Chamber Hypertrophy and Enlargment: Difference between revisions

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==Left ventricular hypertrophy==
==Left ventricular hypertrophy==
[[Image:E_lvh.jpg|thumb|left|300px|LVH. R in V5 is 26mm, S in V1 in 15mm. The sum is 41 mm which is more than 35 mm and therefore LVH is present according to the Sokolow-Lyon criteria.]]
[[Image:E_lvh.jpg|thumb|right|300px|LVH. R in V5 is 26mm, S in V1 in 15mm. The sum is 41 mm which is more than 35 mm and therefore LVH is present according to the Sokolow-Lyon criteria.]]
[[Image:LVH.png|thumb|250px]]
[[Image:LVH.png|thumb|250px]]


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In the '''Romhilt-Estes Score''' LVH is ''likely'' with 4 or more points. LVH is ''present'' with 5 or more points:
In the '''Romhilt-Estes Score''' LVH is ''likely'' with 4 or more points. LVH is ''present'' with 5 or more points:
* Amplitude of R or S wave in limb leads >2.0 mV, or S wave in V1 or V2 >3.0 mV, or R wave in V5 or V6 >3.0 mV = 3 points.
Romhilt-Estes point score system ("diagnostic" >5 points; "probable" 4 points):
* ST-segment changes with or without digitalis = 1 or 2 points, respectively.
{|
* LA abnormality = 3 points.
||ECG Criteria||Points
* Left-axis deviation -30° or more = 2 points.
|-
* QRS duration >90 ms = 1 point.
||Voltage Criteria (any of):
* Intrinsicoid deflection in V5 or V6 = 0.05 to 0.07 s.
# R or S in limb leads ≥20 mm
# S in V<sub>1</sub> or V<sub>2</sub> ≥30&nbsp;mm
# R in V<sub>5</sub> or V<sub>6</sub> ≥30&nbsp;mm
||3
|-
||ST-T Abnormalities:
* ST-T vector opposite to QRS without digitalis
* ST-T vector opposite to QRS with digitalis
||
3<br/>
1
|-
||Negative terminal P mode in V<sub>1</sub> 1&nbsp;mm in depth and 0.04 sec in duration (indicates [[left atrial enlargement]])
||3
|-
||Left axis deviation (QRS of -30° or more)
||2
|-
||QRS duration ≥0.09 sec
||1
|-
||Delayed [[intrinsicoid deflection]] in V<sub>5</sub> or V<sub>6</sub> (>0.05 sec)
||1
|}
 


Left ventricular hypertrophy has prognostic consequences as has been found in several studies.<cite>Levy</cite><cite>Sundstrom</cite>
Left ventricular hypertrophy has prognostic consequences as has been found in several studies.<cite>Levy</cite><cite>Sundstrom</cite>
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