Voir la suite de cet article sur Cursus ECG
Patient
Young patient with familial hypertrophic cardiomyopathy;
Trace
Left ventricular hypertrophy with major increase in voltages which no longer fit into the grid; very distinct increase in R wave amplitude in V4, V5, V6 but also in leads I, II and aVF; increase in S wave in V1, V2; positive Sokolow index (SV1 + RV5 = 60); positive Lewis index ([RI – SI] + [RIII - SIII] = 35); repolarization disorders in leads I, II, aVF, V4-V6 with ST segment depression and negative T-waves;
Exergue
Left ventricular hypertrophy does not reverse the electrical potentials but rather exaggerates the normal patterns. Diagnosis is based on the increase in voltages corresponding to the activation of the left ventricle. In clinical practice, the Sokolow index is the most commonly used.
Left ventricular hypertrophy corresponds to an increase in the size of left myocardial ventricular fibers most often in response to pressure overload (essential hypertension and aortic stenosis) or volume overload (aortic or mitral regurgitation) with the exception of hypertrophic cardiomyopathy