You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information.
What is A 60 year old marathon runner complains of dizziness episodes. On auscultation ejection systolic murmur is heard. ECG is done. Clinical diagnosis is? and explain in detail?
The ECG shows hea rate of 50/min with left axis. Patient is in normal sinus rhythm. QRS duration is normal. T wave inversion is noted in lead I, aVL and V5-V6 indicating possible ischemic changes. Depth of S wave in V1 =20mm Height of R wave in V5= 30mm SV1 + RV5/6(tallest R in either V5 or V6) >35 mm is diagnostic of Left ventricular hyperophy( Sokolov- Lyon criteria) The low hea rate is explained by high vagal tone seen in marathon runners.