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The p wave morphology can reveal right or left atrial stretch. | The ''p wave morphology'' can reveal right or left atrial stretch. | ||
The P-wave morphology is best determined in leads II and V1 during sinus rhythm. | The P-wave morphology is best determined in leads II and V1 during sinus rhythm. | ||
===The normal P wave=== | ===The normal P wave=== | ||
[[Image:normalSR.jpg|thumb| | [[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.]] | ||
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 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 [[Ischemia#Atrial infarction|Atrial infarction]] or [[Miscelaneous#Pericarditis|pericarditis]]. | |||
If the p-wave is enlarged, the atria are enlarged. | |||
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=== | ===Left atrial enlargement=== | ||
Criteria voor | Criteria for left atrial voor left atrial enlargement: | ||
P | P wave with a broad (>0,04 sec or 1 small square) and deeply negative (>1 mm) terminal part in V1, and / or >0,12 sec in laeds I and / or II | ||
[[Image:left_atrial_enlargement.jpg|thumb| | [[Image:left_atrial_enlargement.jpg|thumb| Left atrial enlargement]] | ||
[[Image:LAE_2.png|thumb| | [[Image:LAE_2.png|thumb| Left atrial enlargement with ECG.]] | ||
[[Image:ECG_LAtrD_v1.jpg|thumb| | [[Image:ECG_LAtrD_v1.jpg|thumb| Left atrial enlargement as seen in lead V1.]] | ||
''' | '''Left atrial enlargement''' is often seen in mitral valve insufficiency. | ||
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