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Additional ECG changes seen in LVH. Left atrial enlargement. Left axis deviation. ST elevation in the right precordial leads V1-3 (“discordant” to the deep S waves) Prominent U waves (proportional to increased QRS amplitude) LVH by voltage criteria: S wave in V2 + R wave in V5 > 35 mm.
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The electrocardiogram (ECG) is a useful but imperfect tool for detecting LVH. The utility of the ECG relates to its being relatively inexpensive and widely available. The limitations of the ECG relate to its moderate sensitivity or specificity depending upon which of the many proposed sets of diagnostic criteria are applied [ 1,2 ].
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