A tool to support learning and decision-making. The result does not replace clinical evaluation of the patient.
About: Romhilt–Estes score
The Romhilt–Estes score, from 1968, adds up points from different ECG findings to diagnose left ventricular hypertrophy (LVH). By combining voltage, repolarization, left atrium, axis and QRS duration, it goes beyond voltage-only criteria.
How to use
Check the findings present: increased amplitude (3), strain-pattern ST-T changes (3), left atrial enlargement (3), left axis deviation (2), QRS ≥ 90 ms (1) and intrinsicoid deflection in V5–V6 ≥ 50 ms (1).
If the patient is on digitalis, check that option too: ST-T then counts 1 point instead of 3.
How to interpret
≥ 5 points: definite LVH.
4 points: probable LVH.
< 4 points: nondiagnostic by this score.
Limitations
Like most ECG criteria for LVH, the score is specific but not very sensitive: a negative result does not rule out hypertrophy. Echocardiography is the confirmatory test.
References
Romhilt DW, Estes EH Jr. A point-score system for the ECG diagnosis of left ventricular hypertrophy. Am Heart J. 1968;75(6):752–8.
