Biventricular hypertrophy is an enlargement of both the left and right ventricles. Ventricular enlargement differs from ventricular dilatation. Biventricular hypertrophy is reliably detected with radiological imaging modalities such as the echocardiogram. 

Clinicians rely on the presentation of the patient and certain imaging techniques to diagnose the causes of biventricular hypertrophy. A diagnosis of biventricular hypertrophy can only be made based on ECG evidence alone if the patient has RVH that is significant enough to dominate the left ventricular hypertrophy.