The deep S wave in leads V1, V2, and V3 in right ventricular hypertrophy.

Six patients with mitral stenosis, 3 with pulmonic stenosis, and 1 with pulmonary hypertension are presented. All had isolated right ventricular hypertrophy and all had deep S waves in V,, V2, or V3. In 3 cases the voltage of R in V1 was less than 0.5 millivolt. In 3 cases R/S ratios in V1 of less than 1.0 were present. Veetorcardiogramns showed characteristic features and illustrated the reasons for the electrocardiographic findings. T HE presence of a deep S wave in leads V1 or V2 is often interpreted as evidence suggesting left ventricular hypertrophy. Since the maximal electric force in left ven-tricular hypertrophy usually moves to the left and posteriorly, the presence of a deep S wave in leads V1 or V2 often correlates well with this condition. In the interpretation of hypertrophies of congenital or acquired heart disease, the presence of a deep S wave in V1 or V2 may, however, not be due to left ventricular hyper-trophy, either isolated, or in combination with right ventricular hypertrophy. Ten cases of isolated right ventricular hypertrophy in which deep S waves were present in either V1, V2, or V3 have been reviewed. There were 6 patients with pure mitral ste-nosis, 3 with isolated pulmonic stenosis, and 1 with " primary " pulmonary hypertension. The mitral stenosis cases were diagnosed by cardiac catheterization (table 1), and were confirmed at surgery in 4 instances. Subsequently one of these was also confirmed at autopsy and had right ventricular hyper-trophy, but no left ventricular hypertrophy. Of the 3 cases with isolated pulmonic stenosis 2 were diagnosed at cardiac catheterization (table 1), and confirmed later at surgery. The third case of pulmonic stenosis was a relatively mild one and was diagnosed by cardiac catheterization alone (table 1). The single