Right bundle branch block and left ventricular hypertrophy

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Tall R waves in lateral leads V5 and V6 with mild ST segment depression suggests left ventricular hypertrophy. In addition there is rSR pattern in V1 with T wave inversion in V1 – V3, suggestive of right bundle branch block. Negative P waves in V1 indicates left atrial enlargement. PR interval is at the upper limit of normal (200 msec).