What are the criteria for left ventricular hypertrophy (LVH) on a 12-lead ECG? What are the causes?
Criteria:
- S in V1 + R in V5 or V6 >35 mm above age 40,
(>40 mm for age 31-40, >45 mm for age 21-30) - R in aVL >11 mm
- 3. R in I + S in III >25 mm
- 4. R in V6 >26 mm
- Additional criteria:
- LV strain pattern (ST depression and T wave inversion in leads I, aVL, V4-V6)
- Left atrial enlargement
Differential includes:
- LV Mass increase & hypertension, hypertrophic cardiomyopathy
- LV Pressure overload – aortic stenosis, hypertrophic cardiomyoathy with obstruction
- LV Volume overload & aortic insufficiency, mitral regurgitation
