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Left Ventricular Hypertrophy Related EKG ChangesAka: Estes Criteria

See Also
1. Left Ventricular Hypertrophy
Quick Measures consistent with LVH
1. (S in V1 or V2) + (R in V5 or V6) >35 mm (over age 35)
2. R in AVL > 12 mm
Scott Criteria
1. Limb Leads
  1. R in I added to S in III exceed 25 mm
  2. R in aVL exceeds 7.5 mm
  3. R in aVF exceeds 20 mm
  4. S in aVR exceeds 14 mm
2. Chest Leads
  1. S in V1 (or V2) Added to R in V5 (or V6) exceed 35 mm
  2. R in V5 or V6 exceeds 26 mm
  3. R + S in any precordial lead exceeds 45 mm
Estes Criteria
1. Major criteria: 3 points if all present
  1. R or S in limb lead exceeds 19 mm
  2. S in V1 or V2 exceeds 29 mm
  3. R in V5 or V6 exceeds 30 mm
2. Other Criteria
  1. Any ST shift without Digoxin: 3 points
  2. ST Strain pattern without Digoxin: 1 point
  3. Left Axis Deviation beyond -30 degrees: 2 points
  4. QRS wider than 0.09 seconds: 1 point
  5. Intrinsicoid deflection in V5-6 over 0.05: 1 point
  6. P-terminal force in V1 exceeds 0.04: 3 points
3. Interpretation
  1. Left Ventricular Hypertrophy: 5 points
  2. Probable Left Ventricular Hypertrophy: 4 points

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This page was written by Scott Moses, MD, and was last revised 1/13/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 5.0.