Echocardiographic diagnosis of right ventricular hypertrophy: correlation with ECG and necropsy findings in 248 patients.

Measurements of right ventricular wall thickness (RVWT) by echocardiography and at necropsy correlated well (r = 0.83) in 36 patients. Echocardiography had a sensitivity of 93% and a specificity of 95% in diagnosing right ventricular hypertrophy (RVH) at necropsy; electrocardiography (ECG) had a sensitivity of 31% and a specificity of 85% in diagnosing RVH. An additional 212 patients were studied by echocardiography and ECG. Based on echocardiographic criteria of RVH (RVWT Greater Than or Equal To 5 mm), 134 of 212 patients had RVH, and 78 were without RVH: the ECG had a sensitivity of 27% and a specificity of 88% for diagnosing RVH when correlated with the echocardiographic criteria. The mean diastolic RVWT was 6.0 +/- 1.4 mm in 134 RVH patients and 3.4 +/- 0.8 mm in 78 no-RVH patients (P Less Than 0.05). Diagnosis of RVH was difficult by ECG in 73 patients due to conduction defects or old myocardial infarction; the RVWT measurements were useful in evaluating RVH in these patients. We conclude that echocardiographic measurements of RVWT are useful in the diagnosis of RVH and are more sensitive than the ECG criteria in adults.