Wednesday, April 27, 2011

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Left ventricular hypertrophy - ECG

The most characteristic finding is increased amplitude of the QRS complex. R waves in leads facing the left ventricle (i.e., leads I, aVL, V5, and V6) are taller than normal, whereas S waves in leads overlying the right ventricle (i.e., V1 and V2) are deeper than normal.
In many patients, the ST segment is depressed and followed by an inverted T wave. In most cases, the ST segment slopes downward from a depressed J point and the T wave is asymmetrically inverted (formerly called a “strain” pattern).
A widening of the QRS complex may be there i.e. more than 110 ms and also the QRS complex may be notched.

Common diagnostic criteria include:
1) Sokolow - Lyon index : SV1 + (RV5 or RV6) > 3.5 mV
                                       : RaVL > 1.1 mV
2) Cornell voltage criteria : SV3 + SaVL ≥ 2.8 mV (for men)
                                       : SV3 + SaVL ≥ 2.0 mV (for women)


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