left ventricular hypertrophy

And they literally just tell you.

I mean, I was convinced I was gonna have some sort of problematic number just 'cause of years of abusing stuff, and I got a zero, and they also tell you if you have any LVH, left ventricular hypertrophy.

So I had no sign of LVH and a zero for the calcium score.

You only have to do it every five years or so, and it was literally, like, that basically cured what I thought was long-term anxiety, um, just not having to worry about that.

So heavily recommended.

So as a detective, it's up to me to know essentially how much organ damage and organ damage you're having.

So are you having LVH sort of out of proportion to your blood pressure? Are you having chronic kidney disease or kidney damage, proteinuria out of proportion? Are you starting to develop a HFPEF phenotype? Have you had a stroke? If you have signs of these and organ damage with your hypertension, that makes me worry, not just that it's a more aggressive phenotype, but perhaps something else underlying could be driving it.

And then, of course, you look at the blood work and you look for clues like hypokalemia because we know that aldosterone and hyperaldosteronism is so common, more common than we appreciate, in fact, but that can cause potassium wasting.

So if you have a hypokalemic phenotype, on your blood work, that could potentially be a sign.

And that is how you diagnose left bundle branch block on 12 lead EKG.

Diagnosis of left ventricular hypertrophy on 12 lead EKG.

So there's a number of different standardized criteria that one can use to diagnose LVH.

Oftentimes providers just look at the lateral leads, V5, V6, or AVL, and say, meh, the R-wave or S-wave look big, so probably LVH.

But there is formal standard criteria, and they should be used when diagnosing LVH.

The first criteria is, that can be used is called the Cornell criteria.

And then there's actually a modified Cornell criteria that's shorter to use.

There's a third criteria.

Um, and some people are genetically predisposed to left ventricular hypertrophy.

This is why it's important to control our blood pressure, to control our lipids, to stay away from, from, um, compounds that could potentially, um, in- cause, uh, increase in, in, um, growth in left, in heart size.

But for mo- mostly, most of the time when L- LVH happens, it's because there's some, some, there's a blockage downstream- There's a partial blockage that the blood pressure is running out of control, and there's some genetic component that plays in there that, that's going to exacerbate it.

It's likely that person still would have had problems long term, but it's-- this is why it's important to stay on top of testing, you know, getting, getting a, um, echocardiogram done every couple years.

Um, could have caught that early and reversed some of that.

I mean, it's more cortisol.

Just all the things that are counterproductive for growth.

I think we need to do enough cardio to keep your heart healthy, probably HIIT cardio, although I [sighs] was talking to somebody about HIIT cardio that may [chuckles] maybe that could contribute to LVH.

Like the voltage criteria for left ventricular hypertrophy-

Right

... or LVH, that is a perfect example of this.

It really is.

Because you look at the precordial leads, right?

Huge spikes.

Massive spikes.

On paper, it absolutely meets the textbook Sokolow-Lyon criteria for LVH.

And just like a bicep lifting heavy weights, the muscle thickens.

Left ventricular hypertrophy, or LVH.

On the ECG, this means massive voltage towering R waves, really deep S waves.

But Dr. Taylor brings up a tough clinical dilemma here.

The ECG is highly specific for LVH, but notoriously insensitive.

It misses a lot of cases.

It does.

They have powerful hearts but really thin chest walls, so the electrodes pick up massive signals.