Skip to Main Content

We have a new app!

Take the Access library with you wherever you go—easy access to books, videos, images, podcasts, personalized features, and more.

Download the Access App here: iOS and Android

23-39: Right Ventricular Hypertrophy

Maite A. Huis in ‘t Veld; Amal Mattu; R. Jason Thurman

ECG Findings

  • Rightward axis

  • Dominant S wave in lateral leads (V5, V6, I, aVL)

  • Dominant R wave in aVR, V1, V2, which may exceed the S-wave amplitude (especially in lead V1)

  • T-wave inversions in relation to QRS complex

Pearls

  1. Right ventricular hypertrophy (RVH) causes characteristic ECG changes as the predominant electrical signal of the left ventricle is overcome.

  2. Congenital heart disease, pulmonic or mitral stenosis, and pulmonary hypertension are common causes of RVH.

  3. As RVH persists, right atrial enlargement may occur as seen in the example (P-wave amplitude in V1 > 1.5 mm).

FIGURE 23.39A

Right Ventricular Hypertrophy. (ECG contributor: James V. Ritchie, MD.)

An E C G tracing with 12 leads from a patient with right ventricular hypertrophy.
View Full Size||Download Slide (.ppt)
FIGURE 23.39B

The R-wave amplitude exceeds the S-wave amplitude (arrows) in lead V1. In addition, the P-wave upward deflection exceeds 1.5 mm, indicating concomitant right atrial enlargement.

An E C G tracing of lead V 1, consists of a small, sharp peak, a curved dip, a sharp peak, a sharp dip, and a wide curved dip. An arrow points up along the sharp peak and down along the sharp dip.
View Full Size||Download Slide (.ppt)

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.

This site uses cookies to provide, maintain and improve your experience. MH Privacy Center Close