Define lvh

[muscles]

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My question is this - what do people use as criteria for LVH.
I have seen several:

1. Romhilt and Estes point score system
2. Cornell Criteria: R in aVL + S in V3 >28 for men or 20 for women
3. Sokolow and Lyon voltage criteria

Any advise/experience is much appreciated.

 

[grendelsdragon]

My question is this - what do people use as criteria for LVH.
I have seen several:

1. Romhilt and Estes point score system
2. Cornell Criteria: R in aVL + S in V3 >28 for men or 20 for women
3. Sokolow and Lyon voltage criteria

Any advise/experience is much appreciated.

In truth, you should be familiar with more than just one (which is also the case for those taking the Cardiology Boards).

My personal strategy is to consider in the following order:

1. Cornell criteria (it is the most accurate).
2. If neg,. then look at precordial leads using age-dependent Sokolow criteria.
3. Otherwise, look at limb leads:
-R in aVL >= 12 (very specific... except if there is LAFB)
-R in I >= 14
-S in aVR >= 15

I don't much care for the Estes. There are also other limb lead criteria and also non-voltage related criteria that I can't be bothered to remember, or I don't care to spend the time with it.