Tricuspid regurgitation electrocardiogram

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Electrocardiogram

Right Atrial Enlargement

ECG findings of right atrial enlargement include:

A P wave >2.5 mm in leads II, III and aVF
A P wave >1.5 mm in lead V1

Shown below is an ECG demonstrating large P waves in leads to 2,3, and aVF which have a P-wave height greater than 2.5 mm consistent with right each one enlargement:

Right Ventricular Hypertrophy

ECG findings of right ventricular hypertrophy include:

Right axis deviation of +90 degrees or more
The R wave in V₁ is 7 mm or more in height
RV₁ + SV₅ or SV₆ = 10 mm or more
R/S ratio in V₁ = 1.0 or more
S/R ratio in V₆ = 1.0 or more
Late intrinsicoid deflection in V₁ (0.035+)
Incomplete RBBB pattern
ST T strain pattern in 2,3,aVF
P pulmonale or P congenitale
S1 S2 S3 pattern in children

Shown below is an ECG demonstrating right ventricular hypertrophy. Note that R wave > the S wave in V1.

Image:RVH.png|Right ventricular hypertrophy

Pulmonary Hypertension

Left Heart Dilatation

2008 and Incorporated 2006 ACC/AHA Guidelines for the Management of Patients with Valvular Heart Disease (DO NOT EDIT) ^[1]

Adolescents (DO NOT EDIT) ^[1]

Class I
"1. An ECG is indicated for the initial evaluation of adolescent and young adult patients with TR, and serially every 1 to 3 years, depending on severity. (Level of Evidence: C)"

Class IIb
"1. Holter monitoring may be considered for the initial evaluation of asymptomatic adolescent and young adult patients with TR, and serially every 1 to 3 years. (Level of Evidence: C)"

References

↑ ^1.0 ^1.1 Bonow RO, Carabello BA, Chatterjee K; et al. (2008). "2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons". Circulation. 118 (15): e523–661. doi:10.1161/CIRCULATIONAHA.108.190748. PMID 18820172. Unknown parameter |month= ignored (help)

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[pmid18820172-1] 1.0 ^1.1 Bonow RO, Carabello BA, Chatterjee K; et al. (2008). "2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons". Circulation. 118 (15): e523–661. doi:10.1161/CIRCULATIONAHA.108.190748. PMID 18820172. Unknown parameter |month= ignored (help)

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