Electrocardiogram of a 62 year old man with longstanding hypertension, type 2 diabetes and recent small stroke.

Rate 77/min
PR 0.20 sec
QRS 0.09 sec
QT 0.38 sec
QTc 0.43 sec
QRS axis -10º

Interpretation: Regular sinus rhythm. Borderline PR interval. Left atrial abnormality. Left ventricular hypertrophy with ST-T changes suggestive of systolic or "pressure" overload.

QRS voltage criteria for LVH include:
RI + SIII >= 2.5 mV
R AVL > 1.2 mV
R AVF > 2.0 mV
S V1 >= 2.4 mV
R V5 or V6 > 2.6 mV
R V5 or V6 + S V1 > 3.5 mV

Sensitivity of voltage criteria is, however, only 25% (specificity 95%).

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