ECG changes in left ventricular hypertrophy (LVH)
Last reviewed 11/2022
If there is left ventricular hypertrophy then this will result in :
- a tall R wave (greater than 25mm in V5 or V6), or R plus S greater than 35 mm (1)
- a deep S in V1 or V2
- if there is significant left ventricular 'strain' then there are also inverted T waves in V5 and V6 and possible ST depression
- left axis deviation may also be present
- QRS may be slightly prolonged
Notes:
- a systematic review investigating the accuracy of ECGs in the diagnosis
of LVH has been undertaken (2)
- from the study data
- in primary care, a negative electrocardiogram result would reduce the typical pre-test probability from 33% to 31%. In secondary care the typical pre-test probability of 65% would be reduced to 63%
- the authors concluded that electrocardiographic criteria should not be used to rule out left ventricular hypertrophy in patients with hypertension
- from the study data
Click here for an ECG and further information concerning left ventricular hypertrophy
Reference: