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 (Ml) 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 > 1.3 mV, 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 Ml. 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 pan of a point scoring system.