Right heart strain

[6] When using an echocardiograph (echo) to visualize the heart,[a] strain can appear with the RV being enlarged and more round than typical.

When normal, the RV is about half the size of the left ventricle (LV).

[5] An important potential finding with echo is McConnell's sign, where only the RV apex wall contracts;[7] it is specific for right heart strain and typically indicates a large PE.

[6] Other EKG signs include a right bundle branch block[13] as well as T wave inversions in the anterior leads, which are "thought to be the consequence of an ischemic phenomenon due to low cardiac output in the context of RV dilation and strain.

"[13] Aside from echo and ECG, RV strain is visible with a CT scan of the chest and via cardiac magnetic resonance.

Electrocardiogram of a person with pulmonary embolism, showing sinus tachycardia of approximately 100 beats per minute, large S wave in Lead I, moderate Q wave in Lead III, inverted T wave in Lead III, and inverted T waves in leads V1 and V3.