Article | ECG REPRESENTATION AND INTERPRETATION

Running Head: ECG REPRESENTATION AND INTERPRETATION 1
ECG Representation and Interpretation
Name
Institution
Date of Submission

ECG REPRESENTATION AND INTERPRETATION
2
1. a) Explain what the ECG representation of an enlarged right atrium would look like
and explain why
In individuals with right atrial enlargement (RAE), the ECG (electrocardiogram)
representation indicates a normal sinus rhythm (Allison et al., 2017). The regular rate being
91 bpm. The P wave duration remains unaffected. However, the shape is peaked and also the
amplitude increases in lead II reaching height taller than 2.5 mm (Dunbar & Saul, 2009).
RAE causes delayed activation of right atrium leading to simultaneous activation and
polarization. As a result, the P value wave is peaked (because of upsurge in depolarized
tissue) and narrower (due to left atrium depolarization which hides the depolarization of right
atrium) than usual (Dunbar & Saul, 2009).
b) ECG representation of an enlarged left atrium with a normal-sized right atrium
In left atrial enlargement (LAE), there is a prolonged P wave. Delayed activation of the
left atrium leads to prolonged depolarization (Badran et al., 2019). As such, the amplitude of
P wave in lead V1 increases by at least 1 mm. This occurs due to the effect of the increased
tissue mass that causes the negative or terminal portion of P wave to increase with at least a
span of 40 msec (Dunbar & Saul, 2009). Also, in lead II, the P wave is notched. And since
the left atrium is usually dominant, there exists no significant axis deviation.

ECG REPRESENTATION AND INTERPRETATION
3
2. Explain in detail the requirements for;
a) Right ventricle hypertrophy (RVH)
RVH arises when there is a chronic pressure overload. It leads to thickening of the wall
of the right ventricle (Keramida, Lazaros, & Nihoyannopoulos, 2018). V1 lead being the closest
to the right ventricle, its enlargement causes an abnormally large R wave. However, the R wave
in VI is not very large, hence keen attention is needed to notice it. Nevertheless, it can be
identified when it is of the same height or greater compared to the depth of S wave (Dunbar &
Saul, 2009). Otherwise, RVH can be detected when the axis shifts to the right and S wave
persists in lead V6.
b) Left ventricle hypertrophy (LVH)