EKG Dictionary
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Axis & chamber enlargement

Right ventricular hypertrophy (RVH)

Also calledRVH · right ventricular hypertrophy · RV hypertrophy

Definition

An electrocardiographic pattern of increased right ventricular mass characterized by right axis deviation and prominent anterior forces: a dominant R wave in V1 (R/S ratio of 1 or more, or a tall R wave, 6 mm in one criterion set), a deep S wave in V5 or V6, and often ST depression with T-wave inversion in the right precordial leads V1 to V3 (a secondary ST-T abnormality; the older label 'right ventricular strain' is discouraged). Supportive findings include right atrial enlargement (P pulmonale) and an rSR' or qR morphology in V1.

Sources

  1. Hancock EW, Deal BJ, Mirvis DM, et al. AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: part V: electrocardiogram changes associated with cardiac chamber hypertrophy. Circulation. 2009;119(10):e251-e261. doi.org/10.1161/CIRCULATIONAHA.108.191097
  2. Samesima N, God EG, Kruse JCL, et al. Brazilian Society of Cardiology guidelines on the analysis and issuance of electrocardiographic reports - 2022. Arq Bras Cardiol. 2022;119(4):638-680. doi.org/10.36660/abc.20220623

Last reviewed 2 October 2026. Every definition in the EKG Dictionary cites the guideline, consensus statement or original paper it comes from.

More in Axis & chamber enlargement

Cardiac axis Cornell criteria Extreme axis deviation Hexaxial reference system Left atrial enlargement (LAE) Left axis deviation (LAD) Left ventricular hypertrophy (LVH) Normal axis P mitrale P pulmonale Right atrial enlargement (RAE) Right axis deviation (RAD) Sokolow-Lyon criteria

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