LVH is caused by the following pathologic conditions: 

• Systemic hypertension
• Aortic stenosis
• Aortic regurgitation
• Dilated cardiomyopathy
• Hypertrophic cardiomyopathy
• Ventricular septal defect
• Infiltrative cardiac processes such as Fabry disease or Danon disease

Other medical conditions that can increase left ventricular thickness without signs of LVH on an ECG:

• Amyloidosis
• Sarcoidosis
• Hemochromatosis

The ECG criteria for LVH may be preset in the absence of any structural disorders of the heart, especially if there is also an isolated, prominent QRS voltage. Young, thin, healthy African American male athletes may have this finding. 

On the other hand, negative ECG findings despite known increased left ventricular mass are also possible and present with negative prognostic implications.³