# Left Ventricular Hypertrophy EKG Interpretation | EKG.Academy

## Left Ventricular Hypertrophy

### Tech Series ECG Interpretation

Thomas E. O'Brien
AS CCT CRAT RMA

## Objectives

Upon completion of the accompanying narrative and practice, the student will be able to:

• Recall the process for measurement to determine the presence of left ventricular hypertrophy
• Apply the process for measurement to determine the presence of left ventricular hypertrophy
• Determine whether there is electrocardiographic evidence of left ventricular hypertrophy

## Analysis of ECGs

People may choose to analyze ECG’s in a number of different ways. The sequence doesn’t necessarily matter as long as you gather and report the proper information each time.

Lessons

## Intro

Hypertrophy refers to an abnormal thickening of a chamber wall.

Simply put, this abnormal thickening translates to an increase in the voltage of the QRS complex.

The wall thickens due to increased vascular resistance over time

## Intro 2

QRS complexes will show greater amplitude (more muscle mass = more electrical activity)

Taller and deeper ventricular depolarization waves will be seen

Remember: Hypertrophy increases voltage – BBB increases duration.

## Step 1

Determining the presence of LVH is a fairly simple and straight forward three-step process.

• Refer to leads V1 & V2
• Measure and select the deepest ventricular depolarization of the 2 views (not including aberrant complexes)
• Measure from the isoelectric line down to the tip of the deepest QS complex.
• Measure from the isoelectric line down to the tip of the deepest QS complex.
• Write this number down

## Step 2

• Refer to leads V5 & V6
• Measure and select the tallest ventricular depolarization of the 2 views (not including aberrant complexes)
• Measure from the isoelectric line up to the tip of the tallest “R” wave.
• Count the number of millimeters (small boxes)
• Write this number down

## Step 3

• Add the 2 numbers together
• If it adds up to 35mm or more, clinically you must suspect left ventricular hypertrophy

## Example

• Note the red arrows. The deepest “QS” wave from V1 and V2 has been selected
• The tallest R wave in V5 and V6 has been selected
• What is the total number?
• 37 mm, YES!

## Tracing

Take measurements for LVH on this tracing, then answer the questions below.

Yes Correct!

No Incorrect.

## Measurement

What number did you get?

## Tracing

On this tracing, take LVH measurements, then answer the questions below.

Yes Correct!

No Incorrect.

## Measurement

What number did you get?

## Tracing

Using the tracing, determine LVH measurements, then answer the questions below.

Yes Correct!

No Incorrect.

## Measurement

What number did you get?

## Tracing

Take LVH measurements on this practice tracing, then answer the questions below.

Yes Incorrect.

No Correct!

## Measurement

What number did you get?

## Tracing

Practice taking LVH measurements on this tracing, the answer the questions below.

Yes Incorrect.

No Correct!

## Measurement

What number did you get?

## Sources

? v:2 | cc: | tar: False | onAr:0 | onPs:2 | tLb:2 | tLbJs:0
| pv: 1 uStat: False | db:0 | shouldInvoke:False | pu:False | em: | refreshTime: 1/1/0001 12:00:00 AM || now: 6/25/2024 10:29:48 PM | firstPage: True
| statusStg: | cDbLookup# 0