Criterion Value Reference
Tall R V1 >6 mm Myers
Increased R:S ratio V1 >1.0 Myers
Deep S V5 >10 mm Myers
Deep S V6 >3 mm Myers
Tall R aVR >4 mm Sokolow
Small S V1 <2 mm Myers
Small R V5,6 <3 mm Myers
Reduced R:S ratio V5 <0.75 Myers
Reduced R:S ratio V6 <0.4 Myers
Reduced R:S V5 to R:S V1 <0.04 Sokolow
(R I+S III)-(S I+R III) <15 mm Lewis
Max R V1,2+max S I, aVL-S V1 >6 mm Butler
R V1+S V5,6 >10.5 mm Sokolow
R peak V1 (QRS duration <0.12 sec) >0.035 sec Myers
QR V1 Present Myers
Supporting Criteria    
RSR V1 (QRS duration >0.12 sec) Present  
S>R in I, II, III Present  
S I and Q III Present  
R:S V1>R:S V3,4 Present  
Negative T-wave V1 through V3 Present  
P II amplitude >2.5 mm  

Amplitudes are given in millimeters, where 1 mm=0.1 mV. Adapted from Table 2 of Hancock et al.

References

  • Hancock EW, Deal BJ, Mirvis DM, Okin P, Kligfield P, Gettes LS. AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram. Journal of the American College of Cardiology. 2009;53(11):992-1002. https://doi.org/10.1016/j.jacc.2008.12.015
  • Butler PM, Leggett SI, Howe CM, Freye CJ, Hindman NB, Wagner GS. Identification of electrocardiographic criteria for diagnosis of right ventricular hypertrophy due to mitral stenosis. Am J Cardiol. 1986;57(8):639-643. https://doi.org/10.1016/0002-9149(86)90850-7
  • Myers GB, Klein HA, Stofer BE. The electrocardiographic diagnosis of right ventricular hypertrophy. Am Heart J. 1948;35(1):1-40. https://doi.org/10.1016/0002-8703(48)90182-3