Objective: To compare the diagnostic value of dynamic electrocardiogram and ultrasonic electrocardiogram in patients with right ventricular hypertrophy (RVH) of pulmonary heart disease (PHD), and to analyze the clinical diagnostic value of dynamic electrocardiogram combined with platelet (PLT) count and mean platelet volume (MPV). Methods: From January 2022 to December 2023, 80 patients with PHD with RVH were selected as the observation group, and 42 patients with non-respiratory or non-cardiovascular diseases treated in our hospital during the same period were selected as the control group. Dynamic electrocardiogram was performed in both groups, and the performance characteristics of dynamic electrocardiogram in the two groups were statistically analyzed. receiver operating characteristic (ROC) curve and maximum Youden index were used to analyze the diagnostic efficacy of Dynamic electrocardiogram combined with PLT count and MPV. Results: The incidence rates of sinus bradycardia (SB), ventricular premature beat (VPB), ventricular tachycardia (VT) and MPV in observation group were significantly higher than those in control group, while the turbulence slope (TS), turbulence Onset(TO) and PLT count was significantly lower than that in control group (P<0.05). ROC results showed that the AUC of combined diagnosis was 0.982, and the diagnostic efficiency was the highest. Conclusion: Dynamic electrocardiogram can effectively reflect the occurrence of arrhythmia in PHD patients with RVH, and can clarify the abnormal condition of heart rate turbulence index. Combined with PLT count, MPV, and Dynamic electrocardiogram performance characteristics has high clinical diagnostic value