ECG changes commonly associated with pulmonary diseases such as COPD. ECG findings often suggest right ventricular pressure overload or strain.

•Common ECG findings:

Right axis deviation or vertical axis of the QRS complex.

Right axis deviation of the P waves.

•Prominent P waves in the inferior leads (right atrial abnormality).

Late transition (clockwise rotation).

•Persistent S waves in lead V6.

•Absence of R waves in leads V1 through V3 (SV1, SV2, SV3 pattern).

•PR and ST segment sagging (exaggerated atrial depolarization).

Low QRS voltage (especially in the precordial leads).