Background and Objectives: Left ventricular hypertrophy is a common condition thatprofoundly affects morbidity and mortality from cardiovascular diseases including myocardial infarction, congestive heart failure, and stroke. The ECG in the assessment of cardiac dimensions has lost its prominence in favor of imaging techniques that provide a multidimensional display of the heart but secondary ST­T changes due to LVH which are uniquely determined from the ECG are known to increase the risk of cardiovascular morbidity and mortality. Two­dimensional echocardiogram still demands considerably more time, cost, technical skill of the operator than routine 12 lead ECG. Considering the magnitude of LVH the study is designed to correlate between three different ECG criteria of left hypertrophy using echocardiography as diagnostic standard and to assess Diastolic dysfunction in patients with ECHO proven LVH with normal systolic function.

Methods: Patients from outpatient and inpatient department of tertiary care centre were included. Diagnostic standard of left ventricular hypertrophy was taken by Echocardiography. Patients with high index of clinical suspicion of left ventricular hypertrophy were subjected to electrocardiography and echocardiography, clinical suspicion was done by thorough physical examination and history. Statistical analysis was done by EPI Info Statistical Software version 3.5.2 and proportions; Chi­square test was used for test of significance.

Results: The sensitivity was 46.5%, 36% and 37% for S – L Index, R.E. system and total QRS voltage criteria respectively. 44% of cases had diastolic dysfunction according to E/A Ratio and among them majority (26%) were in stage 1.

Conclusion: This study shows that all the ECG criteria have low sensitivity than ECHO in diagnosing LVH. And hence these methods have a limited use as screening test. Interestingly ECG criteria were more sensitive in diagnosing Hypertensive LVH than LVH of other causes. Study also concludes that it is important to screen for diastolic dysfunction in patients with LVH.