Case 6

Mohsen, a male aged 58 has had hypertension with moderate non-compliance to treatment for years.

He now complains of increasing shortness of breath.

Examination reveals:
 
- BP 195/115 mmHg and an apex beat 2 cm outside the mid-clavicular line.

There were no other abnormalities detected.

Author's report:

Rate

85/min

Axis

left Normal

QRS

R wave in lead 1 = 17 mm;
AVL = 10 mm;
SV1 plus RV5 = 46 mm

ST

depressed in leads AVL + 1,2,AVL,V4-V6.- depressed in leads AVL + 1,2,AVL,V4-V6.

T

 inverted in 1, 2, AVL, V4-V6