ECG - LVH/RVH

ECG - LVH/RVH

LVH:

• • SV1 + RV5 or RV6 >35 mm in adults >30 years

  • RV5 or RV6 >30 mm

  • SV1-2 >20 mm

  • RaVL >11 mm

  • R in I > 11 mm

  • LAD> -30°

  • ST seg depression of 1mm or more in leads I, aVL, V5 - V6

  • T wave inversion in I, aVL, V5 - V6 (strain pattern)

  • LAE usually present

Conditions: HTN, AS, HOCM, MR, AR, PDA

RVH:

• • R/S in V1 >1. (R/o post MI)

  • RV1 >7 mm

  • Decreasing R waves V1 - V4

  • S waves in V5 - V6 >5 mm. Prominent S waves across the precordial leads in the presence of RAD, suggest RVH.

  • RAD: >100°

  • ST segment depression >1 mm, flipped T waves in II, III, aVF, V1 - V3 (strain pattern)

  • RAE present

  • RAD +110°

Conditions: PS, Pulmonary HTN, TR, ASD

RVH in pulmonary disease:

• • Deep S waves across most precordial leads

  • R wave transition acrosss precordial leads is delayed

  • RAD

  • RAE

  • Low voltage R waves (R + S) <5 mm in all limb leads & <10 mm in all precordial leads

    • COPD, pericardial effusion, pleural effusion, obesity, myxedema, restrictive or infiltrative CMP, diffuse CAD.