LVH Criteria on ECG
🧠Remember: ECG has low sensitivity but high specificity for LVH.
✅ Sokolow-Lyon Criteria
- S wave in V1 + R wave in V5 or V6 ≥ 35 mm
- R wave in aVL ≥ 11 mm
✅ Cornell Criteria
- R wave in aVL + S wave in V3 >
- 28 mm in men
- 20 mm in women
✅ Romhilt-Estes Point Score System
- Voltage criteria: 3 points
- ST-T strain pattern: 3 points
- Left atrial enlargement: 3 points
- Left axis deviation: 2 points
- QRS duration ≥ 0.09s: 1 point
- Delayed intrinsicoid deflection in V5/V6: 1 point
- ≥5 points = definite LVH
- 4 points = probable LVH
âš¡ LVH-Associated ST-T Changes (Strain Pattern)
- Downsloping ST depression
- T wave inversion
- Seen in lateral leads (I, aVL, V5–V6)