Left ventricular hypertrophy (LVH)
Also calledLVH · left ventricular hypertrophy · LV hypertrophy
Definition
An electrocardiographic pattern of increased left ventricular mass shown by increased QRS voltage, which may be accompanied by secondary ST-T abnormalities in the left-sided leads (ST depression with asymmetric T-wave inversion; the older label 'strain' is now discouraged). Common voltage criteria include Sokolow-Lyon (S in V1 plus R in V5 or V6 of 35 mm, i.e. 3.5 mV, or more) and Cornell (R in aVL plus S in V3 greater than 28 mm in men and greater than 20 mm in women), where 10 mm equals 1 mV at standard calibration.
Clinical noteVoltage criteria are specific but insensitive: sensitivity is usually under 50 percent while specificity is often 85 to 90 percent. High QRS voltage without hypertrophy can occur in children, young adults, slender people and athletes, and the commonly used voltage criteria apply to adults over 35.
Sources
- Hancock EW, Deal BJ, Mirvis DM, et al. AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: part V: electrocardiogram changes associated with cardiac chamber hypertrophy. Circulation. 2009;119(10):e251-e261. doi.org/10.1161/CIRCULATIONAHA.108.191097
- Casale PN, Devereux RB, Alonso DR, Campo E, Kligfield P. Improved sex-specific criteria of left ventricular hypertrophy for clinical and computer interpretation of electrocardiograms: validation with autopsy findings. Circulation. 1987;75(3):565-572. doi.org/10.1161/01.cir.75.3.565
- Samesima N, God EG, Kruse JCL, et al. Brazilian Society of Cardiology guidelines on the analysis and issuance of electrocardiographic reports - 2022. Arq Bras Cardiol. 2022;119(4):638-680. doi.org/10.36660/abc.20220623
Last reviewed 2 October 2026. Every definition in the EKG Dictionary cites the guideline, consensus statement or original paper it comes from.