P Wave Morphology: Difference between revisions

From ECGpedia
Jump to navigation Jump to search
mNo edit summary
mNo edit summary
Line 14: Line 14:
{{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 stretch 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 bifasic 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==
==The abnormal P wave==


Line 32: Line 33:


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="center">
<div align="left">
{| class="wikitable"
{| class="wikitable"
|-
|-
Line 38: Line 39:
{|
{|
|-
|-
| | [[Image:normalSR.jpg|thumb|center|300px| Normal sinus rhythm with a positive p wave in leads I, II en AVF and a biphasic p wave in V1.]]
| | [[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 morfology 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.]]
Line 44: Line 44:
|}
|}
</div>
</div>
==Examples==
 
<div align="center">
 
<gallery>
Image:Normaal ecg.jpg|An example of normal sinus rhythm.
Image:Nsr.jpg|Another example of normal sinus rhythm.
</gallery>
</div>
{{clr}}
{{box|
{{box|
==References==
==References==

Revision as of 19:08, 30 May 2009

«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 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. 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 bifasic 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 morfology is seen in left or right atrial enlargement.
The PTa segment can be used to diagnose pericarditis or atrial infarction.