Right atrial enlargement
| Right atrial enlargement | ||
 | ||
|---|---|---|
| MeSH | [1] | |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [3]
Synonyms and keywords: Himalayan P waves, Himalayan P-wave, giant P waves, P pulmonale, right atrial abnormality, RAE
Overview
Right atrial enlargement can result from increased pressure in the pulmonary artery. A P wave >2.5 mm in leads II, III and aVF or a P wave >1.5 mm in lead V1 indicates right atrial enlargement. Despite the increase in the height of the P wave, the width of the P wave does not change. Sometimes these large P waves can be referred to as Himalayan P waves.
Causes of Right Atrial Enlargement
In alphabetical order:
- Atrial aneurysm
- Atrial septal defect
- Cor pulmonale or right heart failure
- Ebstein's anomaly
- Pulmonic stenosis
- Tricuspid prolapse
- Tricuspid regurgitation
- Tricuspid stenosis
- Tumor
The EKG in Right Atrial Enlargement
Right atrial enlargement is defined as either:
Shown below is an illustration of right atrial enlargement:
Shown below is an EKG demonstrating large P waves in leads to 2,3, and aVF which have a P-wave height greater than 2.5 mm consistent with right each one enlargement:
Chest X-Ray
Shown below is the chest x-ray of a patient with Ebstein's anomaly in whom the right atrium is markedly enlarged as demonstrated by the convex curvature to the right border the heart.
