On in E.C.G tracing, the presence of right atrial hyperophy is suggested by -
Right atrial enlargement produces a peaked P wave (P pulmonale) with amplitude: > 2.5 mm in the inferior leads (II, III and AVF) > 1.5 mm in V1 and V2 Ref : Harrison 20th edition pg 1583
Tall spiky P wave
Widened P wave
Prolonged P-R interval
Increased P-Q segment
C.V.S