The electrocardiographic diagnosis of right ventricular hypertrophy

Myers, Gordon B.; Klein, Howard A.; Stofer, Bert E.

doi:10.1016/0002-8703(48)90182-3

Cited by 203 publications

(39 citation statements)

References 37 publications

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“…The ECG criteria for LVH shown in Table 1 have evolved over the years. [65][66][67][68][69][70][71][72][73][74][75][76][77][78] Criteria were originally based on R and S amplitudes in standard limb leads I and III, using clinical and autopsy data as reference standards. 4 -6 (Amplitudes of ECG complexes are referred to in millimeters, rather than millivolts.…”

Section: Left Ventricular Hypertrophy Diagnostic Criteria Based On Qrmentioning

confidence: 99%

AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram

Hancock¹,

Deal²,

Mirvis³

et al. 2009

Circulation

286

111

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Section: Left Ventricular Hypertrophy Diagnostic Criteria Based On Qrmentioning

confidence: 99%

AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram

Hancock¹,

Deal²,

Mirvis³

et al. 2009

Circulation

286

111

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“…Occurrence of a QS pattern or of a significant Q wave in leads V3 and V4 and on some occasions even in leads V5 and V6, in the absence of myocardial infarction, has been demonstrated in cases of left ventricular hypertrophy,1' , 12,14,15,28 hypertrophy or dilatation of the right ventricle8 10, 12, 13, 19-22, complete or "incomplete" left bundle branch block, 16' 17, 18, 23-26 right bundle branch block,23 and displacement of the heart. 15 In his study of electrocardiograms which may be mistaken for myocardial infarction, Myers emphasized the occurrence of these patterns on several occasions.…”

mentioning

confidence: 99%

QS- and QR-Pattern in Leads V ₃ and V ₄ in Absence of Myocardial Infarction: Electrocardiographic and Vectorcardiographic Study

et al. 1955

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A QS or QR pattern in the absence of myocardial infarction is frequently present in lead V3 and occasionally in lead V4. Exploration by means of multiple chest and abdominal unipolar leads and vectorcardiograms revealed that in almost all such cases, the vector of the initial portions of the QRS complex is directed downwards. Accordingly, in the absence of infarction, patients presenting this pattern almost invariably showed an initial R wave in the leads recorded from positions below the standard level of V3 and V4. The vast majority of patients with myocardial infarction with a similar QRS pattern showed a Q wave in the lower leads. Consideration of vertical components of cardiac voltages may be helpful in the interpretation of the precordial leads.T HE PRESENCE of a QS pattern or of an abnormally deep and wide Q wave (deeper than 25 per cent of succeeding R wave and wider than 0.04 second) in precordial leads V3 to V6 is usually, although not invariably, attributed to myocardial infarction. Occurrence of a QS pattern or of a significant Q wave in leads V3 and V4 and on some occasions even in leads V5 and V6, in the absence of myocardial infarction, has been demonstrated in cases of left ventricular hypertrophy,1' , 12, 14, 15, 28 hypertrophy or dilatation of the right ventricle8 10, 12, 13, 19-22, complete or "incomplete" left bundle branch block,16' 17, 18, 23-26 right bundle branch block,23 and displacement of the heart.15 In his study of electrocardiograms which may be mistaken for myocardial infarction, Myers emphasized the occurrence of these patterns on several occasions.

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“…In case 7 the R wave in V1 is 0.25 millivolt. The 7) shows the reason for the small R wave in V1. Although the loop is inscribed in a clockwise direction, and far to the right, it lies only slightly anterior to the E point, hence the relatively small R in V1.…”

Section: Horizontal Planementioning

confidence: 94%

The Deep S Wave in Leads V ₁ , V ₂ , and V ₃ in Right Ventricular Hypertrophy

Shubin¹,

Levinson²

1958

Circulation

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Six patients with mitral stenosis, 3 with pulmonic stenosis, and 1 with pulmonary hypertension are presented. All had isolated right ventricular hypertrophy and all had deep S waves in V,, V2, or V3. In 3 cases the voltage of R in V1 was less than 0.5 millivolt. In 3 cases R/S ratios in V1 of less than 1.0 were present. Veetorcardiogramns showed characteristic features and illustrated the reasons for the electrocardiographic findings.T HE presence of a deep S wave in leads V1 or V2 is often interpreted as evidence suggesting left ventricular hypertrophy. Since the maximal electric force in left ventricular hypertrophy usually moves to the left and posteriorly, the presence of a deep S wave in leads V1 or V2 often correlates well with this condition.In the interpretation of hypertrophies of congenital or acquired heart disease, the presence of a deep S wave in V1 or V2 may, however, not be due to left ventricular hypertrophy, either isolated, or in combination with right ventricular hypertrophy.Ten cases of isolated right ventricular hypertrophy in which deep S waves were present in either V1, V2, or V3 have been reviewed. There were 6 patients with pure mitral stenosis, 3 with isolated pulmonic stenosis, and 1 with " primary " pulmonary hypertension. The mitral stenosis cases were diagnosed by cardiac catheterization (table 1), and were confirmed at surgery in 4 instances. Subsequently one of these was also confirmed at autopsy and had right ventricular hypertrophy, but no left ventricular hypertrophy. Of the 3 cases with isolated pulmonic stenosis 2 were diagnosed at cardiac catheterization (table 1), and confirmed later at surgery. The third case of pulmonic stenosis was a relatively mild one and was diagnosed by cardiac catheterization alone (table 1). The single

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The electrocardiographic diagnosis of right ventricular hypertrophy

Cited by 203 publications

References 37 publications

AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram

AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram

QS- and QR-Pattern in Leads V ₃ and V ₄ in Absence of Myocardial Infarction: Electrocardiographic and Vectorcardiographic Study

The Deep S Wave in Leads V ₁ , V ₂ , and V ₃ in Right Ventricular Hypertrophy

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The electrocardiographic diagnosis of right ventricular hypertrophy

Cited by 203 publications

References 37 publications

AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram

AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram

QS- and QR-Pattern in Leads V 3 and V 4 in Absence of Myocardial Infarction: Electrocardiographic and Vectorcardiographic Study

The Deep S Wave in Leads V 1 , V 2 , and V 3 in Right Ventricular Hypertrophy

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QS- and QR-Pattern in Leads V ₃ and V ₄ in Absence of Myocardial Infarction: Electrocardiographic and Vectorcardiographic Study

The Deep S Wave in Leads V ₁ , V ₂ , and V ₃ in Right Ventricular Hypertrophy