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P-wave changes in left and right atrial hypertrophy. Bifid P waves (known as P mitrale) indicate left-atrial abnormality - e.g. dilatation [6] or hypertrophy. [1] If at least three different shaped P waves can be seen in a given ECG lead tracing, this implies that even if one of them arises from the SA node, at least two others are arising ...
P mitrale is a broad, bifid notched P wave in several or many leads with a prominent late negative component to the P wave in lead V 1, and may be seen in MR, but also in mitral stenosis, and, potentially, any cause of overload of the left atrium. [18]
Electrocardiography may show P mitrale, that is, broad, notched P waves in several or many leads with a prominent late negative component to the P wave in lead V 1, and may also be seen in mitral regurgitation, and, potentially, any cause of overload of the left atrium. [14] Thus, P-sinistrocardiale may be a more appropriate term. [14]
Upon auscultation of an individual with mitral valve prolapse, a mid-systolic click, followed by a late systolic murmur heard best at the apex, is common. The length of the murmur signifies the time period over which blood is leaking back into the left atrium, known as regurgitation.
Junctional rhythm can be diagnosed by looking at an ECG: it usually presents without a P wave or with an inverted P wave. Retrograde, or inverted, P waves refers to the depolarization from the AV node back towards the SA node. [8]
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Bifascicular block is a combination of right bundle branch block and either left anterior fascicular block or left posterior fascicular block. Conduction to the ventricle would therefore be via the remaining fascicle. The ECG will show typical features of RBBB plus either left or right axis deviation. [7] [8]
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