ELECTROCARDIOGRAPHIC LEFT-VENTRICULAR HYPERTROPHY IN CHEST PAIN PATIENTS - DIFFERENTIATION FROM ACUTE CORONARY ISCHEMIC EVENTS

Electrocardiographic left ventricular hypertrophy (LVH) and related re polarization changes alter the morphology of the ST segment and/or the T wave. Such electrocardiographic abnormalities-all features that are encountered in patients with acute ischemic heart disease-may con fou nd the early emergency department evaluation of the chest pain patient , In the instance of the chest pain patient demonstrating ST segment/T wave abnormality, the correct electrocardiographic diagnosis must be made not only to offer appropriate management for that particular illn ess but also to avoid the incorrect application of potentially dangero us therapies such as thrombolysis. This report presents two cases in w hich the electrocardiogram demonstrated significant repolarization cha nges consistent with LVH, and focuses on the recognition of the expect ed ST segment/T waves changes and their differentiation from the prima ry ST segment/T wave changes associated with acute ischemic heart dise ase. Copyright (C) 1998 by W.B. Saunders Company.