Cornell Voltage LVH Criteria Calculator

How it is calculated

The Cornell voltage is the sum R(aVL) + S(V3). Enter the height of the R wave in lead aVL and the depth of the S wave in lead V3 as positive numbers in millimetres, measured on the tracing at the standard calibration of 10 mm per mV (so 1 mm is 0.1 mV). The tool adds them and compares the total with a threshold that depends on sex: sum > 28 mm for men and sum > 20 mm for women. A sum exactly equal to the threshold does not count as meeting it. Any sex value other than 'female' uses the male threshold. Negative entries return no result. The output is a screening flag for an ECG reading, not a diagnosis, and it does not adjust for body size, age or other criteria.

Common mistakes

• Selecting the wrong sex. The same 26 mm sum is positive for a woman and negative for a man, because the thresholds are 20 and 28 mm.
• Entering a negative number for the S wave. Use the depth as a positive value; the engine rejects negatives instead of taking the absolute value.
• Entering millivolts instead of millimetres. At the standard 10 mm/mV calibration, 2.8 mV must be typed as 28.
• Ignoring the calibration of the tracing. If the ECG was recorded at half standard (5 mm/mV), the millimetre readings must be doubled before comparing with these thresholds.
• Treating a positive result as proof of hypertrophy, or a negative one as exclusion. Voltage criteria are a screen and need echocardiography or a clinician's judgement to confirm.