Left Ventricular Hypertrophy: A Common STEMI Mimic

Left ventricular hypertrophy (LVH) is a common condition that can be difficult to diagnose using electrocardiographic diagnostic criteria. In this article, we will explore the importance of recognizing LVH as a potential STEMI mimic and discuss its characteristics and implications.

The most widely used criteria for diagnosing LVH is the Sokolow-Lyon criteria, which states that if the sum of the amplitude of the S wave in lead V1 and R wave in lead V5/6 is greater than 35 mm, LVH is present. However, electrical remodeling of the left ventricle in the setting of hypertrophy can cause ST elevation in leads V1-V3, which may be mistaken for a STEMI.

LVH is recognized as a common STEMI mimic, with studies showing that it accounts for up to 25% of cases. This is important because LVH can lead to inappropriate activation of cardiac catheterization lab personnel and unnecessary treatment of patients who do not require it. In addition, LVH may exhibit ST changes or other electrocardiographic abnormalities that can be difficult to distinguish from a true STEMI.

As advanced practice providers, it is essential to be able to recognize the differences between LVH and a true STEMI on an ECG. This requires a thorough understanding of the characteristics of each condition and the ability to interpret electrocardiograms accurately.

In conclusion, left ventricular hypertrophy is a common condition that can mimic a STEMI on an electrocardiogram. It is essential for healthcare providers to be aware of this possibility and to use accurate diagnostic criteria to distinguish LVH from a true STEMI. By recognizing LVH as a potential STEMI mimic, we can avoid unnecessary treatment and improve patient outcomes.

Lvh with ivcd