Significance of high voltage QRS anterior forces in young asymptomatic adults. Evaluation by wide-angle two-dimensional echocardiography

Francesco Loperfido, Alessandro Digaetano, Faustino Pennestri, Rocco Mongiardo, Salvatore Infantino, Raffaele Fanelli, Paolo Guccione, Elda Coppola

Research output: Contribution to journalArticlepeer-review

Abstract

Thirteen asymptomatic adults less than 40 years old who showed tall right precordial R waves on the ECG were examined by VCG, M-mode and two-dimensional echocardiography (2D Echo). Common causes of QRS anterior displacement, such as right ventricular enlargement or right bundle branch block, were excluded in each subject. Although each subject was normal at physical examination, 2D Echo revealed areas of left ventricular hypertrophy in eight of these 13 subjects. Four had a prevailing hypertrophy of the basal portion of the interventricular septum, three had an isolated apical hypertrophy, and one had a diffuse concentric left ventricular hypertrophy. Results were normal in five cases. 2D Echo classification was confirmed by heart catheterization findings, when available. The subjects with asymmetric septal hypertrophy showed low-voltage QRS leftward forces on the ECG and VCG. ECGs and VCGs were not useful in differentiating the subjects with atypically distributed left ventricular hypertrophy from the normals: high-voltage QRS leftward forces and T wave abnormalities were evident in some subjects of both groups. Tall right precordial R waves may constitute a marker of hypertrophic cardiomyopathy in asymptomatic young adults. 2D Echo is useful to exactly classify these subjects.

Original languageEnglish
Pages (from-to)287-295
Number of pages9
JournalJournal of Electrocardiology
Volume16
Issue number3
DOIs
Publication statusPublished - 1983

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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