Abstract
Normal limits for selected electrocardiographic measurements were determined in 120 healthy male Saudi Arabian military recruits. These were compared with widely accepted normal values previously established in 115 healthy American men of similar age by Simonson. While most measurements were closely similar, left ventricular chest lead voltages were significantly higher in the recruits. Similar findings have previously been described in Africans, but not in an Arabic population. The application of left ventricular hypertrophy (LVH) voltage criteria recommended by the World Health Organisation for epidemiological studies was found to produce an unacceptable number of false positives in our subjects. Conversely, the ‘point score’ LVH criteria of Romhilt produced only one false positive. We recommend first: careful evaluation of left ventricular voltage in the ECGs of Saudi Arabian (and, by implication, other Middle Eastern) patients seen in Europe and secondly; that the Romhilt point score system should replace the currently recommended LVH voltage criteria for epidemiological studies in developing countries.