LVH

1. R wave in lead V5 or V6 > or = to 26 mm
2. R wave in lead V5 or V6 plus S wave in lead V1 > or = 35 mm
3. R wave in lead I >= 15 mm
4. R wave in lead I plus S wave in lead III >= 25 mm
5. R wave in lead aVL >= 13 mm or R wave in lead II,III, or avF >= 20 mm
6. Evidence of T wave change in V5-6 suggestive of systolic overload (t inversion/strain pattern)

RVH

1. Right axis deviation
2. Tall R wave in lead V1
3. Evidence of T wave change in V1-3 suggestive of systolic overload (strain pattern)

LAH

1. Wide (3 mm +) notched P waves (I, II, avL)
2. Diphasic T wave in V1 or V2 with terminal swing large and wide

RAH

1. Tent shaped tall (3+mm) p waves in II, III, avF
2. Diphasic T wave in V1 or V2 with initial large and wide upswing

aVR

• STE with associated STE in lead V1 (but of lesser magnitude) is predictor of (LMCA)
• Acute right ventricular strain is often reflected in the EKG as ST-segment elevation in lead aVR