Normal Adult ECG

 

It shows what happens in LVH!

An example of severe LVH

     
The mean frontal plane QRS axis is - 15°. There are pronounced changes of LVH. R wave height in V5 and V6 is abnormal. The S wave depth in V1 is abnormal. The ventricular activation time in V5 and V6 is prolonged (0.06 sec). There is ST segment depression and T wave inversion in the left precordial leads. Since the heart is horizontal the changes seen in the left preoordial leads are also shown in I and aVL. There is evidence of left atrial hypertrophy.

It shows what happens in RVH!

An example of RVH

     
The mean trontal plane ORS axis is + 135". There is a dominant R wave in V1. There is clockwise cardiac rotation. The appearances are indicative of right ventricular hypertrophy. There is a dominant R wave (an Rs complex) in V1. There is therefore right ventricular hypertrophy. There are no S-T,T changes of right ventricular hypertrophy. The P waves are tall and pointed in Lead II suggesting right atrial hypertrophy.

LVH + RVH

Rate 58. QRS axis +30. Left atrial enlargement (broad diphasic P waves in V1.) RSR' in V1 suggestive of right ventricular hypertrophy. Voltage criteria for left ventricular hypertrophy are present.