Mitral regurgitation electrocardiogram: Difference between revisions
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{{CMG}}; '''Associate Editor-In-Chief:''' [[User:Mohammed Sbeih|Mohammed A. Sbeih, M.D.]][mailto:msbeih@perfuse.org]. | {{CMG}}; '''Associate Editor-In-Chief:''' [[User:Mohammed Sbeih|Mohammed A. Sbeih, M.D.]][mailto:msbeih@perfuse.org]. | ||
==Electrocardiographic findings in | ==Electrocardiographic findings in Mitral Regurgitation== | ||
Patient with mild mitral insufficiency can | Patient with mild mitral insufficiency can have a normal ECG. In severe cases, patients may have left ventricular hypertrophy and strain; pulmonary hypertension may occur as well. Chronic mitral regurgitation increases the risk for atrial fibrillation. | ||
'''1.''' [[LA enlargement]]: Left atrial enlargement produces a broad, bifid P wave in lead II ('''P mitrale''') and enlarges the terminal negative portion of the P wave in VI. | |||
In '''lead II''' following may be seen: | |||
*Bifid P wave with > 40 ms between the two peaks | |||
*Total P wave duration > 110 ms | |||
[[Image:P mitrale.gif|200px]] | |||
In '''lead V1''' follwing may be seen: | |||
*Biphasic P wave with terminal negative portion > 40 ms duration | |||
*Biphasic P wave with terminal negative portion > 1mm deep | |||
[[Image:LAE-v1.png|Left atrial enlargement as seen in lead V1|400px]] | |||
'''2.''' [[Right ventricular hypertrophy]]: A mean QRS axis in the frontal plane is greater than 80 and an R-to-S ratio of greater than 1 in lead V1. | |||
'''3.''' [[Right axis deviation]]: mean QRS axis in the frontal plane moves toward the right as pulmonary hypertension worsens. | |||
'''4.''' [[Atrial fibrillation]] is commonly seen with mitral regurgitation: Irregularly irregular rhythm with absence P waves. | |||
Below is an '''ECG in mitral regurgitation''' | |||
[[Image:LAE_12lead.jpg|Left atrial enlargement, a 12 lead ECG|700px]] | |||
==References== | ==References== | ||
Revision as of 17:06, 26 September 2011
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Mohammed A. Sbeih, M.D.[2].
Electrocardiographic findings in Mitral Regurgitation
Patient with mild mitral insufficiency can have a normal ECG. In severe cases, patients may have left ventricular hypertrophy and strain; pulmonary hypertension may occur as well. Chronic mitral regurgitation increases the risk for atrial fibrillation.
1. LA enlargement: Left atrial enlargement produces a broad, bifid P wave in lead II (P mitrale) and enlarges the terminal negative portion of the P wave in VI.
In lead II following may be seen:
- Bifid P wave with > 40 ms between the two peaks
- Total P wave duration > 110 ms
In lead V1 follwing may be seen:
- Biphasic P wave with terminal negative portion > 40 ms duration
- Biphasic P wave with terminal negative portion > 1mm deep
2. Right ventricular hypertrophy: A mean QRS axis in the frontal plane is greater than 80 and an R-to-S ratio of greater than 1 in lead V1.
3. Right axis deviation: mean QRS axis in the frontal plane moves toward the right as pulmonary hypertension worsens.
4. Atrial fibrillation is commonly seen with mitral regurgitation: Irregularly irregular rhythm with absence P waves.
Below is an ECG in mitral regurgitation
