What does LVH by voltage criteria in an ECG mean?!


Question: LVH - left ventricular hypertrophy means a thickening of the muscle in the main pumping chamber of the heart. There are many causes, of which high blood pressure(hypertension) is by far the most common. In fact anything that makes the heart have to pump harder will also cause the muscle to thicken, just as say your biceps would if you did a lot of weight training.

The ECG measures the electrical activity of the heart muscle, so it stands to reason that the more muscle there is, the high the voltages produced. This is essentially the most common method for detecting LVH on an ECG and there have been a number of diagnostic criteria devised.

HOWEVER, this is an extremely inaccurate method of determining whether the heart muscle is thicker than it should be and results should be viewed with extreme caution. For example in thin people there is often LVH by voltage criteria but on further investigation this is not the case. It also misses a significant percentage of people with LVH and has never been recommended for use as a screening tool.

The best test for detecting LVH is an ultrasound scan of the heart, known as an Echocardiogram or echo for short.


Answers: LVH - left ventricular hypertrophy means a thickening of the muscle in the main pumping chamber of the heart. There are many causes, of which high blood pressure(hypertension) is by far the most common. In fact anything that makes the heart have to pump harder will also cause the muscle to thicken, just as say your biceps would if you did a lot of weight training.

The ECG measures the electrical activity of the heart muscle, so it stands to reason that the more muscle there is, the high the voltages produced. This is essentially the most common method for detecting LVH on an ECG and there have been a number of diagnostic criteria devised.

HOWEVER, this is an extremely inaccurate method of determining whether the heart muscle is thicker than it should be and results should be viewed with extreme caution. For example in thin people there is often LVH by voltage criteria but on further investigation this is not the case. It also misses a significant percentage of people with LVH and has never been recommended for use as a screening tool.

The best test for detecting LVH is an ultrasound scan of the heart, known as an Echocardiogram or echo for short.

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The previous answer was pretty thorough and is correct. I am an echo tech, and as far as I am concerned, there is no better test for left ventricular hypertrophy than an echo, short of dissection. In reference to hypertension, I believe there is a very high correlation with LVH and hypertension, though I am sure there are exceptions. Also, cardiomegaly simply means that the heart is enlarged. It can be enlarged due to LVH, RVH (yes, you guessed it. Right ventricular hypertrophy), or due to dilation of any of the chambers of the heart. Dilation is caused by an increase in blood volume in the heart, and hypertrophy is caused by an increase in pressure.





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