ECG (electrocardiogram)

An electrocardiographic study can uncover indications of hypertrophy and strain on the right ventricle, as well as dilation and hypertrophy of the right atrium. Right ventricular hypertrophy is identified in 87% of cases, and a deviation of the electrical axis of the heart to the right is observed in 79% of patients with idiopathic pulmonary hypertension. The method's low sensitivity (55%) and specificity (70%) suggest that electrocardiographic signs are not justified for widespread screening in diagnosing pulmonary hypertension. Ventricular arrhythmias are infrequent, while supraventricular arrhythmias often manifest as extrasystoles and atrial fibrillation.

In cases of severe pulmonary hypertension, an unaltered ECG may be detected. If ECG changes only occur with sufficiently pronounced hypertrophy of the right heart, vectorcardiography can aid in diagnosing these changes at earlier stages. Phonocardiographic examination not only allows the diagnosis of hypertension or hypervolemia in pulmonary circulation but also helps identify relative insufficiency of the tricuspid valve and pulmonary valve. Additionally, it aids in detecting acquired and congenital heart defects accompanied by secondary pulmonary hypertension.