Left ventricular hypertrophy: Difference between revisions

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#R in aVL and S in V3 >28 mm in men
#R in aVL and S in V3 >28 mm in men
#R in aVL and S in V3 >20 mm in women
#R in aVL and S in V3 >20 mm in women
===Other Voltage Based Criteria===
*Lead I: R wave > 14 mm
*Lead aVR: S wave > 15 mm
*Lead aVL: R wave > 12 mm
*Lead aVF: R wave > 21 mm
*Lead V<sub>5</sub>: R wave > 26&nbsp;mm
*Lead V<sub>6</sub>: R wave > 20&nbsp;mm
*V4-V6 precordial leads may show ST depression & T wave inversions known as the '''LV Strain pattern'''
===Common Causes===
*[[Hypertension (Main)]]
*[[Aortic Stenosis]]
*[[Aortic Regurgitation]]
*[[Coarctation of the Aorta]]
*[[Hypertrophic Cardiomyopathy]]
*[[Mitral Regurgitation]]


===Romhilt-Estes Criteria<ref>Romhilt DW and Estes EH Jr. A point-score system for the ECG diagnosis of left ventricular hypertrophy. Am Heart J 1968 Jun; 75(6) 752-8. lmid:4231231</ref>===
===Romhilt-Estes Criteria<ref>Romhilt DW and Estes EH Jr. A point-score system for the ECG diagnosis of left ventricular hypertrophy. Am Heart J 1968 Jun; 75(6) 752-8. lmid:4231231</ref>===
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* ST-T vector opposite to QRS with digitalis
* ST-T vector opposite to QRS with digitalis
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3<br/>
3
1
1
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||1
||1
|-
|-
||Delayed [[intrinsicoid deflection]] in V<sub>5</sub> or V<sub>6</sub> (>0.05 sec)
||Delayed intrinsicoid deflection in V<sub>5</sub> or V<sub>6</sub> (>0.05 sec)
||1
||1
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===Other Voltage Based Criteria===
*Lead I: R wave > 14 mm
*Lead aVR: S wave > 15 mm
*Lead aVL: R wave > 12 mm
*Lead aVF: R wave > 21 mm
*Lead V<sub>5</sub>: R wave > 26&nbsp;mm
*Lead V<sub>6</sub>: R wave > 20&nbsp;mm
*V4-V6 precordial leads may show ST depression & T wave inversions known as the '''LV Strain pattern'''
===Common Causes===
[[Hypertension (Main)]]
[[Aortic Stenosis]]
[[Aortic Regurgitation]]
[[Coarctation of the Aorta]]
[[Hypertrophic Cardiomyopathy]]
[[Mitral Regurgitation]]


==See Also==
==See Also==

Revision as of 03:53, 3 June 2014

ECG Findings

Sokolow-Lyon criterium[1]

  • Most commonly used criteria
  1. R in V5 or V6 + S in V1 >35 mm.

Cornell Criteria

  1. R in aVL and S in V3 >28 mm in men
  2. R in aVL and S in V3 >20 mm in women


Other Voltage Based Criteria

  • Lead I: R wave > 14 mm
  • Lead aVR: S wave > 15 mm
  • Lead aVL: R wave > 12 mm
  • Lead aVF: R wave > 21 mm
  • Lead V5: R wave > 26 mm
  • Lead V6: R wave > 20 mm
  • V4-V6 precordial leads may show ST depression & T wave inversions known as the LV Strain pattern

Common Causes

Romhilt-Estes Criteria[2]

ECG Criteria Points
Voltage Criteria (any of):
  1. R or S in limb leads ≥20 mm
  2. S in V1 or V2 ≥30 mm
  3. R in V5 or V6 ≥30 mm
3
ST-T Abnormalities:
  • ST-T vector opposite to QRS without digitalis
  • ST-T vector opposite to QRS with digitalis

3 1

Negative terminal P mode in V1 1 mm in depth and 0.04 sec in duration (indicates left atrial enlargement) 3
Left axis deviation (QRS of -30° or more) 2
QRS duration ≥0.09 sec 1
Delayed intrinsicoid deflection in V5 or V6 (>0.05 sec) 1

See Also

Source

  • Adapted from lecture by Dr. James Niemann MD, Lampe, Pani, Donaldson, ECGpedia.org
  • Journal of Electrocardiology. Vol 43 (2010). 40-42.
  1. Sokolow M, Lyon TP: The ventricular complex in left ventricular hypertrophy as obtained by unipolar precordial and limb leads. Am Heart J 37: 161, 1949
  2. Romhilt DW and Estes EH Jr. A point-score system for the ECG diagnosis of left ventricular hypertrophy. Am Heart J 1968 Jun; 75(6) 752-8. lmid:4231231