ABSTRACT
Additional comments In the chest leads there are deep S waves (up to 15 mm in lead V2) and tall R waves (up to 39 mm) in lead V4.
1. This ECG shows deep S waves (up to 15 mm in lead V2) and tall R waves (up to 39 mm) in lead V4 in the chest leads. These appearances are indicative of left ventricular hypertrophy. The diagnostic criteria in this case include: • R wave in lead V4 measuring 39 mm • S wave in lead V1 plus R wave in lead V5
totalling 41 mm • Tallest R wave and deepest S wave in chest
leads totalling 54 mm. 2. An echocardiogram (or cardiac magnetic reso-
nance scan) would allow direct visualization of the left ventricle, assessment of the extent of left ventricular hypertrophy, assessment of left ventricular systolic (and diastolic) function, and also assessment of the heart valves.
