Chamber enlargements on ECG

Chamber enlargements on ECG Atrial enlargement  The normal P wave has a maximum amplitude of 2.5 mm (0.25 mV) and a maximum width of 2.5 mm (100 ms). In right atrial enlargement, the amplitude increases while in left atrial enlargement, it is the width (duration) which increases. Both increases in biatrial enlargement. P wave abnormalities are best assessed in leads II and V1. Normal P wave is upright in lead II. In V1, a tiny initial spike is followed by a shallow negative wave. P mitrale: P mitrale is a notched and broad P wave with taller second peak indicating left atrial enlargement. It may be noted that initial part of P wave is contributed by right atrium as it is activated first and the second part by left atrium which is activated later. It is associated with a prominent negative deflection of P wave in V1, the left atrial component. P mitrale P pulmonale: Tall peaked P wave in right atrial enlargement is known as P pulmonale. It is found in cor pulmonale. The tall P of right atrial enlargement is called P congenitale. P wave axis is rightward in P pulmonale while it is leftward in P congenitale. The initial spike in V1 more than 1.5 mm in V1 is also a feature of right atrial enlargement. P tricuspidale has been described in tricuspid atresia. The pattern is mirror image of P mitrale. The initial peak is taller than the second peak in P tricuspidale. P pulmonale P tricuspidale   Ventricular enlargement While atrial enlargement is manifest as changes in P wave, c...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: HBC incomplete right bundle branch block pattern Left ventricular pressure overload left ventricular volume overload LVH strain pattern P mitrale P pulmonale P tricuspidale Right ventricular pressure overload right ventricular volume ove Source Type: blogs