Display options
Cite
Shoenberger JM, Voskanian S, Johnson S, et al. Left ventricular hypertrophy may be transient in the emergency department. West J Emerg Med. 2009;10(3):140-3
Shoenberger, J. M., Voskanian, S., Johnson, S., Ahern, T., & Henderson, S. O. (2009). Left ventricular hypertrophy may be transient in the emergency department. The western journal of emergency medicine, 10(3), 140-3.
Shoenberger, Jan M, et al. "Left ventricular hypertrophy may be transient in the emergency department." The western journal of emergency medicine vol. 10,3 (2009): 140-3.
Shoenberger JM, Voskanian S, Johnson S, Ahern T, Henderson SO. Left ventricular hypertrophy may be transient in the emergency department. West J Emerg Med. 2009 Aug;10(3):140-3. PMID: 19718372; PMCID: PMC2729211.
Copy Download .nbib Format: NLM
Share it on

West J Emerg Med. 2009 Aug;10(3):140-3.

Left ventricular hypertrophy may be transient in the emergency department.

The western journal of emergency medicine

Jan M Shoenberger, Serineh Voskanian, Sara Johnson, Terence Ahern, Sean O Henderson

Affiliations

  1. Keck School of Medicine of the University of Southern California, Department of Emergency Medicine, Los Angeles, CA.

PMID: 19718372 PMCID: PMC2729211

Abstract

BACKGROUND: While research has established that the bedside electrocardiogram (ECG) is an insensitive test for the presence or absence of left ventricular hypertrophy (LVH), the finding, when present, is thought to be reproducible.

OBJECTIVE: To assess the reproducibility of serial ECGs done in the emergency department (ED) with regard to the presence or absence of LVH.

METHOD: A prospective study on consecutive patients admitted to an ED-run cardiac observation unit. A single reviewer collected and scored ECGs for the presence of LVH, using three established criteria (Cornell, Sokolow-Lyon and Romhilt-Estes). Demographic and medical history was also collected.

RESULTS: Over a three-year time period, 295 patients were enrolled; 132 males and 163 females with a mean age of 54.4 years (range, 19-89 years). The prevalence of LVH ranged from 11-14% and the agreement among all three criteria was fair (kappa = 0.325). Using the Cornell criteria, 33 patients had ECG#1 consistent with LVH. Of the patients meeting LVH criteria on ECG #1, only 15 retained their diagnosis of LVH on ECG#2 (i.e. 55% of the LVH identified in ECG#1 was not seen in ECG#2). Additionally, nine patients developed an ECG diagnosis of LVH between ECG#1 and ECG#2. In total, 27 (nine percent of the total) had ECG measurements that changed between ECG#1 and ECG#2. We made similar findings with the Sokolow-Lyon and Romhilt-Estes criteria. The results were not modified by gender, blood pressure or medication use.

CONCLUSION: The finding of LVH on ECG was not very reproducible during serial measurements on the same person during a single 24-hour observation period.

References

  1. J Cardiovasc Med (Hagerstown). 2006 Nov;7(11):812-6 - PubMed
  2. Circulation. 2003 Aug 12;108(6):684-90 - PubMed
  3. Circulation. 2001 May 15;103(19):2346-51 - PubMed
  4. Blood Press Monit. 1999;4 Suppl 1:S19-22 - PubMed
  5. BMJ. 2007 Oct 6;335(7622):711 - PubMed
  6. Circulation. 2001 Oct 2;104(14):1615-21 - PubMed
  7. J Am Coll Cardiol. 1990 Mar 1;15(3):618-23 - PubMed
  8. Eur Heart J. 1992 Dec;13(12):1606-10 - PubMed
  9. Lancet. 2002 Mar 23;359(9311):1004-10 - PubMed
  10. Blood Press. 2007;16(5):328-34 - PubMed
  11. Circulation. 1990 Mar;81(3):815-20 - PubMed
  12. Arq Bras Cardiol. 2002 Jan;78(1):59-82 - PubMed
  13. Cardiol Clin. 2007 Feb;25(1):15-33, v - PubMed
  14. J Am Coll Cardiol. 1998 Feb;31(2):383-90 - PubMed
  15. Heart. 1998 Dec;80(6):570-7 - PubMed
  16. JAMA. 1999 Feb 24;281(8):707-13 - PubMed
  17. Am J Hypertens. 2003 Aug;16(8):646-52 - PubMed
  18. Eur J Cardiovasc Prev Rehabil. 2003 Dec;10(6):420-8 - PubMed
  19. Hypertension. 2004 Aug;44(2):175-9 - PubMed
  20. Am J Emerg Med. 2004 May;22(3):156-63 - PubMed
  21. Am J Cardiol. 1995 Jun 15;75(17):1233-8 - PubMed
  22. JAMA. 2004 Nov 17;292(19):2343-9 - PubMed
  23. J Am Soc Nephrol. 2003 Feb;14(2):462-8 - PubMed
  24. J Am Geriatr Soc. 1996 May;44(5):524-9 - PubMed
  25. Am J Hypertens. 1998 Nov;11(11 Pt 1):1394-404 - PubMed

Publication Types