High-Voltage QRS Complexes in the Absence of Left Ventricular Hypertrophy

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Abstract
Of an unselected group of otherwise normal electrocardiograms in which the sum of S in V1 and R in V5 exceeded 35 mm., 39 per cent came from patients with no clinical evidence of cardiac disease. Of electrocardiograms in which R in AVL exceeded 11 mm., 29 per cent were from patients without cardiac disease. All of the cases in which the voltage was abnormal in both lead aVL and the precordial leads had evident or possible heart disease. Thus, while the voltage indexes for left ventricular hypertrophy of Sokolow and Lyon are useful and easy to apply, the lack of specificity of voltage changes limits clinical application.