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Left ventricular hypertrophy with secondary repolarization abnormalities as seen on ECG Histopathology of (a) normal myocardium and (b) myocardial hypertrophy. Scale bar indicates 50 μm. Gross pathology of left ventricular hypertrophy. Left ventricle is at right in image, serially sectioned from apex to near base.
In electrocardiography, a strain pattern is a well-recognized marker for the presence of anatomic left ventricular hypertrophy (LVH) in the form of ST depression and T wave inversion on a resting ECG. [1] It is an abnormality of repolarization and it has been associated with an adverse prognosis in a variety heart disease patients.
The clinician must therefore be well versed in recognizing the so-called ECG mimics of acute myocardial infarction, which include left ventricular hypertrophy, left bundle branch block, paced rhythm, early repolarization, pericarditis, hyperkalemia, and ventricular aneurysm. [7] [8] [9] Localisation of the occlusion in the ECG showing STEMI changes
Ventricular hypertrophy can result from a variety of conditions, both adaptive and maladaptive. For example, it occurs in what is regarded as a physiologic, adaptive process in pregnancy in response to increased blood volume; but can also occur as a consequence of ventricular remodeling following a heart attack .
This delays the onset of the intrinsicoid deflection. This prolongation or delay is an important criterion for diagnosing bundle branch block or ventricular hypertrophy. Time of onset of intrinsicoid deflection > 0.04 seconds (just over one small box) is used as a non-voltage related criterion to diagnose left ventricular hypertrophy. [2]
The diagnosis of left ventricular outflow tract obstruction is usually made by echocardiographic assessment and is defined as a peak left ventricular outflow tract gradient of ≥ 30 mmHg. [35] Another, non-obstructive variant of HCM is apical hypertrophic cardiomyopathy (AHCM or ApHCM), [37] also called Yamaguchi syndrome.
Horizontal ST depression in V4, V5, V6 leads during a cardiac stress ECG. Other, non-ischemic, causes include: Side effect of digoxin [4] [3] Hypokalemia [4] [3] Right or left ventricular hypertrophy [3] Intraventricular conduction abnormalities (e.g., right or left bundle branch block, WPW, etc.) [3] Hypothermia [4] Tachycardia [4] Reciprocal ...
Ventricular remodeling may include ventricular hypertrophy, ventricular dilation, cardiomegaly, and other changes. It is an aspect of cardiomyopathy, of which there are many types. Concentric hypertrophy is due to pressure overload, while eccentric hypertrophy is due to volume overload. [6]
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