Evaluation of Electrocardiographic Diagnosis of Ventricular Hypertrophy Based on Autopsy Comparison By BERTRAM

RECENT advances in the field of cardiac surgery require greater precision in the diagnosis of early ventricular hypertrophy. Although many electrocardiographic criteria are proposed for the diagnosis of ventricular hypertrophy, only a few articles discuss their accuracy. Most studies apply criteria to either left or right ventricular hypertrophy as found in proved hypertrophy, but sufficient studies of the occurrence of false positives are lacking. It is the object of this study to analyze various criteria for ventricular hypertrophy, as found in isolated hypertrophy and in normal hearts. Method Five hundred and twelve consecutive cases autopsied between January 1954 and October 1956, at the City of Hope Medical Center, were studied. Excluded were eases under the age of 15, those in which an electrocardiogranm had not been taken within 3 months prior to death, and those with myoeardial infaretion, myocardial fibrosis, advanced coronary sclerosis, or definite evidence of myocardial bleeding. Sixty-five cases remained for this study. Thirty-two had anatomically normal hearts, 17 had isolated left ventricular hypertrophy, and 16 had isolated right ventricular hypertrophy (table 1). The thickness of the ventricular wall was used as the indication of ventricular hypertrophy. According to Saphir,15 the thickness of the normal left ventricular wall should not exceed 10 mm. and that of the normal right ventricular wall should not exceed 3 mm. We considered a heart as normal when the thickness of the left ventricle was 10 mm. or less and the thickness of the right ventricular wall was 3 mm. or less. We classified as isolated left ventricular hypertrophv a heart in which the thickness of the left ventricular wall was 13 mm. or more and the thickness of the right ventricular wall was 3 mm.