Voltage
Results:
Hypertrophic Obstructive Cardiomyopathy (HOCM)
Key Points Definition and mechanics: Genetic hypertrophic cardiomyopathy with asymmetric LV hypertrophy, typically septal, causing dynamic LVOT obstruction from systolic anterior motion (SAM) of the mitral valve. Gradient worsens when…
Right Ventricular Hypertrophy (RVH)
Key Points Definition: Chronic pressure/volume overload → thickened RV (pulm HTN, congenital lesions, pulmonary disease). ECG signature: Rightward axis, dominant R in V1, deep S in V5–V6, with possible right-sided…
Left Ventricular Hypertrophy (LVH)
Key Points Pathophysiology: Chronic pressure overload thickens the LV wall. Expect prolonged depolarization vectors and delayed repolarization that produce characteristic ECG voltage and ST-T changes. ECG signature: High precordial voltages,…
LV Aneurysm
Key Points Definition: LVA is a chronic complication of prior transmural MI, caused by scar tissue formation and paradoxical wall motion. Persistent ST Elevation: ST elevation lasting > 2 weeks…
QRS Voltage: Basics
Key Points Definition: QRS voltage represents the amplitude (height) of the QRS complex on ECG, reflecting ventricular electrical activity during depolarization. High Voltage: Increased QRS voltage typically indicates ventricular hypertrophy—most…
Low Voltage QRS: DDx
Key Points: Definition: Low voltage QRS complexes reflect decreased myocardial electrical amplitude on ECG. Sensitive Definition (Preferred): Limb leads (I + II + III) sum < 15 mm OR precordial…
Electrical Alternans
Key Points Classically associated with pericardial tamponade but seen in fewer than 30% of confirmed cases. Combination of low-voltage QRS + sinus tachycardia strongly suggests pericardial effusion/tamponade. Always perform rapid…
Pericardial Effusion
Key Point Always consider pericardial effusion in any patient with new low-voltage QRS complexes combined with sinus tachycardia. Prompt bedside ultrasound (POCUS) prevents diagnostic delays and potentially catastrophic outcomes. Classic…
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