Left ventricular hypertrophy with LV strain pattern

A 51 years old male who was a known hypertensive since last 10 years, came for routine evaluation. Patient ECG is shown below

ECG (Click on the image to enlarge it)

ECG is showing Sinus rhythm at rate 80 beats per minutes, PR interval 160 msec, QT interval 320 msec, there is ST-segment depression with T wave inversion seen in lead II, III, aVF, V5-V6, S wave height in V1 is 6 square boxes( 3 mv) and in V2 it is 9 squares boxes (4.5 mv), R wave height in lead V5 and V6 is 7 square boxes (3.5 mv) so, the sum of  S wave in lead V1 and V6 is 6.5 mv suggestive of concentric type of Left ventricular hypertrophy with left ventricular strain pattern. The patient underwent ECHO, which was suggestive of severe concentric left ventricular hypertrophy with grade 1 diastolic dysfunction.

Let's discuss ECG criteria for Left ventricular hypertrophy

Thank you

Praveen Gupta