Difference between revisions of "P Wave Morphology"

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|nextname=Step 6: QRS morphology
 
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|mainauthor= [[user:Drj|J.S.S.G. de Jong, MD]], A. Bouhiouf, Msc
 
|mainauthor= [[user:Drj|J.S.S.G. de Jong, MD]], A. Bouhiouf, Msc
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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.]]
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[[Image:p_wave_morphology.png|thumb|Altered P wave morfology is seen in left or right atrial enlargement.]]
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[[Image:pta_changes.svg|thumb|The PTa segment can be used to diagnose pericarditis or atrial infarction.]]
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| | [[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.]]
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| | [[Image:p_wave_morphology.png|center|thumb|300px|Altered P wave morfology is seen in left or right atrial enlargement.]]
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| | [[Image:pta_changes.svg|thumb|center|300px|The PTa segment can be used to diagnose pericarditis or atrial infarction.]]
 
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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 stretch or atrial arrhythmias and is best determined in leads II and V1 during sinus rhythm.
 
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! Characteristics of a normal p wave:<cite>Spodick</cite>
 
! Characteristics of a normal p wave:<cite>Spodick</cite>
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*The p wave duration is usually shorter than 0.12 seconds
 
*The p wave duration is usually shorter than 0.12 seconds
 
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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]].
  
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==Examples==
 
==Examples==
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Image:Normaal ecg.jpg|An example of normal sinus rhythm.
 
Image:Normaal ecg.jpg|An example of normal sinus rhythm.
 
Image:Nsr.jpg|Another example of normal sinus rhythm.
 
Image:Nsr.jpg|Another example of normal sinus rhythm.
 
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Revision as of 18:23, 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


Normal sinus rhythm with a positive p wave in leads I, II en AVF and a biphasic p wave in V1.
Altered P wave morfology is seen in left or right atrial enlargement.
The PTa segment can be used to diagnose pericarditis or atrial infarction.

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 usually shorter than 0.12 seconds

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.

Examples