The characteristic features of left ventricular hypertrophy demonstrated here include increased voltage, reflected by the tall R waves in aVL exceeding 11 mm; ST-T abnormalities well seen in this lead as well as in leads I, V5, and V6; a prolongation of the QRS interval, and left atrial enlargement, reflected by the wide P wave in lead II and the prominent negative P wave in lead V1.

Left anterior fascicular block is manifested by left axis deviation of ≥ -45°, and is reflected by the negative QRS in lead II, with an rS morphology.