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Left Ventricular Hypertrophy

Definition

Enlargement of the Left Ventricle of the heart, causing ECG changes that may mimic STEMI but which are generally benign.

History/Physical Exam

History may include hypertension, aortic stenosis, hypertrophic cardiomyopathy.

Key 12-Lead Features

Presence of LVH

S(V1 or V2) + R(V5 or V6) > 35mm

Strain Pattern

ST Elevation V1-4
ST Depression / Inverted T waves V5 and V6
Generally proceeds from most elevated V1/2 to most depressed V6
Consider utilizing LP15 measurements to help identify

12 Lead ECG Sample

Further Reading

Reference

Ogah OS, et al. Electrocardiographic left ventricular hypertrophy with strain pattern: Prevalence, mechanisms and prognostic implications. 2008. [Link]