P Wave Morphology: Difference between revisions

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[[Image:normalSR.jpg|thumb|Normal sinus rhythm with a positive p wave in leads I, II en AVF and a biphasic p wave in V1.]]
<div style="float:left">
[[Image:p_wave_morphology.png|thumb|Altered P wave morfology is seen in left or right atrial enlargement.]]
__TOC__
[[Image:pta_changes.svg|thumb|The PTa segment can be used to diagnose pericarditis or atrial infarction.]]
</div>
{{clr}}
==The Normal P wave==
{{box|
The '''P wave morphology''' can reveal right or left atrial hypertrophy or atrial arrhythmias and is best determined in leads II and V1 during sinus rhythm.


The ''p wave morphology'' can reveal right or left atrial stretch.
'''Characteristics of a normal p wave:'''<cite>Spodick</cite>
 
*The maximal height of the P wave is 2.5 mm in leads II and / or III
The P-wave morphology is best determined in leads II and V1 during sinus rhythm.
*The p wave is positive in II and AVF, and biphasic in V1
*The p wave duration is shorter than 0.12 seconds
}}
<div align="left">
{| class="wikitable"
{| class="wikitable"
! Characteristics of a normal p wave:<cite>Spodick</cite>
|-
|-
|
| |[[Image:Normaal ecg.jpg|thumb|center|300px|An example of normal sinus rhythm.]]
*The maximal height of the P wave is 2.5 mm in leads II and / or III
| |[[Image:Nsr.jpg|300px|thumb|center}Another example of normal sinus rhythm.]]
*The p wave is positive in II and AVF, and bifasic in V1
*The p wave duration is usually shorter than 0.12 seconds
|}
|}
</div>
==The Abnormal P wave==


Elevation or depression of the [[PTa segment]] (the part between the p wave and the beginning of the QRS complex) can result from [[Ischemia#Atrial infarction|Atrial infarction]] or [[Clinical Disorders#Pericarditis|pericarditis]].
Elevation or depression of the [[PTa segment]] (the part between the p wave and the beginning of the QRS complex) can result from [[Ischemia#Atrial infarction|atrial infarction]] or [[Clinical Disorders#Pericarditis|pericarditis]].


If the p-wave is enlarged, the [[Chamber_Hypertrophy_and_Enlargment#Left_atrial_enlargement|atria are enlarged]].
If the p-wave is enlarged, the [[Chamber_Hypertrophy_and_Enlargment#Left_atrial_enlargement|atria are enlarged]].


If the P wave is inverted, it is most likely an [[ectopic atrial rhythm]] not originating from the sinus node.
If the P wave is inverted, it is most likely an [[ectopic atrial rhythm]] not originating from the sinus node.
{{clr}}
<div align="left">
==Examples==
{| class="wikitable"
<gallery>
|-
Image:Normaal ecg.jpg|thumb| An example of normal sinus rhythm.
|
Image:Nsr.jpg|thumb| Another example of normal sinus rhythm.
{|
</gallery>
|-
| | [[Image:p_wave_morphology.png|center|thumb|300px|Altered P wave morphology is seen in left or right atrial enlargement.]]
| | [[Image:pta_changes.svg|thumb|center|300px|The PTa segment can be used to diagnose pericarditis or atrial infarction.]]
|}
|}
</div>
 
 
{{box|
==References==
==References==
<biblio>
<biblio>
#Spodick pmid=1575201
#Spodick pmid=1575201
</biblio>
</biblio>
}}
[[Category:ECG Course]]

Latest revision as of 08:39, 12 January 2011

«Step 4:Heart axis Step 6: QRS morphology»


Author(s) J.S.S.G. de Jong, MD, A. Bouhiouf, Msc
Moderator J.S.S.G. de Jong, MD
Supervisor
some notes about authorship


The Normal P wave

The P wave morphology can reveal right or left atrial hypertrophy or atrial arrhythmias and is best determined in leads II and V1 during sinus rhythm.

Characteristics of a normal p wave:[1]

  • The maximal height of the P wave is 2.5 mm in leads II and / or III
  • The p wave is positive in II and AVF, and biphasic in V1
  • The p wave duration is shorter than 0.12 seconds
An example of normal sinus rhythm.
center}Another example of normal sinus rhythm.

The Abnormal P wave

Elevation or depression of the PTa segment (the part between the p wave and the beginning of the QRS complex) can result from atrial infarction or pericarditis.

If the p-wave is enlarged, the atria are enlarged.

If the P wave is inverted, it is most likely an ectopic atrial rhythm not originating from the sinus node.

Altered P wave morphology is seen in left or right atrial enlargement.
The PTa segment can be used to diagnose pericarditis or atrial infarction.