Cardiovascular Medicine Book

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Left Ventricular Hypertrophy Related EKG Changes

Aka: Left Ventricular Hypertrophy Related EKG Changes, Estes Criteria
  1. See Also
    1. Left Ventricular Hypertrophy
  2. 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
  3. 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
  4. 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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