A notched P waveA wave generated from the depolarization of the atria; the P wave is upright when originating from the SA node. The P wave represents the depolarization of the right and left atria. The P wave begins with the first deviation... in lead II with increased amplitudeThe height or depth of waves and complexes of an ECG in millimetres; represents millivolts where 10 mm is 1 millivolt with a properly calibrated monitor. 1. Six Second ECG Guidebook (2012), T Barill, p. 190 to the latter aspect of the P wave (left atrium) suggests left atrial enlargementAtrial enlargement and dilation can be caused by tricuspid and bicuspid (mitral) valve disease, hypertension, and ventricular hypertrophy among other causes. A P wave can change with atrial enlargement to be taller than 2.5 mm in leads I, II and....
Atrial enlargement is best analysed using lead II. A P wave should always be upright in lead II (see Chapter 3). A normal P wave begins with the depolarizationThe rapid influx of positive ions (sodium and/or calcium) into a cell – depolarization is necessary for contraction to occur. A depolarizing wave moves through the myocardium on average along a trajectory or vector. A vector is a force moving... of the right atrium and completes with the depolarization of the left atrium. A notched P wave in lead II with increased amplitude to the latter aspect of the P wave (left atrium) suggests left atrial enlargement. Right atrial enlargement is reflected by a tall upright P wave of more than 2.5 mm in leads II, III and/or aVF.
Right atrial enlargement is often caused by chronic lung disease such as pulmonary hypertensionBlood pressure above acceptable limits – above 90 mm of Hg diastolic and above 140 mm of Hg systolic. 1. Six Second ECG Guidebook (2012), T Barill, p. 167, 197 and COPDChronic obstructive pulmonary disease (COPD) is a group of respiratory diseases that involve structural changes to the lung tissue that impair gas exchange (oxygen and carbon dioxide exchange). Emphysema and chronic bronchitis are two of the most common conditions. Table.... Left atrial enlargement arises from left ventricular failure and mitral valve disease. Criteria for atrial enlargement is illustrated in Figure 6.18.
1. Six Second ECG GuidebookA Practice Guide to Basic and 12 Lead ECG Interpretation, written by Tracy Barill, 2012 Introduction The ability to correctly interpret an electrocardiogram (ECG), be it a simple six second strip or a 12 lead ECG, is a vital skill... (2012), T Barill, p. 172