In a patient with COPD leading to right ventricular hypertrophy, what would the ECG typically show?

In a patient with COPD that results in right ventricular hypertrophy (RVH), the ECG would typically demonstrate right axis deviation. This is due to the increased workload and hypertrophy of the right ventricle, leading to a shift in the electrical activity of the heart.

As the right ventricle becomes enlarged and the muscle mass increases, the vectors of electrical depolarization are altered. Normally, the heart's electrical axis aligns in a certain direction, but with RVH, the vector shifts rightward due to hypertrophy. This primarily affects the QRS complex in the leads, showing a deviation in the expected axis towards the right.

Right axis deviation is often noted on an ECG when there is right ventricular overload or ventricular hypertrophy, conditions commonly seen in patients with COPD, especially if they have pulmonary hypertension as a result of chronic lung disease. This characteristic finding helps clinicians identify underlying right ventricular stress and is an essential part of the ECG interpretation in these patients.