<prompt> A 40-year-old male complained of tachypnea. On examination his respiratory rate is 32min with pulmonary hypeension and BP 13290 mmHg. JVP was raised. What is your diagnosis?Aoic dissection and ruptureEsophageal ruptureTension pneumothoraxRight ventricular hyperophy  <response>: The above clinical scenario describes that the patient is suffering from Right ventricular hyperophy. The most common aetiology of right ventricular hyperophy is severe lung disease. The disorders that induce pulmonary hypeension and secondary right ventricular hyperophy include the following: Pulmonary aerial hypeension PAH Pulmonary hypeension owing to left hea disease Pulmonary hypeension from lung disease andor hypoxia On Examination: Jugular Veins- Distended and prominent jugular veins are apparent and reflect right atrial pressure elevation. Palpation of the chest may reveal a dynamic right ventricular heave due to the dilated right ventricle. On JVP: prominent a wave. Hea sounds: S3 and S4 can be heard. Ascites and peripheral oedema of variable severity may be present. Liver is often enlarged and tender. 