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


'''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 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.
<div align="left">
{| class="wikitable"
|-
|
{|
|-
| | [[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>


==Examples==
 
<gallery>
{{box|
Image:Normaal ecg.jpg|thumb| An example of normal sinus rhythm.
Image:Nsr.jpg|thumb| Another example of normal sinus rhythm.
</gallery>
==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.