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NY 92-657 AS compared to tne last record of November 16, 1960: In the standard limb leads the R wave is smaller in II and the S wave broader witn a different type of slurring and lowering of the RS-T segments. However,tne patient is getting digitalis which might account for this RS-T depression. Two ventricular extra-systoles are recorded in III. Tne augmented limb leads do not show any new change except in AVF where the ORS group is smaller and the RS-T segment still depressed and here again we may suspect digitalis, In tne chest leads we do note changes with more definite elevation of BS-T in Ve and V3 altnougn in V3 the T wave is more definitely upright. Beyond this the broad S yaves are seen in V> and Vo but are simply characteristic of the right BB Block. Depression of RS-T in V6 may again be due to digitalis. 1. Tne BB Block in this case developed some time between March 2nd, 1960 and July 22, 1960 and this development guring a period of observation is strong evidence of degenerative heart disease and not the simple benign type of Right BB Block whici we find in routine health examinations in subjects otnerwise apparently normal, 2. Depression of the T waves in chest leads from the last is of course incidental to the BB Block of this type. “Also elevation of RS-T seems to have been a fairly constant feature in V2 and V3 and this series and is not a fresh development since November 16, 1960 although it seems to be getting more marked. This has a rather coronary appearance and mignt point to subandocardial or anterior ischemic damage but as it is not entirely anew finding, we must be cautious in assigning Significance to it. 3. Tne low RS-T segment would rather suggest coronary insufficiency or subandocardial iscnemia but here we are dealing with digitalis admlnistration which could well account for tnis cnange.