The diverse causes of right-sided heart failure (RHF) include, among others, primary cardiomyopathies with right ventricular (RV) involvement, RV ischemia and infarction, volume loading caused by cardiac lesions associated with congenital heart disease and valvular pathologies, and pressure loading resulting from pulmonic stenosis or pulmonary hypertension from a variety of causes, including left-sided heart disease.
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Criteria for the Diagnosis of Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC)
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited cardiomyopathy that predominantly affects the right ventricle. With a prevalence in the range of 1:5000 to 1:2000 persons, ARVC is one of the leading causes of sudden cardiac death in young people and in athletes.
Common Diagnostic Criteria for Left and Right Atrial Abnormalities
Left Atrial Abnormality
- Prolonged P wave duration of >120 msec in lead II
- Prominent notching of the P wave, usually most obvious in lead II, with an interval between the notches of >40 msec (p mitrale)
- Ratio between the duration of the P wave in lead II and the duration of the PR segment of >1.6
- Increased duration and depth of the terminal negative portion of the P wave in lead V1 (the P terminal force) so that the area subtended by it exceeds 0.04 mm-sec (Morris index)
- Leftward shift of the mean P wave axis to between -30 and +45 degrees