Electrocardiography: right ventricular hypertrophy

Not only is RVH difficult to diagnose electrocardiographically but it is frequently mimicked by true posterior infarction. The R/S-amplitude ratio in lead V1 and the S wave in lead V5 are the most useful indices of RVH. The ECG in chronic lung disease can be distinguished from that in RVH and is more often confused with that of anterior infarction. The ECG changes found in pulmonary embolism are the same as those found in RVH but they are transient; they are more easily interpreted by means of serial ECGs. In conjunction with clinical data the ECG can be used to predict the severity of pulmonary valve stenosis.