Remove ACE Inhibitor Remove Electrocardiogram Remove Ischemia
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Understanding an Enlarged Heart (Cardiomegaly): Causes, Symptoms, and Treatment

MIBHS

This may result in ischemia (lack of oxygen to the heart muscle), causing parts of the heart to weaken and enlarge. Electrocardiogram (ECG/EKG) An ECG records the electrical activity of the heart and can help detect abnormalities in the heart’s rhythm that might contribute to enlargement.

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A man in his 70s with chest pain during a bike ride

Dr. Smith's ECG Blog

The patient stated he had a long history of well-controlled hypertension for which he was compliant with his ACE-inhibitor. These findings are concerning for inferior wall ischemia with possible posterior wall involvement. You will note that it is essentially an unremarkable electrocardiogram except for some PACS.