This case report is kindly provided by Michael Rosengarten from McGill and is part of the McGill Cases. These cases come from the McGill EKG World Encyclopedia.
The rhythm is not clear. It could be sinus with very flat P waves (there are prominent U waves that make it difficult to see P waves) or perhaps nodal rhythm, with most likely ventricular premature complexes. There is a right axis deviation of the QRS and tall R waves in V5 (> 35mm) with wide spread ST changes. The EKG suggest left ventricular hypertrophy with possibly a left posterior fascicular block.
