The Influence of Q-wave Acute Anteroseptal Myocardial Infarction on the Voltage Criteria for Left Ventricular Hypertrophy

The influence of Q wave acute anteroseptal myocardial infarction (MI) on the sensitivity of the voltage electrocardiographic criteria of left ventricular hypertrophy (LVH) was assessed in this study. Patients with Q wave acute anteroseptal myocardial infarction but without echocardiographic (echo) LVH, showed augmentation of QS deflections in leads V1 and / or V2 , and of R waves in V6. Utilization of the criteria RI > 1.3mV, R aVL >1.1 mV and SV1 + RV5 / RV6 > 3.5 mV resulted in 30% false positive voltage criteria of LVH. However, compared to age and sex dependent normal limits, the voltages of RI and R aVL were not augmented by acute Q wave acute anteroseptal MI. These results inevitably influence the accuracy of the standard electrocardiographic (ECG) criteria for the diagnosis of LVH and therefore there is a need to consider whether or not they should be used alone or as a part of a point scoring system.