Cardiology Question 29 Instructor

What are the criteria and differential for right ventricular hypertrophy (RVH) on a 12-lead ECG? What are the causes?


  1. Right axis deviation (>=100 degree)
  2. Tall R in V1 (R/S ratio>1)
  3. Additional criteria:
    • RV Strain pattern with ST depression & T wave inversion V1-V4
    • Right atrial enlargement favours the diagnosis

Differential includes:

  • RV mass approaches or exceeds LV mass
  • chronic lung disease
  • primary pulmonary hypertension
  • congenital pulmonary stenosis
  • Tetralogy of Fallot

Subscribe to Pearls

Uncle Sam wants you to subscribe to Medical Pearls

Subscribe today! It’s always free, and you can easily unsubscribe at any time. We will never share your email address. Subscribe to...

Multiple Pearls
Cardiology Pearls
Endocrinology Pearls
Hematology Pearls
Nephrology Pearls
Rheumatology Pearls
Transplant Pearls
General Internal Medicine Pearls
Instructor Pearls

Subscribe to receive your pearls today—it's free!