ECGs by Example
An 84 year old lady with hypertension.
Left anterior hemiblock, LVH, LAH, and long PR
There are a number of abnormalities here.
left anterior hemiblock
more left than -30 degrees
initial R wave in the inferior leads (II, III and aVF)
absence of any other cause of
left axis deviation
left ventricular hypertrophy
In the presence of left anterior hemiblock the
diagnostic criteria of LVH
are changed. Rosenbaum suggested that an S wave in lead III deeper than 15 mm as predictive of LVH.
long PR interval (also called first degree heart block)
PR interval longer than 0.2 seconds
left atrial hypertrophy
M shaped P wave in lead II
P wave duration > 0.11 seconds
terminal negative component to the P wave in lead V1