The electrocardiographic diagnosis of left ventricular hypertrophy in apparently normal children

Serial electrocardiographic, vectorcardiographic, and clinical features in 18 children with markedly increased precordial electrocardiographic voltages suggestive of left ventricular hypertrophy are presented. Patients were followed for an average of 31/2 years in order to determine the long-term significance of this finding. Follow-up electrocardiograms were normal in about 30 per cent; precordial voltages were unchanged or increased in about 70 per cent. No child had signs or symptoms of cardiovascular disease, but three subjects (15 per cent) had persistently increased precordial voltages and increased cardiothoracic ratio on chest radiographs. It is suggested that children with increased precordial voltages be followed clinically until the electrocardiogram becomes normal or the diagnosis is otherwise clarified.