Voltage
Results:
Electrical Alternans
Key Points: Electrical alternans is a beat-to-beat alternation in QRS amplitude, axis, or both. It is classically associated with a large pericardial effusion and may support concern for tamponade, but…
Pericardial Effusion
Key Points: Pericardial effusion is the accumulation of fluid in the pericardial sac. ECG may provide clues, but it is not sensitive enough to exclude effusion. Important ECG clues include…
Left Ventricular Hypertrophy (LVH)
Key Points: LVH reflects increased left ventricular muscle mass, usually from chronic pressure overload. Common causes include longstanding hypertension and aortic stenosis. ECG diagnosis is imperfect. Voltage criteria are specific…
ECG Findings of LV Aneurysm
Key Points: Definition: A true LV aneurysm is a chronic, post transmural MI complication from scarred myocardium with akinetic or dyskinetic (paradoxical) wall motion. ECG hallmark: Persistent ST elevation in…
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…
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…
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