1 MCQs in Medicine for NEET PG
A 52-year-old man with severe COPD (GOLD Stage IV, FEV₁ 22% predicted) and 60 pack-year smoking history presents with progressive exertional dyspnea, bilateral lower limb swelling, and abdominal distension. On examination, he has central cyanosis, raised JVP with prominent A waves, left parasternal heave, loud P₂, and pansystolic murmur at the lower left sternal edge accentuated on inspiration. His 12-lead ECG shows sinus rhythm, right axis deviation (+120°), and the structure marked **A** (tall R wave in V1 with R>S ratio of 12 mm/4 mm). Which of the following best explains the pathophysiological basis for this ECG finding?
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