pulmonary hypertension on ecg

Manifestations of pulmonary arterial hypertension on an electrocardiogram (ECG) may include right ventricular hypertrophy, right bundle branch block, and pulmonary P waves, reflecting the heart's adaptive response to elevated pulmonary artery pressures.

Firstly, right ventricular hypertrophy is a common ECG finding in pulmonary arterial hypertension. As pulmonary artery pressure rises, the right ventricle must exert greater force to pump blood through the lungs, leading to myocardial cell proliferation and ventricular wall thickening. On ECG, this is indicated by an R/S ratio greater than 1 in lead V1 and a combined amplitude of RV1+SV5 exceeding 1.05 millivolts.

Secondly, right bundle branch block is also frequently observed in ECGs of patients with pulmonary arterial hypertension. The enlargement and fibrosis of the right ventricle slow the conduction velocity of the right bundle branch, causing delays and distortions in the terminal part of the QRS complex. On ECG, this is seen as an rSR' pattern in the terminal portion of the QRS complex in lead V1, with an extended Q wave duration.

Additionally, pulmonary P waves may be present on the ECG. The increased pulmonary artery pressure requires the right atrium to exert more force to push blood into the right ventricle, resulting in right atrial enlargement and atrial muscle cell proliferation. On ECG, this is reflected by a P wave amplitude greater than 0.25 millivolts in lead V1.

It is important to recognize that these ECG findings are not pathognomonic, and similar changes can be associated with other cardiac conditions. Therefore, if pulmonary arterial hypertension is suspected, timely medical consultation and further diagnostic evaluations are essential.

For individuals with pulmonary arterial hypertension, maintaining a healthy lifestyle is crucial, including smoking cessation, moderate alcohol intake, weight control, and regular physical activity. Regular monitoring of blood pressure and heart rate is also advised, along with adhering to the prescribed treatment regimen under a physician's guidance. Self-medication should be avoided, and medication should be used responsibly under medical supervision.