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ECG changes in right ventricular hypertrophy (RVH)

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Features of the ECG in right ventricular hypertrophy include:

  • right axis deviation
  • possibly a predominant R wave in lead V1 - in a normal ECG the S wave is dominant in V1
  • there will be a deep S in V6 - in a normal ECG the QRS complex is predominantly upwards in V6
  • inverted T waves in right praecordial leads - V2, V3 - will be present in severe cases; it is normal to have inverted T waves in V1
  • peaked P waves may also occur due to right atrial hypertrophy
  • QRS < 0.12s

Click here for an example ECG and further information concerning right ventricular hypertrophy

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