Left ventricular hypertrophy in the myocardial infarction. the variability ofdepolarization in the the derivations which do not record myocardial infarction on the EKG

Introduction: The left ventricular hypertrophy (LVH) „silent killer” is an important risk factor for the cardiac events, including the myocardial infarction (MI). In the known context the MI causes are multiple, but LVH in HTA or at patients without HTA keep the attention. It was found that 1/3 from MI with ST elevation (STEMI) have LVH. There are authors, who use 14 EKG criteria’s for the LVH discovery, but the most used criterion is the SOKOLOW-LYON (S-L) voltage with a sensibility of 12%-29% and a specificity of 93%-96%.
Methods: The presented EKG observations are 57 cases with MI between 35-76 years, with average 55.3, M 44 and W 13; 28 with an acute MI, 9 with old MI and 20 with multiple MI acute and/or old. From the total of 57 cases, 32 (50.7%) are with known HTA. It is possible that HTA is more frequent than 50.7%, because some of the patients (as well as diabetes mellitus) are disco-vered with HTA at the sometime with MI.
Results: LVH determined by the S-L index was present in 13 cases (20.2%), but with some probability also in 9 cases with HAS (10.5%) and in 11 cases with repola-rization of HVS (10.8%); in all, LVH seems to be pre-sent in 30.5% of cases. Sometimes, in the evolution, is noticed the variability of the amplitude of ventricular depolarization in leads outside of those with Q wave, with transmural necrosis. So, in the 57 cases conside-red, there were recorded (without technical errors) on 32 EKG (50.6%) the variability of the amplitude of the ventricular depolarization: in 12 cases under 5 mm, in cases between 5-10 mm, in 5 cases between 10-15 mm and in 4 cases over 15 mm. In these 32 EKG re-cordings, 17 (30%) are accompanied by the labiality of the repolarization, which supposes that beside the EKG derivations with MI with Q wave of necrosis, trasmural there are also other active ischemic areas in the myo-cardium.
Conclusions: The EKG investigations are accessible and widespread in the medical assistance and especially in the cardiovascular diseases. The EKG information’s are inexhaustible and often without prevision. The obser-vation of the variability of depolarization in the EKG leads which do not record MI with Q wave, is not to be found in the studied literature is a first step possible electrocardiographic and must be evaluated by com-plex para clinic investigations, including the negative cardiac implications, hard to asses clinically in the pre-sence of concomitant MI.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
ESC search engine
CODE: 379
CME Credits: 10 (Romanian College of Physicians)