Mitral stenosis electrocardiogram: Difference between revisions
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There are a few key findings seen in the electrocardiogram of mitral stenosis. | There are a few key findings seen in the electrocardiogram of mitral stenosis. | ||
== | ==Electrocardiogram== | ||
===Left atrial 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 V1. | |||
Shown below is an ECG depicting the following in lead II: | |||
*Bifid P wave with > 40 ms between the two peaks | *Bifid P wave with > 40 ms between the two peaks | ||
*Total P wave duration > 110 ms | *Total P wave duration > 110 ms | ||
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Shown below is an ECG depicting the following in lead V1: | |||
*Biphasic P wave with terminal negative portion > 40 ms duration | *Biphasic P wave with terminal negative portion > 40 ms duration | ||
*Biphasic P wave with terminal negative portion > 1mm deep | *Biphasic P wave with terminal negative portion > 1mm deep | ||
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Copyleft image obtained courtesy of, http://en.ecgpedia.org/wiki/Main_Page | Copyleft image obtained courtesy of, http://en.ecgpedia.org/wiki/Main_Page | ||
===Right Ventricular Hypertrophy=== | |||
ECG findings suggestive of [[right ventricular hypertrophy]] include: | |||
* [[Right axis deviation]] of +90 degrees or more | |||
* RV1 = 7 mm or more | |||
* RV1 + SV5 or SV6 = 10 mm or more | |||
* R/S ratio in V1 = 1.0 or more | |||
* S/R ratio in V6 = 1.0 or more | |||
* Late intrinsicoid deflection in V1 (0.035+) | |||
* Incomplete [[RBBB]] pattern | |||
* ST T strain pattern in 2,3,aVF | |||
* [[P pulmonale]] or [[Right atrial enlargement]] or P congenitale | |||
* S1 S2 S3 pattern in children | |||
* Tall R wave in V1 or qR in V1 | |||
* R wave greater than S wave in V1 | |||
* R wave progression reversal | |||
* Inverted [[T wave]] in the anterior precordial leads | |||
===Rigth Axis Deviation=== | |||
In [[right axis deviation]], the mean QRS axis in the frontal plane moves toward the right as [[pulmonary hypertension]] worsens. | |||
===Atrial Fibrillation=== | |||
[[Atrial fibrillation]] is commonly seen with mitral stenosis. Atrial fibrillation is characterized by an irregularly irregular rhythm with absent P waves. | |||
==EKG Examples of Mitral stenosis== | ==EKG Examples of Mitral stenosis== | ||
Revision as of 20:22, 12 September 2014
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Varun Kumar, M.B.B.S.; Lakshmi Gopalakrishnan, M.B.B.S.
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Mitral Stenosis Microchapters |
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Mitral stenosis electrocardiogram On the Web |
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American Roentgen Ray Society Images of Mitral stenosis electrocardiogram |
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Risk calculators and risk factors for Mitral stenosis electrocardiogram |
Overview
There are a few key findings seen in the electrocardiogram of mitral stenosis.
Electrocardiogram
Left atrial 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 V1.
Shown below is an ECG depicting the following in lead II:
- Bifid P wave with > 40 ms between the two peaks
- Total P wave duration > 110 ms
Shown below is an ECG depicting the following in lead V1:
- Biphasic P wave with terminal negative portion > 40 ms duration
- Biphasic P wave with terminal negative portion > 1mm deep
Copyleft image obtained courtesy of, http://en.ecgpedia.org/wiki/Main_Page
Right Ventricular Hypertrophy
ECG findings suggestive of right ventricular hypertrophy include:
- Right axis deviation of +90 degrees or more
- RV1 = 7 mm or more
- RV1 + SV5 or SV6 = 10 mm or more
- R/S ratio in V1 = 1.0 or more
- S/R ratio in V6 = 1.0 or more
- Late intrinsicoid deflection in V1 (0.035+)
- Incomplete RBBB pattern
- ST T strain pattern in 2,3,aVF
- P pulmonale or Right atrial enlargement or P congenitale
- S1 S2 S3 pattern in children
- Tall R wave in V1 or qR in V1
- R wave greater than S wave in V1
- R wave progression reversal
- Inverted T wave in the anterior precordial leads
Rigth Axis Deviation
In right axis deviation, the mean QRS axis in the frontal plane moves toward the right as pulmonary hypertension worsens.
Atrial Fibrillation
Atrial fibrillation is commonly seen with mitral stenosis. Atrial fibrillation is characterized by an irregularly irregular rhythm with absent P waves.
EKG Examples of Mitral stenosis
Shown below is an EKG image of mitral stenosis.
Copyleft image obtained courtesy of, http://en.ecgpedia.org/wiki/Main_Page