Left ventricular hypertrophy electrocardiogram: Difference between revisions
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==Overview | ==Overview== | ||
The [[electrocardiogram]] (ECG) often shows signs of increased voltage from the heart in individuals with LVH, so this is often used as a screening test to determine who should undergo further testing with an echocardiogram. | The [[electrocardiogram]] (ECG) often shows signs of increased voltage from the heart in individuals with LVH, so this is often used as a screening test to determine who should undergo further testing with an echocardiogram. | ||
==Electrocardiogram Criteria for Diagnosing LVH== | |||
There are multiple criteria used to diagnose LVH via electrocardiography. None of them are perfect. However, by using multiple different criteria the [[sensitivity (tests)|sensitivity]] and [[Specificity (tests) | specificity]] are increased. | There are multiple criteria used to diagnose LVH via electrocardiography. None of them are perfect. However, by using multiple different criteria the [[sensitivity (tests)|sensitivity]] and [[Specificity (tests) | specificity]] are increased. | ||
Revision as of 14:22, 24 August 2012
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Left ventricular hypertrophy Microchapters |
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Differentiating Left ventricular hypertrophy from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Left ventricular hypertrophy On the Web |
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American Roentgen Ray Society Images of Left ventricular hypertrophy |
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Directions to Hospitals Treating Left ventricular hypertrophy |
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Risk calculators and risk factors for Left ventricular hypertrophy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
The electrocardiogram (ECG) often shows signs of increased voltage from the heart in individuals with LVH, so this is often used as a screening test to determine who should undergo further testing with an echocardiogram.
Electrocardiogram Criteria for Diagnosing LVH
There are multiple criteria used to diagnose LVH via electrocardiography. None of them are perfect. However, by using multiple different criteria the sensitivity and specificity are increased.
The Sokolow and Lyon criteria
- S in V1 + R in V5 or V6 (whichever is larger) =/> 35 mm
- R in aVL =/> 11 mm
The Cornell criteria1 for the ECG diagnosis of LVH involves measurement of the sum of the R wave in lead aVL and the S wave in lead V3. The Cornell criteria for LVH are:
- S in V3 + R in aVL > 28 mm (men)
- S in V3 + R in aVL > 20 mm (women)
Other voltage-based criteria for LVH include:
- 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
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LVH: R in V5 is 26mm, S in V1 in 15mm. The sum is 41 mm which is more than 35 mm and therefore LVH is present according to the Sokolow-Lyon criteria.
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ECG of patient with left ventricular hypertrophy according to the Sokolow-Lyon criteria -
Another example of extreme left ventricular hypertrophy in a patient with severe aortic valve stenosis
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ECG of a patient with LVH and subendocardial ischemia leading to positive cardiovascular markers in blood testing -
