ECG left ventricular hypertrophy

ECG shows sinus rhythm at 75 beats/minute with normal intervals and a mean QRS axis of approximately –10 degrees. Prominent left atrial abnormality is seen with broad, notched P waves (eg, in lead II) and a biphasic P with a broad, negative terminal component in lead V1. Voltage criteria for LVH are met in the limb and precordial leads by multiple sets of criteria in this elderly woman with long-standing systemic hypertension.