Left ventricular hypertrophy EKG examples
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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EKG examples
Shown below is an EKG depicting sinus rhythm with P waves that are terminally negative in V1 which is suggestive of a left atrial abnormality. There is a tall R wave in V5 greater than 30 mm., a deep S wave greater than 30 mm in V2, and an R wave in lead II greater than 20mm. There are diffuse ST/T wave changes. All of these finding suggest left ventricular hypertrophy. This woman in fact has idiopathic hypertrophic subaortic stenosis.
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Shown below is an EKG with a rhythm which is not clear. It could be sinus with very flat P waves (there are prominent U waves that make it difficult to see P waves) or perhaps a nodal rhythm, with ventricular premature complexes. There is a right axis deviation of the QRS and tall R waves in V5 (> 35mm) with wide spread ST changes. The EKG suggest left ventricular hypertrophy with possibly a left posterior fascicular block.
Copyleft image obtained courtesy of ECGpedia, http://en.ecgpedia.org/wiki/File:E197.jpg
The EKG below shows rhythm as that of atrial fibrillation, and there are marked increases in the QRS deflections with an R in V6 greater than that in V5 and also greater than 35mm. There are marked ST changes in the absence of digitalis. The EKG is diagnostic of left ventricular hypertrophy. This patient has IHSS.
Copyleft image obtained courtesy of ECGpedia, http://en.ecgpedia.org/wiki/File:E199.jpg
The EKG below shows an RsR' pattern (M pattern) in leads I, II, aVL, and V4 depicting a left bundle branch block. The EKG also shows left axis deviation with left ventricular hypertrophy, and ST segment elevations in V1, V2, and V3 as well as an ST depression in V6. There is widening of the QRS complexes throughout the precordial leads.
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The EKG below shows an RsR' pattern (M pattern) in leads V1, V4, V5, and aVL depicting a left bundle branch block. The EKG also shows ST depression with T wave inversion in lead V6 indicating a left ventricular strain pattern. Wide QRS complexes are seen throughout the EKG. The EKG also shows evidence of left ventricular hypertrophy.
Copyleft image obtained courtesy of ECGpedia, http://www.ecgpedia.org