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5.4 Left ventricular hypertrophy
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5.4 Left ventricular hypertrophy

Ischemic heart disease, arterial hypertension, atherosclerosis of aorta are the most widely spread causes of left ventricular hypertrophy, but others include rheumatic aortic stenosis and congenital coarctation of the aorta.

Left ventricular hypertrophy (LVH) may be difficult to diagnose with certainty from the ECG. Different scoring criteria have been recommended. One of the simplest uses five criteria, with the certainty of diagnosis based on the number of criteria present. If one criterium is present, diagnose LVH is possible; if two is probable; if three are found - definite LVH.

mi_lvh.gif (6139 bytes)

 

Figure 49 — Left ventricular hypertrophy

Signs of left ventricular hypertrophy:

R-I + S-III >25 mm.

S-V1 + R-V5 >35 mm.

Negative deflection of ST-Ts in left leads.

R aVL >11 mm.

Signs of left atrial enlargement + other criteria.

Other characteristics of left ventricular hypertrophy: left axis deviation of ventricles; lead V5 and V6 may reveal delayed intrinsic deflection; U wave often may be inverted.



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