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Atrial enlargement

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Biatrial enlargement is diagnosed when criteria for both right and left atrial enlargement are present on the same ECG.
The diagnosis of biatrial enlargement requires criteria for LAE and RAE to be met in either lead II, lead V1 or a combination of leads.

Published in: Health & Medicine
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Atrial enlargement

  1. 1. ATRIAL ENLARGEMENT 12 LEAD ELECTROCARDIOGRAM
  2. 2. CHEST X-RAY PA VIEW :CRHD ,SEVERE MITRAL STENOSIS ,RVSP=84MMHG
  3. 3. X-RAY SHOWS RVH 01 RAE 02 LAE 03 PAH 04 PVH 05
  4. 4. 12 LEAD ECG
  5. 5. FINDINGS ECG RIGHT AXIS DEVIATION OF P WAVE RIGHT AXIS DEVIATION OF QRS BIATRIAL ENLARGEMENT
  6. 6. RIGHT ATRIAL ENLARGEMENT  Peaked P waves with amplitudes in lead II to >0.25 mV (“P pulmonale”)  Prominent initial positivity in lead V 1 or V 2 >0.15 mv  Increased area under initial positive portion of P wave in lead V 1 to >0.06 mm-sec  Rightward shift of mean P wave axis to >+75 degrees
  7. 7. Left atrial enlargement  Prolonged P wave duration to >120 msec in lead II  Prominent notching of P wave, usually most obvious in lead II, with interval between notches of >40 msec (“P mitrale”)  Ratio between duration of P wave in lead II and duration of PR segment >1.6  Increased duration and depth of terminal-negative portion of P wave in lead V 1 (P terminal force) so that area subtended by it >0.04 mm-sec  Leftward shift of mean P wave axis to between −30 and −45 degrees
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