VALIDITY AND PREDICTIVE VALUE OF ELECTROCARDIOGRAM IN DIAGNOSING LEFT VENTRICULAR HYPERTROPHY AS COMPARED TO 2D ECHOCARDIOGRAPHY

Background: Left ventricular hypertrophy (LVH) is a common condition that profoundly affects morbidity and mortality from cardiovascular diseases. The ECG in the assessment of cardiac dimensions has lost its prominence in favour of imaging techniques that provide a multidimensional display of the heart. Two-dimensional echocardiogram still demands considerably more time, cost, technical skill of the operator than routine 12 lead ECG. Objectives: 1) To diagnose the LVH by different ECG criteria’s and 2D ECHO 2) To find the sensitivity, specificity, positive predictive value and negative predictive value of ECG in diagnosing LVH as Compared to echocardiography. Methodology: A cross sectional study was conducted on 100 patients at Adichunchangiri hospital during the year 2011-2013. Patients were divided into two groups, one is echo evidence of LVH and another one is with no evidence of LVH by echo. Different ECG criteria’s were used to identify LVH. Results: The sensitivity and specificity for S – L Index was 38.88% and 64.28 %, For R.E. system it was 36.11% and 67.85% for 4 point score ,43.05% and 64.28 % for 5 point score and for Cornell voltage criteria it was 55.55% and 78.57%. Conclusion: All the ECG criteria’s have a high specificity but a low sensitivity. ECG can be recommended as a routine investigation because of high specificity and secondary ST-T changes which are associated with high cardiac morbidity and mortality.