurgitation
Aortic regurgitationAortic regurgitation
Aortic regurgitation
 
ECG interpretation
ECG interpretationECG interpretation
ECG interpretation
 
Eisenmenger syndrome
Eisenmenger syndromeEisenmenger syndrome
Eisenmenger syndrome
 
Right bundle branch block
Right bundle branch blockRight bundle branch block
Right bundle branch block
 
Approach to patient with Dilated Cardiomyopathy
Approach to patient with Dilated CardiomyopathyApproach to patient with Dilated Cardiomyopathy
Approach to patient with Dilated Cardiomyopathy
 
Heart block
Heart blockHeart block
Heart block
 
Atrial Fibrillation by Dr. Aryan
Atrial Fibrillation by Dr. AryanAtrial Fibrillation by Dr. Aryan
Atrial Fibrillation by Dr. Aryan
 
Restrictive cardiomyopathy
Restrictive cardiomyopathyRestrictive cardiomyopathy
Restrictive cardiomyopathy
 
Jugular Venous Pressure (JVP) Jugular Venous Pulse
Jugular Venous Pressure (JVP) Jugular Venous PulseJugular Venous Pressure (JVP) Jugular Venous Pulse
Jugular Venous Pressure (JVP) Jugular Venous Pulse
 
Hypertrophic cardiomyopathy
Hypertrophic cardiomyopathyHypertrophic cardiomyopathy
Hypertrophic cardiomyopathy
 
LBBB
LBBBLBBB
LBBB
 

Destacado (7)

Hypertensive heart disease
Hypertensive heart diseaseHypertensive heart disease
Hypertensive heart disease
 
Hypertension & heart
Hypertension & heartHypertension & heart
Hypertension & heart
 
Lvh
LvhLvh
Lvh
 
Metaplasia
MetaplasiaMetaplasia
Metaplasia
 
Atrophy
AtrophyAtrophy
Atrophy
 
Dysplasia by dr manzoor n
Dysplasia by dr manzoor nDysplasia by dr manzoor n
Dysplasia by dr manzoor n
 
Cell Injury Patho
Cell Injury PathoCell Injury Patho
Cell Injury Patho
 

Similar a Right and left ventricular hypertrophy

Htn Heart Failure 2010
Htn Heart Failure 2010Htn Heart Failure 2010
Htn Heart Failure 2010NorthTec
 
Htn Heart Failure 2010
Htn Heart Failure 2010Htn Heart Failure 2010
Htn Heart Failure 2010NorthTec
 
hypertension فشار بلند ابتدایی
hypertension فشار بلند ابتداییhypertension فشار بلند ابتدایی
hypertension فشار بلند ابتداییmujtaba daqiq
 
Acute heart failure by elmadana.pptx
Acute heart failure by elmadana.pptxAcute heart failure by elmadana.pptx
Acute heart failure by elmadana.pptxAhmedElmadana2
 
Hypertensive heart disease
Hypertensive heart diseaseHypertensive heart disease
Hypertensive heart diseaseEromosele Udabor
 
Cardiac Failure Sem 5.pptx
Cardiac Failure Sem 5.pptxCardiac Failure Sem 5.pptx
Cardiac Failure Sem 5.pptxSharveen2
 
A brief synopsis of acute decompensated heart failure
A brief synopsis of acute decompensated heart failureA brief synopsis of acute decompensated heart failure
A brief synopsis of acute decompensated heart failureDr Emad efat
 
Valvularheartdisease 101005111315-phpapp01
Valvularheartdisease 101005111315-phpapp01Valvularheartdisease 101005111315-phpapp01
Valvularheartdisease 101005111315-phpapp01chandra sekhar behera
 
UNIT - II.pptx
UNIT - II.pptxUNIT - II.pptx
UNIT - II.pptxJane756411
 
Pulmonary Hypertension.pptx
Pulmonary Hypertension.pptxPulmonary Hypertension.pptx
Pulmonary Hypertension.pptxRAHULSUTHAR46
 
sheikh Jeelani sadiq internal disease.pptx
sheikh Jeelani sadiq internal disease.pptxsheikh Jeelani sadiq internal disease.pptx
sheikh Jeelani sadiq internal disease.pptxPeerzadaUmair
 

Similar a Right and left ventricular hypertrophy (20)

Htn Heart Failure 2010
Htn Heart Failure 2010Htn Heart Failure 2010
Htn Heart Failure 2010
 
Htn Heart Failure 2010
Htn Heart Failure 2010Htn Heart Failure 2010
Htn Heart Failure 2010
 
hypertension فشار بلند ابتدایی
hypertension فشار بلند ابتداییhypertension فشار بلند ابتدایی
hypertension فشار بلند ابتدایی
 
Acute heart failure by elmadana.pptx
Acute heart failure by elmadana.pptxAcute heart failure by elmadana.pptx
Acute heart failure by elmadana.pptx
 
Hypertension
HypertensionHypertension
Hypertension
 
Tag training version 1.0
Tag training version 1.0Tag training version 1.0
Tag training version 1.0
 
Heart Failure
Heart FailureHeart Failure
Heart Failure
 
Heart failure
Heart failureHeart failure
Heart failure
 
Hypertension
HypertensionHypertension
Hypertension
 
Hypertensive heart disease
Hypertensive heart diseaseHypertensive heart disease
Hypertensive heart disease
 
Hypertension
HypertensionHypertension
Hypertension
 
Cardiac Failure Sem 5.pptx
Cardiac Failure Sem 5.pptxCardiac Failure Sem 5.pptx
Cardiac Failure Sem 5.pptx
 
A brief synopsis of acute decompensated heart failure
A brief synopsis of acute decompensated heart failureA brief synopsis of acute decompensated heart failure
A brief synopsis of acute decompensated heart failure
 
Valvularheartdisease 101005111315-phpapp01
Valvularheartdisease 101005111315-phpapp01Valvularheartdisease 101005111315-phpapp01
Valvularheartdisease 101005111315-phpapp01
 
UNIT - II.pptx
UNIT - II.pptxUNIT - II.pptx
UNIT - II.pptx
 
Congestive Heart Failure.pptx
Congestive Heart Failure.pptxCongestive Heart Failure.pptx
Congestive Heart Failure.pptx
 
Valvular heart disease and anaesthesia
Valvular heart disease and anaesthesiaValvular heart disease and anaesthesia
Valvular heart disease and anaesthesia
 
Heart Failure
Heart FailureHeart Failure
Heart Failure
 
Pulmonary Hypertension.pptx
Pulmonary Hypertension.pptxPulmonary Hypertension.pptx
Pulmonary Hypertension.pptx
 
sheikh Jeelani sadiq internal disease.pptx
sheikh Jeelani sadiq internal disease.pptxsheikh Jeelani sadiq internal disease.pptx
sheikh Jeelani sadiq internal disease.pptx
 

Más de Rawalpindi Medical College (20)

Pertussis
PertussisPertussis
Pertussis
 
Nephrotic syndrome.
Nephrotic syndrome.Nephrotic syndrome.
Nephrotic syndrome.
 
Symptomtology of cardiovascular diseases
Symptomtology of cardiovascular diseasesSymptomtology of cardiovascular diseases
Symptomtology of cardiovascular diseases
 
Symptomatology-GIT-1
Symptomatology-GIT-1Symptomatology-GIT-1
Symptomatology-GIT-1
 
Symptomatology-GIT
Symptomatology-GITSymptomatology-GIT
Symptomatology-GIT
 
Symptomalogy in RENAL impairement
Symptomalogy in RENAL impairementSymptomalogy in RENAL impairement
Symptomalogy in RENAL impairement
 
History taking
History takingHistory taking
History taking
 
Right bundle branch block
Right bundle branch blockRight bundle branch block
Right bundle branch block
 
Rheumatoid arthritis 2
Rheumatoid arthritis 2Rheumatoid arthritis 2
Rheumatoid arthritis 2
 
Systemic lupus erythematosus
Systemic lupus erythematosusSystemic lupus erythematosus
Systemic lupus erythematosus
 
Supraventricular tachyarrythmias
Supraventricular tachyarrythmiasSupraventricular tachyarrythmias
Supraventricular tachyarrythmias
 
Supraventricular tacchycardias
Supraventricular tacchycardias Supraventricular tacchycardias
Supraventricular tacchycardias
 
Skin-
Skin-Skin-
Skin-
 
Skin
Skin  Skin
Skin
 
Sick sinus syndrome-2
Sick sinus syndrome-2Sick sinus syndrome-2
Sick sinus syndrome-2
 
Sick sinus syndrome
Sick sinus syndrome Sick sinus syndrome
Sick sinus syndrome
 
X rays
X raysX rays
X rays
 
Ventricular arrhythmias
Ventricular arrhythmias Ventricular arrhythmias
Ventricular arrhythmias
 
Ventricular tachyarrhythmias
Ventricular tachyarrhythmias Ventricular tachyarrhythmias
Ventricular tachyarrhythmias
 
antiplatelet effect of aspirin
antiplatelet effect of aspirinantiplatelet effect of aspirin
antiplatelet effect of aspirin
 

Último

Bulimia nervosa ( Eating Disorders) Mental Health Nursing.
Bulimia nervosa ( Eating Disorders) Mental Health Nursing.Bulimia nervosa ( Eating Disorders) Mental Health Nursing.
Bulimia nervosa ( Eating Disorders) Mental Health Nursing.aarjukhadka22
 
Physiology of Smooth Muscles -Mechanics of contraction and relaxation
Physiology of Smooth Muscles -Mechanics of contraction and relaxationPhysiology of Smooth Muscles -Mechanics of contraction and relaxation
Physiology of Smooth Muscles -Mechanics of contraction and relaxationMedicoseAcademics
 
Mental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil ThirusanguMental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil Thirusangu Medical University
 
Neurological history taking (2024) .
Neurological  history  taking  (2024)  .Neurological  history  taking  (2024)  .
Neurological history taking (2024) .Mohamed Rizk Khodair
 
historyofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusanguhistoryofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusangu Medical University
 
pA2 value, Schild plot and pD2 values- applications in pharmacology
pA2 value, Schild plot and pD2 values- applications in pharmacologypA2 value, Schild plot and pD2 values- applications in pharmacology
pA2 value, Schild plot and pD2 values- applications in pharmacologyDeepakDaniel9
 
Role of Soap based and synthetic or syndets bar
Role of  Soap based and synthetic or syndets barRole of  Soap based and synthetic or syndets bar
Role of Soap based and synthetic or syndets barmohitRahangdale
 
Clinical Research Informatics Year-in-Review 2024
Clinical Research Informatics Year-in-Review 2024Clinical Research Informatics Year-in-Review 2024
Clinical Research Informatics Year-in-Review 2024Peter Embi
 
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdfCONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdfDolisha Warbi
 
Unit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.pptUnit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.pptPradnya Wadekar
 
EXERCISE PERFORMANCE.pptx, Lung function
EXERCISE PERFORMANCE.pptx, Lung functionEXERCISE PERFORMANCE.pptx, Lung function
EXERCISE PERFORMANCE.pptx, Lung functionkrishnareddy157915
 
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D.  Bawankar.pptPharmacokinetic Models by Dr. Ram D.  Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D. Bawankar.pptRamDBawankar1
 
MedMatch: Your Health, Our Mission. Pitch deck.
MedMatch: Your Health, Our Mission. Pitch deck.MedMatch: Your Health, Our Mission. Pitch deck.
MedMatch: Your Health, Our Mission. Pitch deck.whalesdesign
 
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...Shubhanshu Gaurav
 
SGK ĐIỆN GIẬT ĐHYHN RẤT LÀ HAY TUYỆT VỜI.pdf
SGK ĐIỆN GIẬT ĐHYHN        RẤT LÀ HAY TUYỆT VỜI.pdfSGK ĐIỆN GIẬT ĐHYHN        RẤT LÀ HAY TUYỆT VỜI.pdf
SGK ĐIỆN GIẬT ĐHYHN RẤT LÀ HAY TUYỆT VỜI.pdfHongBiThi1
 
Using Data Visualization in Public Health Communications
Using Data Visualization in Public Health CommunicationsUsing Data Visualization in Public Health Communications
Using Data Visualization in Public Health Communicationskatiequigley33
 
Male Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and BeyondMale Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and BeyondSujoy Dasgupta
 
blood bank management system project report
blood bank management system project reportblood bank management system project report
blood bank management system project reportNARMADAPETROLEUMGAS
 
AORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissectionAORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissectiondrhanifmohdali
 
Female Reproductive Physiology Before Pregnancy
Female Reproductive Physiology Before PregnancyFemale Reproductive Physiology Before Pregnancy
Female Reproductive Physiology Before PregnancyMedicoseAcademics
 

Último (20)

Bulimia nervosa ( Eating Disorders) Mental Health Nursing.
Bulimia nervosa ( Eating Disorders) Mental Health Nursing.Bulimia nervosa ( Eating Disorders) Mental Health Nursing.
Bulimia nervosa ( Eating Disorders) Mental Health Nursing.
 
Physiology of Smooth Muscles -Mechanics of contraction and relaxation
Physiology of Smooth Muscles -Mechanics of contraction and relaxationPhysiology of Smooth Muscles -Mechanics of contraction and relaxation
Physiology of Smooth Muscles -Mechanics of contraction and relaxation
 
Mental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil ThirusanguMental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil Thirusangu
 
Neurological history taking (2024) .
Neurological  history  taking  (2024)  .Neurological  history  taking  (2024)  .
Neurological history taking (2024) .
 
historyofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusanguhistoryofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusangu
 
pA2 value, Schild plot and pD2 values- applications in pharmacology
pA2 value, Schild plot and pD2 values- applications in pharmacologypA2 value, Schild plot and pD2 values- applications in pharmacology
pA2 value, Schild plot and pD2 values- applications in pharmacology
 
Role of Soap based and synthetic or syndets bar
Role of  Soap based and synthetic or syndets barRole of  Soap based and synthetic or syndets bar
Role of Soap based and synthetic or syndets bar
 
Clinical Research Informatics Year-in-Review 2024
Clinical Research Informatics Year-in-Review 2024Clinical Research Informatics Year-in-Review 2024
Clinical Research Informatics Year-in-Review 2024
 
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdfCONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
 
Unit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.pptUnit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.ppt
 
EXERCISE PERFORMANCE.pptx, Lung function
EXERCISE PERFORMANCE.pptx, Lung functionEXERCISE PERFORMANCE.pptx, Lung function
EXERCISE PERFORMANCE.pptx, Lung function
 
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D.  Bawankar.pptPharmacokinetic Models by Dr. Ram D.  Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
 
MedMatch: Your Health, Our Mission. Pitch deck.
MedMatch: Your Health, Our Mission. Pitch deck.MedMatch: Your Health, Our Mission. Pitch deck.
MedMatch: Your Health, Our Mission. Pitch deck.
 
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
 
SGK ĐIỆN GIẬT ĐHYHN RẤT LÀ HAY TUYỆT VỜI.pdf
SGK ĐIỆN GIẬT ĐHYHN        RẤT LÀ HAY TUYỆT VỜI.pdfSGK ĐIỆN GIẬT ĐHYHN        RẤT LÀ HAY TUYỆT VỜI.pdf
SGK ĐIỆN GIẬT ĐHYHN RẤT LÀ HAY TUYỆT VỜI.pdf
 
Using Data Visualization in Public Health Communications
Using Data Visualization in Public Health CommunicationsUsing Data Visualization in Public Health Communications
Using Data Visualization in Public Health Communications
 
Male Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and BeyondMale Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and Beyond
 
blood bank management system project report
blood bank management system project reportblood bank management system project report
blood bank management system project report
 
AORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissectionAORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissection
 
Female Reproductive Physiology Before Pregnancy
Female Reproductive Physiology Before PregnancyFemale Reproductive Physiology Before Pregnancy
Female Reproductive Physiology Before Pregnancy
 

Right and left ventricular hypertrophy

  • 2.  Defination:  Left ventricular hypertrophy is defined as an increase in the mass of the left ventricle, which can be secondary to an increase in wall thickness, an increase in cavity size, or both  Causes:  Hypertension Hypertrophic cardiomyopathy Aortic stenosis Athelitic training   
  • 3.        Risk factors for left ventricular hypertrophy include the following: Age Gender High blood pressure, a blood pressure reading greater than 140/90 mm Hg, is the greatest risk factor. Aortic stenosis, narrowing of the main valve through which blood leaves the heart, may increase the left ventricle's workload. Obesity can cause high blood pressure and increase your body's demand for oxygen, factors that may lead to left ventricular hypertrophy. Genetic factor
  • 4.   The development of LVH is a relatively early response to hypertension,  Ambulatory BP monitoring has suggested that there may be two additional risk factors for LVH: The daily BP load (the percentage of pressures above 135/85 during the day and 120/80 mmHg at night Nocturnal hypertension (in which the expected nighttime reduction in BP is not seen)  maximal daytime blood pressure or peak exercise blood pressure are most predictive of the level of hypertrophy . There is also evidence that left ventricular mass may be increased prior to the development of overt hypertension. 
  • 5. High BP → ↑ LV wall stress Wall stress ∝ 1/ wall thickness LV wall thickening → ↓ wall stress Myocyte hypertrophy and ↑ collagen matrix  .The same factors, such as angiotensin II, norepinephrine, epinephrine, increased peripheral and cardiac sympathetic drive and endothelin, promote both hypertension and LVH. The tendency to LVH may be an inherited trait that predisposes to the development of hypertension
  • 6. › To diagnose LVH you can use the following criteria*:   avL R in V5 (or V6) + S in V1 (or V2) > 35 mm, or R > 13 mm
  • 7. Symptoms:          Shortness of breath Chest pain palpitations Dizziness Fainting Rapid exhaustion with physical activity Fatigue Syncope Some time patient shows no symptoms
  • 8. Signs:      • • • systolic murmur best heard between the apex and left sternal border - increases in intensity with maneuvers that decrease preload (Valsalva, squatting to standing position). - does not radiate to the carotid arteries sustained apical impulse S4 bisferiens pulse (carotids, femoral arteries)
  • 9.       Complications that can occur as a result of these problems include: Inability of your heart to pump enough blood to your body (heart failure) Abnormal heart rhythm (arrhythmia) Insufficient supply of oxygen to the heart (ischemic heart disease) Interruption of blood supply to the heart (heart attack) Sudden, unexpected loss of heart function, breathing and consciousness (sudden cardiac arrest)
  • 10. Defination:   right ventricular hypertrophy is the enlargement of heart’s right ventricle Right ventricular hypertrophy, or simply RVH, is considered to be one of the rare diseases of the heart. Unlike the left ventricle, which tends to overwork itself when it detects abnormalities, the right ventricle dilutes itself. This is the reason why left ventricular hypertrophy is way more common than right ventricular hypertrophy.
  • 11.        Pulmonary hypertension Fallot tetralogy Pulmonary valve stenosis Ventricular septal defect (VSD) High altitude Cardiac fibrosis Chronic obstructive pulmonary disease (COPD)
  • 12.       Chest pain and tightness Palpitation Dizziness Loss of consciousness Light headedness Edema of feet,leg,ankle
  • 13. To diagnose RVH you can use the following criteria:   V1 Right axis deviation, and R wave > 7mm tall
  • 14.
  • 16.  Hyperkalemia Hypokalemia  Hyperkalemia: affects Na channels and causes  depolarizaion . Na channels inactivate and refractory. Ventricular fibrillation and asystole. At the same time increases activity of potassium channels and increases memb. repolarization. Causes: Renal insufficiency Medication Blood transfusion, Massive hemolysis Addison's disease congenital adrenal hyperplasia Burns,necrosis,tumor lysis syndrome Potassium containg dietary supplements
  • 17. Hyperkalemia:causes hyperpolarization of RMP. Greater than normal stimulus is required to generate A.P.  Opposite in case of heart and it become hyperexcitable. Lower A.P in atria may cause arrhythmias. Causes: Inadequate intake Postemetic,Diarrhea Diuretic Alkalosis Renal artery stenosis Tumors of adrenal gland
  • 18.  Hypermagnesemia Hypomagnesemia  Hypomagnesemia  required for Na/K ATPase. Normal Mg inhibits release of K . In hypo more K is released so cells depolarize causing tachyarrhythmias  Causes:  Alcohol abuse Delirium tremens Ch.Diarhea Thiamine deficiency Diuretics Aminoglycoside Gentamycin,tobramycin Cisplatin,cyclosporin       
  • 19.            Hypermagnesemia: Acts as physiological Ca channel blocker. Causes arrhythmias such as A/F, interventricular conduction delay. Causes: Antacids Vitamins Acute renal failure Maternal eclampsia Tumor hypoparathyoidism Iatrogenic Sis syndrome Milk alkali syndrome Hypothyroidism
  • 20.   Hypercalsemia Hypocalsemia  Hypercalsemia:  rarely too high to effect heart but may cause heart to fail to relax during diastole and eventually stops in systole(Ca rigor). Causes:          Hyperparathyroidism Sarcoidosis Iatrogenic Breast cancer Phaeochromocytoma Hyperthyroidism Post renal transplant Adrenal insufficiency
  • 21.            Hypocalsemia: exact mech. nt known but ECG changes are seen. Cause : Hypoparathyroidism Sepsis Alcoholism Renal failure Pacreatitis Hyperphosphatemia Phosphate enemas Malnutrition