Tarazi RC, Miller A, Frohlich ED, Dustan HP.Electrocardiographic left atrial abnormalities and risk of ischemic stroke. Stroke. Kohsaka S, Sciacca RR, Sugioka K, Sacco RL, Homma S, Di Tullio MR.Are left atrial abnormalities a risk for stroke? Neurosciences (Riyadh). LeoSchamroth – An Introduction to Electrocardiography. Same group of authors have reported the utility of left atrial abnormality in the ECG for diagnosis of left ventricular hypertrophy in the presence of left bundle branch block as well. 5 Six commonly used criteria for left ventricular hypertrophy could detect only 5% of cases of left ventricular hypertrophy in the presence of right bundle branch block. In the echocardiographic study by Mehta A and associates 92% of those with left atrial abnormality had estimated left ventricular mass diagnostic of left ventricular hypertrophy. Left atrial abnormality in the ECG has been used to predict left ventricular hypertrophy in the presence of right bundle branch block which may mask electrocardiographic evidence of left ventricular hypertrophy. 1,2,3 The terminology of left atrial abnormality was in use earlier also, but less frequently. The change in terminology from left atrial overload to left atrial abnormality has been suggested because the same pattern can be seen in left atrial dilatation, hypertrophy or increased pressure in the left atrium or any of these in combination. When the P wave widens, it is due to left atrial enlargement as the second component of the normal P wave is contributed by the left atrial activation as it spreads leftwards from the sinus node across the Bachmann’s bundle, an interatrial conduction pathway. Normal P wave has a width of up to 2.5 millimeters (duration of 100 milliseconds). P mitrale is the wide and notched P wave of left atrial overload (left atrial abnormality), typically seen in lead II in mitral stenosis. P Mitrale – Left atrial abnormality / overloadĪbstract: P mitrale is the wide and notched P wave of left atrial overload (left atrial abnormality), typically seen in lead II in mitral stenosis.
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