Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content +++ ECG Findings ++ Increased amplitude of P wave without affecting duration (as commonly seen with left atrial abnormalities) Peaked P waves (> 2.5 mm) in leads II, III, aVF P-wave upward deflection > 1.5 mm in lead V1 or V2 +++ Pearls ++ Normal P-wave morphology has amplitude of < 2.5 mV (2.5 small vertical boxes) and duration (width) of < 120 ms (three small boxes). The right atrium depolarizes before the left atrium and therefore has the most effect on the 1st portion of the P wave. Right atrial enlargement is often associated with RVH, COPD, some congenital heart diseases, and pulmonary hypertension, and may be seen transiently with pulmonary embolus. ++ FIGURE 23.41A Right Atrial Hypertrophy. (ECG contributor: James V. Ritchie, MD.) Graphic Jump LocationView Full Size||Download Slide (.ppt) ++ FIGURE 23.41B The P wave in lead II (an inferior lead) is greater than 2.5 mm in amplitude (double arrow). Graphic Jump LocationView Full Size||Download Slide (.ppt) Your Access profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth