LVH (Left Ventricular Hypertrophy) on ECG

Last updated 10.08.13





-  Features on ECG which suggest Left Ventricular Hypertrophy (LVH)



-  Increased QRS Voltage

-  Increased mass causes

Increased voltate & amplitude of R & S Waves over right chest lease (V1 – V3)

Increased R Waves in I, aVL

-  Increased QRS Duration

-  Increased mass causes increased width of QRS complex

-  May be associated with LBBB

-  May cause or be caused by LBBB

-  Sokolow-Lyon Index

Sum of S Wave V1 + R Wave V5 (or V6) =/> 3.5mV (35mm)

OR R Wave in aVL =/> 1.1mV (11mm)

-  Left Axis Deviation

-  Axis shift from increased mass

-  Repolarisation Abnormality

-  LV strain = LVH with associated ST-T Waves abnormalities

-  ST depression & TWI in leads with tall R Waves

-  Left Atrial Abnormality

-  Abnormal left atrial depolarization from conduction delay or atrial enlargement

-  Increased duration of P Waves (=/> 120ms) in limb leads

-  &/OR biphasic P Waves with prominent negative component (=/> 40ms &/OR =/> 1mV depth) in V1




UpToDate: ECG Diagnosis of Left Ventricular Hypertrophy, 27/11/2012