Left ventricular hypertrophy: Difference between revisions
Ostermayer (talk | contribs) (→Source) |
Ostermayer (talk | contribs) No edit summary |
||
| Line 1: | Line 1: | ||
==ECG Findings== | ==ECG Findings== | ||
# | |||
# | ===Sokolow-Lyon criterium<ref>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</ref>=== | ||
#R | *Most commonly used criteria | ||
#R in | |||
#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 | |||
===Romhilt-Estes Criteria<ref>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</ref>=== | |||
{| class="wikitable" | |||
||'''ECG Criteria'''||'''Points''' | |||
|- | |||
||Voltage Criteria (any of): | |||
# R or S in limb leads ≥20 mm | |||
# S in V<sub>1</sub> or V<sub>2</sub> ≥30 mm | |||
# R in V<sub>5</sub> or V<sub>6</sub> ≥30 mm | |||
||3 | |||
|- | |||
||ST-T Abnormalities: | |||
* ST-T vector opposite to QRS without digitalis | |||
* ST-T vector opposite to QRS with digitalis | |||
|| | |||
3<br/> | |||
1 | |||
|- | |||
||Negative terminal P mode in V<sub>1</sub> 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 V<sub>5</sub> or V<sub>6</sub> (>0.05 sec) | |||
||1 | |||
|} | |||
===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 V<sub>5</sub>: R wave > 26 mm | |||
*Lead V<sub>6</sub>: R wave > 20 mm | |||
*V4-V6 precordial leads may show ST depression & T wave inversions known as the '''LV Strain pattern''' | |||
===Common Causes=== | |||
[[Hypertension (Main)]] | |||
[[Aortic Stenosis]] | |||
[[Aortic Regurgitation]] | |||
[[Coarctation of the Aorta]] | |||
[[Hypertrophic Cardiomyopathy]] | |||
[[Mitral Regurgitation]] | |||
==See Also== | ==See Also== | ||
| Line 13: | Line 67: | ||
*Adapted from lecture by Dr. James Niemann MD, Lampe, Pani, Donaldson, ECGpedia.org | *Adapted from lecture by Dr. James Niemann MD, Lampe, Pani, Donaldson, ECGpedia.org | ||
*Journal of Electrocardiology. Vol 43 (2010). 40-42. | *Journal of Electrocardiology. Vol 43 (2010). 40-42. | ||
<references/> | |||
[[Category:Cards]] | [[Category:Cards]] | ||
Revision as of 03:51, 3 June 2014
ECG Findings
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
Romhilt-Estes Criteria[2]
| 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 |
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
Common Causes
Hypertension (Main) Aortic Stenosis Aortic Regurgitation Coarctation of the Aorta Hypertrophic Cardiomyopathy Mitral Regurgitation
See Also
Source
- Adapted from lecture by Dr. James Niemann MD, Lampe, Pani, Donaldson, ECGpedia.org
- Journal of Electrocardiology. Vol 43 (2010). 40-42.
- ↑ 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