What constitutes left ventricular hypertrophy (LVH) pattern on ECG/telemetry?

What constitutes left ventricular hypertrophy (LVH) pattern on ECG/telemetry?

• A. Increased QRS voltage in left-sided leads with repolarization abnormalities
• B. ST elevation in V1
• C. Prolonged QT interval
• D. Increased QRS voltage in left-sided leads with possible repolarization abnormalities

Answer: (D)

Left ventricular hypertrophy on ECG is identified by higher-than-normal QRS voltages in the left-sided leads (such as V5–V6 and I/aVL) often accompanied by repolarization changes that reflect LV strain. The key idea is that increased QRS voltage is the main clue, and repolarization abnormalities may be present but are not required. ST elevation in V1 and a prolonged QT interval don’t describe the LVH pattern, so the description that combines increased QRS voltage with possible repolarization abnormalities best fits LVH.

Left ventricular hypertrophy on ECG is identified by higher-than-normal QRS voltages in the left-sided leads (such as V5–V6 and I/aVL) often accompanied by repolarization changes that reflect LV strain. The key idea is that increased QRS voltage is the main clue, and repolarization abnormalities may be present but are not required. ST elevation in V1 and a prolonged QT interval don’t describe the LVH pattern, so the description that combines increased QRS voltage with possible repolarization abnormalities best fits LVH.