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Question:

Can one's position while having an EKG cause the heart to appear partially enlarged? 

Is it possible the way the heart is lying that with an EKG, it may appear one side is larger but is not? 

submitted by Melissa from Ft. Worth, Texas on 5/18/2013

Answer:

by Texas Heart Institute cardiologist, Scott R. Sherron, MD  Scott R. Sherron, MD

It is definitely true that the orientation of your heart in your chest can affect the "axis" on the ECG tracing and can lead to a tracing that appears to indicate an enlarged heart relative to a 'normal' tracing. For example, a more vertically oriented heart will have more of the electrical force (vector) pointing rightward and imply right ventricular enlargement. The best test to assess the size of the heart is echocardiography, an ultrasound of the heart. It is simple and non-invasive, inexpensive and usually available in a cardiologist's office. Also, the relative thickness of the chest wall and a patient's age can lead to ECG criteria that can falsely suggest left ventricular enlargement or hypertrophy. Hope this is helpful. 

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Updated May 2013
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