LVH with secondary repolarization abnormalities
Exertional Palpitations in a Man With Hypertension
A 51-year-old man with longstanding hypertension and kidney disease presents with palpitations, chest discomfort, and exertional breathlessness.
Some QRS peaks are already clipped in the source figure. Use this tracing for recognition without requiring measurements of clipped peaks.
Look for
- High QRS voltages.
- Associated ST–T abnormalities described by the source.
Where to look. Compare precordial voltages and ST segments/T waves in I, aVL, V5–V6.
Altered ventricular activation and recovery can accompany LVH. Inverted T waves therefore do not, in isolation, prove acute ischemia.
Apical hypertrophic cardiomyopathy is documented by other investigations; it must not be inferred from the ECG alone.
References & provenance
The ECG Made Easy, 9e, ch. 5, PDF 125–128; Lilly, 6e, ch. 4, p. 91–92.
Azeem Rathore; Julia C Fortier; Kai Chen; Dinesh Kadariya; John N Catanzaro; Alexander Muacevic; John R Adler. High-Risk Apical Hypertrophic Cardiomyopathy Requiring an Implantable Cardioverter-Defibrillator: A Case Report of an Overlooked Etiology. 2023. doi:10.7759/cureus.41564. Figure 1. CC BY 4.0. CC BY 4.0
Adaptation: cropping and removal of headers/annotations outside the tracing where applicable; metadata removed. Waveforms have not been redrawn.
Compared with the published source; no independent clinical validation is claimed.
Original annotations & limitations
HVG avec anomalies de repolarisation
Homme de 51 ans avec HTA ancienne et maladie rénale; palpitations, gêne thoracique et dyspnée d’effort; cardiomyopathie hypertrophique apicale documentée.
Ne pas demander de diagnostiquer la forme apicale sur l’ECG seul. La légende QT «512 ms» doit être re-mesurée, pas recopiée comme QTc.