Is there chamber enlargement on this EKG?
Answer & Explanation
Sinus at 100/minute
Axis: right axis deviation
Intervals: QRS prolonged at 160ms with a tall R in V1 – RBBB
Now, chamber enlargement?
With a RBBB the usual criteria for both right and left ventricular chamber enlargement are somewhat altered.
R wave in lead V1 > 15mm suggests RVH, especially with rightward deviation of the axis
LVH criteria become less sensitive (eg not seen as reliably), but if voltage criteria for LVH are met with a RBBB they are quite specific.
In this week’s tracing, the very tall T in V1 is 18mm, and with the right axis deviation is diagnostic of right ventricular hypertrophy.