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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 atrial fibrillation, and there are marked increases in the QRS deflections with an R in V6 greater than that in V5 and also greater than 35mm. There aer marked ST changes in the absence of digitalis. The EKG is diagnositic of left ventricular hypertrophy. This patient has IHSS.