Cardiology Question 28 Instructor

What are the criteria for left ventricular hypertrophy (LVH) on a 12-lead ECG? What are the causes?


  1. 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)
  2. R in aVL >11 mm
  3. 3. R in I + S in III >25 mm
  4. 4. R in V6 >26 mm
  5. Additional criteria:
    • LV strain pattern (ST depression and T wave inversion in leads I, aVL, V4-V6)
    • Left atrial enlargement

Differential includes:

  1. LV Mass increase & hypertension, hypertrophic cardiomyopathy
  2. LV Pressure overload – aortic stenosis, hypertrophic cardiomyoathy with obstruction
  3. LV Volume overload & aortic insufficiency, mitral regurgitation

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