Answer 30

30.   Choice A is the correct answer.  With right ventricular hypertrophy, there is a large R wave in lead V1.  There is a more positive deflection toward the V1 electrode and expect the QRS complex more upright than normal.  The S wave in lead V1 is smaller than the R wave.  With left ventricular hypertrophy, the left ventricle causes QRS complexes to be bigger in both height and depth in leads V1-V6.  There is a larger R wave in lead V5 because it is right over the left ventricle.  There is often inversion of the T wave. With atrial hypertrophy there is a biphasic P wave in lead V1.  If the initial component is the largest there is right atrial hypertrophy.  If the terminal portion of the P wave in lead V1 is the largest, it is left atrial hypertrophy.