Newsletter Atrial and Ventricular Hypertrophy This ECG was recorded from a 17-year-old girl who was breathless, had marked ankle swelling with signs of right heart failure, and who had been known to have a heart murmur since birth. She was acyanotic. What ECG abnormalities can you identify and can you suggest a diagnosis? Click the button below to Download 500+ High-Yield Medical Presentations and eBooks Get Lifetime Access to 500+ Medical Presentations Answer Sinus rhythm Markedly peaked P waves (best seen in leads II, Vi) Normal axis Dominant R wave in lead Vl Clinical interpretation The ECG shows right atrial and right ventricular hypertrophy. What to do? Right atrial hypertrophy is seen with pulmonary hypertension of any cause, tricuspid stenosis, and Ebstein’s anomaly. Right ventricular hypertrophy is seen with pulmonary stenosis and pulmonary hypertension. These conditions can all be diagnosed by echocardiography. This patient had Ebstein’s anomaly and an atrial septal defect. Share this : Library Anatomy Anesthesiology Biochemistry Cardiology Dermatology Emergency Endocrinology ENT Examinations Forensic Med. Obs. & Gynae. Hematology Medicine Microbiology Nephrology Neurology Oncology Ophthalmology Orthopaedics Paediatrics Parasitology Pathology Pharmacology Physiology Psychiatry Pulmonology Radiology Rheumatology Surgery Our mission is to provide a free, reliable and first-class education to everyone. Rish Academy is a nonprofit organization.  Every little bit counts and is appreciated. Donate Today For Users Contact us Email Newsletters Advertise here About About Rish Academy Our Mission Founder Terms and Conditions Privacy Policy Disclaimer Find us on