COMMON ECG FINDINGS IN KENYA.

CLINICAL APPLICATION.

 1. Hypertension.

The common feature is left ventricular hypertrophy.
Based on R wave voltage across the chest leads.

Left Ventricular Hypertrophy (LVH)

General ECG features include:

• ≥ QRS amplitude (voltage criteria; i.e., tall R-waves in LV leads, deep S-waves in RV leads)
• Widened QRS/T angle (i.e., left ventricular strain pattern, or ST-T oriented opposite to QRS direction)
• LEFT AXIS DEVIATION  QRS axis 

Please consider the patient's history and the anti-hypertensive medication.
Measure the patients blood pressure and indicate on the report.
Other Voltage Criteria for LVH:

• Limb-lead voltage criteria:
  • R in aVL ≥ 11 mm or, if left axis deviation, R in aVL ≥ 13 mm plus S in III ≥ 15 mm
  • R in I + S in III > 25 mm
• Chest-lead voltage criteria:
  • S in V1 + R in V5 or V6 ≥ 35 mm
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	ECG report

Sinus rhythm with HR 68bpm.Left Ventricular Hypertrophy.

Notice the high R wave in V4/V5  overshooting AND CAUSING OVERLAP.

BP 150/90mmHg

The LVH Criteria.V1 + R in V5 or V6 ≥ 35 mm

other criteria used.

CORNELL Voltage Criteria for LVH (sensitivity = 22%, specificity = 95%) S in V3 + R in aVL > 24 mm (men) S in V3 + R in aVL > 20 mm (women)