Q. My ECG shows LVH, but there are no changes in the echocardiogram. Why?

Answered by
Dr. Muhammad Zohaib Siddiq
and medically reviewed by Dr. Sushrutha Muralidharan
This is a premium question & answer published on Jul 19, 2021

Hi doctor,

I am a 37-year-old female. Three years ago, I had an ECG done, and it showed up LVH. So I had an echocardiogram, and there was no evidence of LVH. I had another ECG last week in the hospital, and it showed up LVH again, worse. And I am so scared. Can the echocardiogram change in three years? If I had LVH, would I have an irregular heartbeat, or would my doctor hear crackles when listening to my chest or lungs? I am just terrified that I have LVH. Kindly give your opinion.



Welcome to

ECG (electrocardiogram) is not reliable for detecting LVH (left ventricular hypertrophy). An echocardiogram is the best test for it. ECG may show LVH patterns in thin, lean persons. If the echocardiogram is normal, then no need to worry. Do you have hypertension? What are your symptoms? Any family history of cardiac issues?

Please answer the questions so that I can guide you accordingly.

Hi doctor,

Thank you.

I have had shortness of breath for one year now, and it is getting worse. It developed when I took treatment for my multiple sclerosis last year. I was diagnosed with multiple sclerosis two years ago, and when I finished the treatment, I developed shortness of breath. That is why I got an ECG also chest X-ray, which was clear. I am just terrified that I have LVH. Can an echocardiogram change in three years? I had two echocardiograms, one three years ago and then another two years ago. Kindly give your opinion.



Welcome back to

LVH occurs in certain conditions, most common of which are:

1) Uncontrolled hypertension for a long time.

2) Aortic valve stenosis.

3) Genetic diseases such as hypertrophic cardiomyopathy.

4) And some other rare diseases.

ECG is not reliable for LVH detection. Echocardiography is reliable. If your echocardiography was normal, then it means there is no LVH. Yes, echocardiography may change in three years if there is uncontrolled hypertension or aortic stenosis. If no hypertension, then why LVH will occur?

Your shortness of breath can be due to anxiety, a sedentary lifestyle, or anemia. Do regular exercise and slowly increase it. Once your body adapts to exercise, you will have no shortness of breath on exertion. You can send me your recent ECG and echocardiography so that I may guide you about these.

I hope this was helpful.

Hi doctor,

Thank you.

I am attaching my echocardiogram results from three years ago. I do not have my ECG report. My doctor has that. Kindly give your opinion.



Welcome back to

Your echocardiography report is very normal (attachments removed to protect the patient's identity). You had anxiety, so your heartbeat was fast. Fast heartbeats also show up as LVH on ECG. Your anxiety is making you feel sick. Otherwise, you are fine. Do you know who the biggest killer of humans is? It lies within our own brains. Kill the killer before it kills you. Do not give a place to stress in your life. Manage it.

ECG is done to see the electrical activity of the heart, and echocardiography is done to see the mechanical activity of the heart. Left ventricular hypertrophy means excessive growth of heart muscles. It can be seen on echocardiography, and your echocardiography is normal.

I hope this was helpful.

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