Criteria for ECG Diagnosis of Left Ventricular Hypertrophy

Criterion

Finding

Points

Cornell

Men: V3 S wave + aVL R wave > 28 mm

N/A

Women: V3 S wave + aVL R wave > 20 mm

N/A

Romhilt-Estes (5 points = definite LVH; 4 points = probable LVH)

R or S wave 20 mm in any limb lead

or

S wave in V1 or V2 30 mm

or

R wave in V5 or V6 30 mm

3

ST-T changes typical of LVH

1

3

Left atrial changes: P terminal wave in V1, amplitude 1 mm, and duration 0.04 second

3

Left axis deviation 30°

2

QRS duration 90 millisecond

1

Interval between QRS and R-wave peak in V5 or V6 0.05 second

1

Sokolow-Lyon

V1 S wave + V5 or V6 R wave 35 mm

or

aVL R wave 11 mm

N/A

ECG = electrocardiography; LVH = left ventricular hypertrophy.

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