ECG recorded from a 46-year-old male with recurrent thromboembolic disease, gross pulmonary hypertension, and RV failure. The chest x-ray showed cardiomegaly and an enlarged pulmonary artery. Note the QR complex in V1 with secondary ST-T changes in V1–V4 indicating RVH. These ST-T changes constitute the classical RV strain pattern. The P waves suggest right atrial enlargement in addition.
15.16 for corresponding 12-1ead ECG); (b) type B
RVH, where there is increased anterior force with counterclockwise
inscription of the loop in the transverse plane (see Fig.
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