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Thread: Where To Look For P Wave Pathology On Ekg

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    Question Where To Look For P Wave Pathology On Ekg

    In what leads the p wave pathology are best appreciated and what are these changes

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    p wave morphology is best seen in lead2 and lead v1. in v1 the p wave is biphasic.. the initial positive deflectio is due to rt. atrium and the negative deflection is due to lt atrium... in lead2 the 2 atria are represented in the same wave.. p wave axis is +60 degrees.. the changes shown are mainly change in the amplitude.. refer tex books for the normal amplitue and normal width.. the main use of the amplitude is to show hypertrophy..

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    P wave morphology is best seen in lead II in limb leads as its axis is parallel to the lead but in chest leads it must be lead V2 rather than V1 as in V1 it may be negative as will depend on where you put the electrode while recording the EKG.

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    Lead-1 & Lead-II.[Check for height,width,inversion]

    V1 & V2. [Check for height,width,inversion. Check for biphasic P wave - phase-1 represents activity of rt.atrium and phase-2 represents activity of Lt.Atrium.]

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    P wave morphology is best seen in lead II because this lead is the most parallel to the direction of the electrical impulse of the heart

    You can evaluate atrial dilatation depending on the morphology of P wave (remember that P wave correspond to atrial depolaritation) if a P wave is too wide (more that 2mm on EKG) and also have an "M" shape (called mitral P) it suggest for a left atrial dilatation. In other hand if the P wave is too high (also more than 2mm on EKG) it suggest for a right atrial dilatation (also called pulmonary P) and you'll have to confirm this in the V1 lead... If P wave is negative you can say that for sure it's a left atrial dilatation; if the P wave is positive and too high you can say that your patient has a right atrial dilatation, of course if you can use an echocardiogram it would give you a more precise Diagnosis, but a simple EKG it's a good start

    PS: Sorry for my english, I'm not used to speak in this language (or at least medical terms)

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