ECG of the Week 13 April 2022 Answer

A 51 year old female presents to ED complaining of shortness of breath and chest pain. Below is the patients ECG:

Describe and Interpret the ECG


Rate: 96 beats per minute

Rhythm: normal sinus rhythm

Axis: Normal Axis


  • PR: 160ms
  • QRS: 110ms
  • QTc: 455ms (Bazett)


Tall deep complexes, specifically

  • very tall R wave in I (off the grid)
  • R wave >11mm in aVL
  • Tall R waves V4-V6
  • Very deep S waves III, V1-V2
  • S wave V2 + R wave V6 > 35mm

Biphasic T waves and ST depression in the lateral leads

Concave ST elevation in aVR

The above ECG shows both voltage and non voltage criteria for LVH with strain pattern.

The patient had a history of Hypertrophic Cardiomyopathy and was clinically in CCF.