The NP works within an interdisciplinary team to continually monitor and manage the disease progression and quality of life of adult Pulmonary hypertension patients. An electrocardiogram (ECG) may reveal right ventricular hypertrophy and strain and right atrial enlargement. Features of the ECG in right ventricular hypertrophy include, right axis deviation, possibly a predominant R wave in lead V1, a deep S in V6, inverted T waves in right precordial leads V2 and V3, and peaked P waves. However, an ECG alone cannot diagnose Pulmonary hypertension. Supraventricular arrhythmias, such as atrial flutter and atrial fibrillation, may be present in advanced stages of Pulmonary hypertension and lead to further clinical deterioration. A chest radiograph may reveal right atrium and ventricular enlargement and pulmonary artery dilatation.