The electrocardiogram in asymmetric septal hypertropy

Area of Science:

• Cardiology
• Medical Diagnostics

Background:

• Asymmetric septal hypertrophy (ASH) is a form of hypertrophic cardiomyopathy.
• Distinguishing ASH from other cardiac conditions like aortic stenosis (AS) is crucial for accurate diagnosis and management.

Purpose of the Study:

• To identify distinctive electrocardiogram (ECG) findings in patients with asymmetric septal hypertrophy.
• To compare ECG characteristics of ASH patients with those of patients with significant aortic stenosis.

Main Methods:

• Retrospective review of electrocardiograms (ECGs) and echocardiograms in 44 patients with ASH.
• Comparison of ECG findings between the ASH group and a control group of patients with significant aortic stenosis.

Main Results:

• Patients with ASH showed lower incidences of left ventricular hypertrophy (33%) and left atrial hypertrophy (25%) on ECG compared to AS patients (70% and 64%).
• Specific ECG markers in ASH included a greater septal-posterior wall thickness ratio, Q waves in lead V4, and an R/S ratio > 0.20 in lead V1 (found in 14/44 ASH patients, none with AS).
• The mean corrected Q-T interval (Q-Tc) was prolonged in ASH patients, whereas it was normal in AS patients.

Conclusions:

• Distinct ECG findings, including specific R/S ratios and Q waves, are significant in diagnosing asymmetric septal hypertrophy.
• A prolonged Q-T interval in ASH may be associated with an increased risk of sudden cardiac death.