Left ventricular hypertrophy

Electrocardiograms from patients presenting with LVH demonstrate variably increased R wave voltage and duration in leads over the right ventricle (V5 and V6 - circled below). In 35% - 90% of the cases, there is a delay between the onset of the QRS complex and the R wave. This intrinsicoid deflection may extend to greater than 0.05 seconds. Furthermore, delayed repolarization as a result of ventricular hypertrophy generally produces ST depression and T wave inversion in the same leads. Enlargement of the left ventricle is commonly associated with left atrial enlargement as well as incomplete LBBB. Leads V2 and V3 commonly demonstrate increased S wave amplitude (arrow below), while leads V5 and V6 show increased R wave amplitude. Left ventricular hypertrophy may be associated with conditions giving rise to pressure or volume overload of the left ventricle such as aortic stenosis or systemic hypertension. Furthermore, LVH increases patient risk of other cardiovascular diseases including myocardial infarction, congestive heart failure, stroke, arrhythmia and sudden death.