Left ventricular hypertrophy
(Redirected from Left ventricular hypertrophy (LVH))
ECG Findings
- Common to have TWI in I and aVL but should be in both
- If only aVL, very likely reciprocal change at the start of inf MI
Sokolow-Lyon criterium[1]
- Most commonly used criteria
- R in V5 or V6 + S in V1 >35 mm.
Cornell Criteria
- R in aVL and S in V3 >28 mm in men
- 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
Romhilt-Estes Criteria[2]
Diagnostic ≥ 5 points and probable ≥ 4 points)
ECG Criteria | Points |
Voltage Criteria (any of):
|
3 |
ST-T Abnormalities:
|
3 |
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 |
Common Causes
- Hypertension (Main)
- Aortic Stenosis
- Aortic Regurgitation
- Coarctation of the Aorta
- Hypertrophic Cardiomyopathy
- Mitral Regurgitation
- Infiltrative Cardiac Processes
Differential Diagnosis
Cardiac Hypertrophy and Enlargement
- Right atrial enlargement
- Left atrial enlargement
- Left ventricular hypertrophy
- Right ventricular hypertrophy
See Also
References
- ↑ 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
- ↑ 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