DETECTION OF LEFT-VENTRICULAR ENLARGEMENT BY ELECTROCARDIOGRAPHY

Cardiomegaly is one of the commonest findings encountered in daily cli nical practice, and its differential diagnosis is a common clinical pr oblem. There are many electrocardiological (ECG) criteria known for le ft ventricular hypertrophy (LVH), but its limitations have also been s uggested. We evaluated 102 patients fulfilling the ECG criteria of pre cordial and limb lead for LVH with echocardiographic findings as a gol d standard. Among these 102 patients, the echocardiogram revealed 38 s ubjects with LVH, 26 subjects with left ventricular dilatation (LVD), 7 subjects with both findings, and 31 subjects with neither findings. Precordial criteria such as SV1+RV5 or RV6 > 30 mm, SV1 or SV2+RV5 > 3 5 mm, R+S > 40 mm, SV1 or SV2+RV5 or RV6 > 35 mm, SV2+RV4 or RV5 > 35 mm, high in sensitivity and low in specificity for LVD and LVH, are ap propriate for screening LVD and LVH. Cornell limb lead criterion, SV3RaVL > 28 mm (male), SV3+RaVL > 20 mm (female), high in sensitivity an d specificity only for LVI-I, is the best elecrocardiographic criterio n to evaluate LVH. Precordial and limb lead criteria such as R > 13 mm , RaVL > 12 mm, RaVF > 20 mm, onset of intrinsicoid deflection in V5 o r V6> 0.05 sec, left axis deviation -30 degrees to -90 degrees, low in sensitivity, and high in specificity, are useful to rule out LVH and/ or LVD. Our findings suggest LVD and LVH can be evaluated by EGG, but similar sensitivity and specificity for both LVH and LVD makes separat ion of LVH from LVD unattainable.