Which electrocardiographic finding is associated with right heart strain in pulmonary hypertension?

Which electrocardiographic finding is associated with right heart strain in pulmonary hypertension?

• A. Left-axis deviation
• B. Short PR interval
• C. Right-axis deviation
• D. Normal ECG

Answer: (C)

Pulmonary hypertension makes the right ventricle work harder, leading to enlargement and remodeling that shifts the heart’s electrical axis toward the right. This rightward shift shows up on the ECG as right-axis deviation, with QRS activity more prominent in the rightward and inferior leads and less in the leftward leads. So the best finding in this scenario is a rightward QRS axis. Left-axis deviation would suggest left-sided (often LV) changes, a short PR interval points to preexcitation or related conduction issues, and a normal ECG would not reflect the RV strain and axis shift typical of pulmonary hypertension.

Pulmonary hypertension makes the right ventricle work harder, leading to enlargement and remodeling that shifts the heart’s electrical axis toward the right. This rightward shift shows up on the ECG as right-axis deviation, with QRS activity more prominent in the rightward and inferior leads and less in the leftward leads.

So the best finding in this scenario is a rightward QRS axis. Left-axis deviation would suggest left-sided (often LV) changes, a short PR interval points to preexcitation or related conduction issues, and a normal ECG would not reflect the RV strain and axis shift typical of pulmonary hypertension.