What does a biphasic P wave mean?
A biphasic P wave in the inferior leads results from interference of the atrial conduction of Bachmann׳s bundle, which in turn results in delayed activation of the left atrium as the impulse propagated from the lower right atrium to the left atrium occurs in a caudo-cranial direction.
Are biphasic P waves normal?
The normal P wave morphology is upright in leads I, II, and aVF, but it is inverted in lead aVR. The P wave is typically biphasic in lead V1 (positive-negative), but when the negative terminal component of the P wave exceeds 0.04 seconds in duration (equivalent to one small box), it is abnormal.
What causes a double P wave?
P Pulmonale The presence of tall, peaked P waves in lead II is a sign of right atrial enlargement, usually due to pulmonary hypertension (e.g. cor pulmonale from chronic respiratory disease).
Why do we use biphasic P wave in V1?
The P wave in V1 is often biphasic. Early right atrial forces are directed anteriorly, giving rise to an initial positive deflection; these are followed by left atrial forces travelling posteriorly, producing a later negative deflection.
What causes biphasic T waves?
There are two main causes of biphasic T waves: Myocardial ischaemia. Hypokalaemia.
What does a notched P wave indicate?
A notched P wave or bifid P wave indicates left atrial enlargement, nearly always the result of a narrowed mitral valve. The mitral valve lets blood flow from the left atrium into the left ventricle.
What is Wellens syndrome?
Wellens syndrome refers to these specific electrocardiographic (ECG) abnormalities in the precordial T-wave segment, which are associated with critical stenosis of the proximal left anterior descending (LAD) coronary artery. Wellens syndrome is also referred to as LAD coronary T-wave syndrome.
What is pulmonary disease pattern on ECG?
ECG demonstrates many of the features of chronic pulmonary disease: Rightward QRS axis (+90 degrees) Peaked P waves in the inferior leads > 2.5 mm (P pulmonale) with a rightward P-wave axis (inverted in aVL) Clockwise rotation of the heart with a delayed R/S transition point (transitional lead = V5)