EASY WAY TO REMEMBER: LEFT VENTRICULAR HYPERTROPHY (LVH)

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 LEFT VENTRICULAR HYPERTROPHY (LVH) BASICS

ECG CHANGES IN LVH

SIMPLE CONCEPT: IN LEAD AVL - TALL (R-WAVE) -  > 11 mm (greater than 11mm, it's consider LVH)

TALL (R-WAVE) IN V5-V6 AND DEEP (S-WAVE) IN V1 (some of this greater than 35mm, then the patient has LVH)

E.G: COUNT (R-WAVE) IN V5 = 25mm  AND COUNT (S-WAVE) IN V1 = 20mm

 (together we have 45mm) 

[ANYTHING GREATER THAN 35 mm, it's consider LVH]


NOTE: 1) SINUS RHYTHM, RATE 83/MIN AND NORMAL AXIS.

             2) TALL R-WAVE IN LEADS V5-V6 (R-wave in lead v5, 40mm) AND DEEP S- WAVES IN                      LEADS V1-V2.

             3) INVERTED T-WAVES IN LEADS 1,VL AND V5-V6.

OVERVIEW:

LEFT VENTRICULAR HYPERTROPHY CAUSES A TALL R-WAVE (GREATER THAN 25mm) IN LEAD V5 (OR) V6 AND DEEP S-WAVE IN V1 (OR) V2, BUT IN PRACTICE SUCH "VOLTAGE" CHANGES ALONE ARE UNHELPFUL IN DIAGNOSING LVH.

 WITH SIGNIFICANT HYPERTROPHY, THERE ARE ALSO INVERTED T-WAVE IN LEADS [1, AVL, V5-V6] AND THERE MAY BE LEFT AXIS DEVIATION.

IT IS DIFFICULT TO DIAGNOSE MINOR DEGREES OF (LVH) FROM THE ECG.

DIF.DIAGNOSIS

AN ECHOCARDIOGRAM IS THE MOST COMMON WAY TO DETERMINE, IF A PATIENT HAS LEFT VENTRICULAR HYPERTROPHY. 

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