• In chronic lung diseases, hypoxia-induced pulmonary vasoconstriction might result in the development of pulmonary hypertension and the right heart pathology.
• Acute cor pulmonale might present similarly to pulmonay embolism on ECG, which includes signs of right heart strain such as:
S1Q3T3 pattern (McGinn-White triad)
Right ventricle hypertrophy
Right atrial enlargement
Right axis deviation
Right bundle branch block
• Chronic cor pulmonale might present with more prominent signs of right heart strain (as listed above), in addition to multifocal atrial tachycardia due to the overstretched atria.
• In chronic obstructive pulmonary disease (COPD), hyperinflated lungs allow air entry in between the heart and the anterior chest wall where ECG electrodes are placed; this might result in low QRS voltage on ECG.
