Which pattern is indicative of LV strain on ECG?

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Multiple Choice

Which pattern is indicative of LV strain on ECG?

LV strain is a repolarization abnormality seen with left ventricular hypertrophy and other causes of LV overload. The classic sign is downsloping ST-segment depression with T-wave inversion in the lateral leads (I, aVL, V5–V6). The ST segment slopes downward into an inverted T wave because the hypertrophied ventricle alters the endocardial–epicardial repolarization pattern, especially on the left side where LVH most affects the surface leads. This pattern helps distinguish strain from other patterns that produce ST changes, such as ST elevations seen with acute ischemia or pericarditis, or tall, peaked T waves seen with hyperkalemia.

LV strain is a repolarization abnormality seen with left ventricular hypertrophy and other causes of LV overload. The classic sign is downsloping ST-segment depression with T-wave inversion in the lateral leads (I, aVL, V5–V6). The ST segment slopes downward into an inverted T wave because the hypertrophied ventricle alters the endocardial–epicardial repolarization pattern, especially on the left side where LVH most affects the surface leads. This pattern helps distinguish strain from other patterns that produce ST changes, such as ST elevations seen with acute ischemia or pericarditis, or tall, peaked T waves seen with hyperkalemia.

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