Braunstein et al reported a score diagnosing left ventricular hypertrophy based on changes seen in the electrocardiogram. The authors are from Albert Einstein College of Medicine and Mount Sinai Medical Center in New York City.
Parameters:
(1) R wave amplitude in V6
(2) S wave amplitude in V3
(3) Q wave amplitude in V3
(4) sex
(5) QRS duration in milliseconds
(6) T wave in V6
(7) limb lead R- and T-wave axis
(8) amplitude of negative P-wave terminal deflection in V1
(9) amplitude of positive deflection in V1
sum of wave amplitudes =
= (R wave amplitude in V6) + (S wave amplitude in V3) + (Q wave amplitude in V3)
Parameter
Finding
Points
sum of wave amplitudes
> 4.0 mV in male
1
> 3.2 mV in female
1
else
0
QRS duration
<= 100 ms
0
> 100 ms
1
T wave in V6
T wave < 0 when overall QRS vector is positive
1
other
0
limb lead R and T wave axis
discordant (difference <= 75 or > 75)
0.5
not discordant
0
amplitudes of P wave in V1
amplitude of negative terminal deflection greater than amplitude of positive deflection
0.5
other
0
where:
• The QRS vector in V6 is positive if the R wave is greater than the S wave.
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 4
• A score >= 1.5 has a sensitivity of 68% and specificity of 81%.
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