P Wave Morphology: Difference between revisions

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==The Normal P wave==
==The Normal P wave==
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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
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==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]].
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| | [[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.]]
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