The 50 year old man comes to emergency with chest pain and shoness of breath. He smokes 2 pack of cigarette diaily. His BP Is 150/90mmHg and HR is 110. ECG is done as shown below. What is your diagnosis ?

Symptoms of RVH can include: Chest pain Dizziness Excess fluid build up Shoness of breath Hea palpitations ECG findings of RVH: Right ventricular wall thickens due to chronic pressure overload, similar to that of left ventricular hyperophy. 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 millimeters 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 to V3.