Left ventricular hypertrophy

Thickening of the wall of the heart's main chamber from pressure overload

Left ventricular hypertrophy (LVH) is a thickening of the wall of the heart’s main pumping chamber. It is the most common form of myocardial hypertrophy and an important sign of target-organ damage in hypertension.

LVH can be suspected on an ECG, and the myocardial mass measured precisely on echocardiography.

What LVH means

The left ventricle ejects blood into the aorta and the whole systemic circulation. When it has to work against elevated pressure or a narrowed valve, the wall muscle thickens. This is compensation, but it comes at a cost: relaxation and blood supply of the myocardium suffer.

Why it develops and why it is dangerous

The leading cause is long-standing arterial hypertension; aortic stenosis, obesity, diabetes and kidney disease contribute. LVH is an independent risk factor: it raises the likelihood of atrial fibrillation, heart failure, heart attack and sudden death. With blood-pressure control the hypertrophy can shrink, improving the prognosis.

Reference ranges

LVH is confirmed by ECG voltage criteria (an approximate screen) and by the myocardial mass index on echocardiography (more precise). The main thresholds:

Sokolow–Lyon (ECG)	S(V1) + R(V5 or V6) ≥ 35 mm
Cornell voltage, men	R(aVL) + S(V3) > 28 mm
Cornell voltage, women	R(aVL) + S(V3) > 20 mm
LV mass index, men	> 115 g/m²
LV mass index, women	> 95 g/m²
LV wall thickness (upper limit of normal)	≈ 11 mm

Important: The thresholds are approximate and differ between guidelines. ECG criteria often miss LVH (low sensitivity), so the gold standard is echocardiography. The result is interpreted by a doctor.

Calculate using this marker

Calculators where Left ventricular hypertrophy (LVH) is used directly:

Heart Age (Echo) A neural network reads five echocardiogram parameters — accurate to within ±5 years Open Blood Pressure Categories Your ACC/AHA category, pulse and mean arterial pressure, risk score, and age-based norms Open Hypertension Risk Your blood pressure category by ACC/AHA, age- and sex-based norms, guidance, and impact on biological age Open

Frequently asked questions

Is LVH visible on a routine ECG?

Sometimes yes — by raised voltage criteria (Sokolow–Lyon, Cornell). But the ECG often misses hypertrophy: a normal tracing does not rule out LVH. The precise method is echocardiography with calculation of the myocardial mass index.

Can left ventricular hypertrophy be treated?

There is no specific “LVH drug,” but controlling blood pressure and losing weight reduce the myocardial mass. Regression of the hypertrophy is accompanied by a lower risk of heart attack, stroke and heart failure.

Sources

info

This content is educational and does not replace consultation with a physician. Reference ranges may vary depending on the laboratory and method — rely on the ranges stated on your own test report.

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