This electrocardiogram shows left atrial enlargement + biventricular hypertrophy.  
		
 
The characteristic features of left atrial enlargement demonstrated here include 
broad, notched P waves  in leads I, II, aVF, V4, V6 and V7. As well as a 
 deep, negative terminal P wave component  in leads V3R and V1.
The characteristic feature of right ventricular hypertrophy demonstrated here include 
 tall, dominant R waves  in precordial leads V3R and V1.
The characteristic feature of left ventricular hypertrophy demonstrated here in the presence of right ventricular hypertrophy is 
 tall R waves  in the left precordial leads.
Biventricular hypertrophy also is indicated by the large 
 biphasic RS complexes  in mid precordial leads V2 and V4.