Thanks to Dr. Nathan Blau for presenting on Cardiac Hypertrophy.
Consider the patient’s clinical picture when reading EKG
COPD, hypertension, athlete, history of volume overload, history of pressure overload, etc.
Right ventricular hypertrophy (RVH)
Right axis deviation is the most common, and at times, the only EKG finding of RVH
Large R-waves in the RIGHT sided leads (V1, V2), rSR’ pattern (but is not RBBB), deep S-wave in LEFT sided leads (V5, V6)
Left ventricular hypertrophy (LVH)
Large R-waves in LEFT sided leads (V5, V6, I, and aVL) and deep S-waves in RIGHT sided leads (V1, V2)
Athletes often have large QRS amplitudes due to ventricular remodeling, but do not have pathological hypertrophy
Many of the voltage criteria for LVH are unreliable in the younger patients
LVH + Right axis deviation
Right axis deviation does not occurs in LVH alone
Questions from the audience:
What voltage criteria do you use for LVH?
The oldest and often most used criteria is the Sokolow-Lyon Criteria. No single criteria is perfect.
Practice with these sample EKGs provided by Dr. Blau: 2018.10.25 Cardiac Hypertrophy
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