======EKG Criteria======

===== LV Hypertrophy =====

Diagnostic criteria
  * Sokolow and Lyon – S in V1 + R wave in V5 or V6 ≥ 35 mm.
  * Cornell – R in aVL + S wave in V3 > 28 mm for men, or > 20 mm for women
  * Roberts – QRS voltage in all leads > 175 to 225 mm.
  * Scott
    * Limb leads:
      * R in I + S in 3 more than 25 mm
      * R in aVL more than 11 mm or >18 mm if left axis is present
      * R in aVF more than 20 mm
      * S in aVR more than 14 mm
    * Chest leads:
      * S in V1 or V2 + R in V5 or V6 more than 35 mm
      * R in V5 or V6 more than 26 mm
      * R + S in any V lead more than 45 mm
  * [[https://www.uptodate.com/contents/image?imageKey=CARD%2F51012&topicKey=CARD%2F2123&source=see_link|Romhilt-Estes scoring system]] — A score of 5 or more indicates "definite" LVH; a score of 4 indicates "probable" LVH.
  
===== RV Hypertrophy =====

  * R > S in V1 (suggestive); exclude other causes
    * Right bundle branch block
    * Posterior wall MI
    * WPW
    * Hypertrophic cardiomyopathy
    * Early precordial transition
  * Other clues to diagnosis:
    * Right axis deviation (>+90)
    * R in V1 >6 mm
    * R in V1 + S in V5 or V6 >10.5 mm
    * R/S ratio in V1 >1
    * S/R ratio in V6 >1
    * Late intrinsicoid deflection in V1 (>0.035 sec)
    * Incomplete right bundle branch block
    * ST-T wave abnormalities ("strain") in inferior leads
    * Right atrial hypertrophy/overload (“P pulmonale”)
    * S>R in leads I, II, III, particularly in children (S1S2S3 pattern)