The features of left ventricular hypertrophy demonstrated here include increased voltage, reflected by the tall R waves in leads I and aVL, with the R wave in aVL exceeding 11 mm. While the voltage increase in this case is not striking, it is not the only criterion to consider.

Additional characteristic features include marked ST-T wave abnormalities in these same leads; a delayed intrinsicoid deflection with some QRS widening, and left atrial enlargement, as reflected by the broad notched P wave in lead II. Left axis deviation, as evidenced by the nearly equiphasic QRS complex in lead II is also consistent with left ventricular hypertrophy.

As a result of this axis shift, note that leads V5 and V6 do not show the typical voltage or ST-T wave changes of left ventricular hypertrophy.