The ECG findings include:
1. Normal sinus rhythm
2. Right ventricular hypertrophy with strain
3. Right atrial enlargement
Right ventricular hypertrophy (RVH) occurs when the right ventricular wall thickens due to chronic pressure overload, similar to that of left ventricular hypertrophy. RVH is diagnosed on ECG in the presence of a R-S ratio of > 1 in lead V1 in the absence of other causes or if the R wave in lead V1 is > 7 mm tall. The strain pattern occurs when the right ventricular wall is quite thick and the pressure is high as well. Strain causes ST segment depression and asymmetric T wave inversions in leads V1 - V3.