Left ventricular hypertrophy (1)

Features of LV strain pattern include:

Limb Leads

R wave in lead I + S wave in lead III > 25 mm
R wave in aVL > 11 mm
R wave in aVF > 20 mm
S wave in aVR > 14 mm

Precordial Leads

R wave in V4, V5 or V6 > 26 mm
R wave in V5 or V6 plus S wave in V1 > 35 mm
Largest R wave plus largest S wave in precordial leads > 45 mm

Left ventricular strain pattern (1)

Features of LV strain pattern include:

  • T-wave inversion – inferior and lateral leads
  • ST-segment depression inferior and lateral leads (becomes increasingly common as the hypertrophy progresses)