ELECTROCARDIOGRAPHIC SIGNS OF RIGHT VENTRICULAR OVERLOAD 

The following abnormalities are regarded as suggestive of right ventricular (RV) overload: S-wave in lead I and Q-wave in lead III each of amplitude > 1.5 mm, with or without T-wave inversion in lead III; S-waves in lead I, II, and III each of amplitude > 1.5 mm; T-wave inversion in right precordial leads; transient right bundle branch block; pseudoinfarction. If any of the above abnormalities are present in electrocardiograms taken prior to the onset of symptoms, they are disregarded.

Reference
Stein PD, Dalen JE, McIntyre KM, Sasahara AA, Wenger NK, Willis III PW. The electrocardiogram in acute pulmonary embolism. Prog Cardiovasc Dis 1975; 17: 247-257.

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