This electrocardiogram in a five-year-old patient shows right ventricular hypertrophy as a result of pulmonary valve stenosis. 
 
The characteristic features of right ventricular hypertrophy in this age group demonstrated here include dominant, notched 
 R waves and positive T waves  in leads V3R and V1. Right axis deviation is reflected by the 
 small R waves and deep S waves  in lead I.