Welch Allyn Cardioperfect Workstation, PEDMEANS ECG Interpretation Module - Physicians - User Manual - Manual (Page 20)

CardioPerfect Workstation
PEDMEANS ECG Interpretation Module Physicians Manual
DIR 80015051 Rev. C 20 / 55
2.12 Biventricular hypertrophy (BVH)
Many forms of congenital heart disease produce overload of both ventricles, with resulting biventricular
hypertrophy. When the criteria for both RVH and LVH are met, the diagnosis of BVH is clear-cut.
However, large equiphasic QRS complexes in mid-precordial leads (Katz-Wachtel phenomenon) are
also suggestive, even in the absence of any clear RVH and LVH.
The severity of BVH is determined by the severity of RVH and LVH, and the size of the equiphasic
QRS complexes. Lead V4 is most important in the detection of equiphasic QRS complexes.
Say: “BVH”
(suppress RVH and LVH)
if: RVH

probable
and LVH

probable
or large equiphasic QRS in V4
and large equiphasic QRS in 1 of V2, V6
Say:
“probable BVH”
(suppress RVH and LVH)
if: equiphasic QRS in V4
and equiphasic QRS in V2, V6
Say:
“possible BVH”
(suppress RVH and LVH)
if: RVH = possible
and LVH = possible
Say:
“consider BVH”
if:
RVH

probable
and LVH = possible
(suppress LVH)
or LVH

probable
and RVH = possible
(suppress RVH)
or large equiphasic QRS in V4
or large equiphasic QRS in V2, V6