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Left Ventricular Hypertrophy with Repolarization Abnormality

Description

A 64 year-old male with uncontrolled hypertension despite maximal three-agent antihypertensive therapy and stage IV chronic kidney disease presents with electrocardiogram findings prominent for normal sinus rhythm at 84 bpm with left-axis deviation and severe left ventricular hypertrophy meeting multiple voltage criteria (below) with evidence of strain/repolarization abnormality in V2-V4 and V6 as ST segments & T-waves deviate in the opposite direction as the QRS. 1.Cornell Criteria: sens (42%), spec (95%) - aVL R Wave (13 mm) + V3 S Wave (18 mm) > 28 mm (males) 2.Sokolow-Lyon Criteria: sens (20%), spec (>85%) - V1 S Wave (21 mm) + V5/V6 R Wave (20 mm) > 35 mm & - aVL R Wave (13 mm) > 11 mm 3. Romhilt-Estes LVH Score Point System: 12 > 5 (83-97% specific)

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