What does prolonged right ventricular hypertrophy reflect on an ECG?

Prolonged right ventricular hypertrophy on an ECG is characterized primarily by the presence of large R waves in the right precordial leads, specifically V1 and V2. This reflects the increased muscle mass of the right ventricle, which causes a change in electrical activity that can be detected on an ECG.

In a normal heart, the electrical impulses that stimulate the ventricles usually generate comparable R wave sizes in both the left and right leads. However, in the case of right ventricular hypertrophy, the additional muscle mass in the right ventricle leads to larger R waves in these leads due to increased depolarization activity associated with the hypertrophied muscle.

The significance of finding large R waves in these specific leads is that it indicates that the right ventricle is under strain or has increased workload, which can occur in conditions such as pulmonary hypertension or congenital heart defects. Therefore, recognizing these patterns on an ECG can provide crucial information about the underlying cardiac condition and guide further diagnostic and therapeutic interventions.