Abstract Two cases are presented with clinical and x-ray findings of hypertrophy and dilatation of the right ventricle and right auricle, associated with tricuspid insufficiency. The electrocardiograms show large, diphasic P waves in Lead CF 1 such as are normally obtained from esophageal leads and experimentally in direct leads from exposed auricles. It is probable that the proximity of the enlarged right auricle to the anterior chest wall is largely responsible for an auricular wave of this type. Further observations may show that, in tricuspid insufficiency and right auricular enlargement, this characteristic auricular complex in parasternal leads is a significant diagnostic sign.