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 select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process 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 Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.