P Wave Morphology: Difference between revisions

From ECGpedia
Jump to navigation Jump to search
mNo edit summary
 
(5 intermediate revisions by 2 users not shown)
Line 15: Line 15:
__TOC__
__TOC__
</div>
</div>
{{clr}}
==The Normal P wave==
==The Normal P wave==
{{box|
{{box|
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 '''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>
'''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 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 bifasic in V1
*The p wave is positive in II and AVF, and biphasic in V1
*The p wave duration is shorter than 0.12 seconds
*The p wave duration is shorter than 0.12 seconds
}}
}}
Line 31: Line 32:
|}
|}
</div>
</div>
==The abnormal P wave==
==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]].
Line 44: Line 45:
{|
{|
|-
|-
| | [[Image:p_wave_morphology.png|center|thumb|300px|Altered P wave morfology is seen in left or right atrial enlargement.]]
| | [[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.]]
| | [[Image:pta_changes.svg|thumb|center|300px|The PTa segment can be used to diagnose pericarditis or atrial infarction.]]
|}
|}

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.