LVH Calculator — ECG Criteria
Check an ECG for left ventricular hypertrophy (LVH) using the three most-used voltage criteria — the Sokolow-Lyon index, Cornell voltage and the Cornell product. Enter the QRS amplitudes in millimetres from the relevant leads (and the QRS duration for the Cornell product) to see each criterion’s value against its cut-off, shown on a bar, and whether any of them meets the threshold for LVH.
About the ECG criteria
These voltage criteria estimate left ventricular hypertrophy from QRS amplitudes on a 12-lead ECG. Sources: Sokolow M, Lyon TP, Am Heart J 1949; Casale PN et al. (Cornell), Circulation 1987; Molloy TJ et al. (Cornell product), J Am Coll Cardiol 1992.
Frequently asked questions
What are the LVH voltage criteria?
Three LVH voltage criteria are widely used. The Sokolow-Lyon index adds the S wave in V1 to the taller of the R waves in V5 or V6; ≥ 35 mm suggests LVH. Cornell voltage adds the R wave in aVL to the S wave in V3; LVH is suggested above 28 mm in men or 20 mm in women. The Cornell product multiplies the Cornell voltage (adding 6 mm in women) by the QRS duration; LVH is suggested above 2440 mm·ms.
How do I measure the amplitudes?
Measure the height or depth of each wave in millimetres at standard calibration, where 10 mm equals 1 mV (one large box is 5 mm). Enter the S waves (V1, V3) as their depth as a positive number and the R waves (aVL, V5, V6) as their height. The QRS duration is in milliseconds, needed only for the Cornell product.
How accurate is ECG for detecting LVH?
ECG voltage criteria are specific but not very sensitive: a positive result makes LVH likely, but a negative ECG does not exclude it, and echocardiography or cardiac MRI is the reference standard for left-ventricular mass. Voltages are also affected by age, sex, body habitus, chest-wall thickness and lead placement, so the criteria are a screen, not a diagnosis. That trade-off is deliberate: the cut-offs were set high enough to keep false positives rare, which necessarily lets many genuine cases through. This calculator therefore reports the Sokolow-Lyon index, Cornell voltage and Cornell product separately, so you can see which criterion is met rather than a single yes-or-no verdict.
Why are the thresholds different for women?
Women tend to have lower QRS voltages than men at the same left-ventricular mass, so using the same cut-off would over-diagnose them. The Cornell criteria therefore use a lower voltage threshold in women (20 vs 28 mm) and add 6 mm to the voltage before the Cornell-product calculation. This calculator applies the sex you select automatically.
What causes a false result?
High voltages without true LVH occur in thin or young people and with lead misplacement; low voltages despite LVH occur with obesity, emphysema, pericardial effusion or a bundle branch block — the criteria are not valid in the presence of left bundle branch block. Always read the ECG in the clinical context. This calculator is an educational reference, not medical advice.
This is a reference tool, not a diagnosis or medical advice. Results depend on the laboratory, assay and clinical context, and reference intervals vary between labs and by age and sex — always read your result against the range printed on your own report and discuss it with a qualified healthcare professional.
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