Right ventricular hypertrophy

ECG Quiz 28 Right ventricular hypertrophy

Right axis deviation of QRS complex with predominant negative QRS in leads I and aVl  and qR pattern in V1 suggests severe right ventricular hypertrophy. Sharp P waves in inferior leads and V1 indicate right atrial overload. T wave inversion in inferior and anterior leads are secondary to right ventricular hypertrophy. The R wave height in V1 multiplied by 5 gives an estimate of right ventricular systolic pressure, especially when the right ventricular hypertrophy is due to pulmonary stenosis. Other important cause of right ventricular hypertrophy is pulmonary hypertension, either primary or secondary.