Mitral regurgitation electrocardiogram
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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. Atrial fibrillation is commonly seen with mitral regurgitation: Irregularly irregular rhythm with absence P waves.
Below is an ECG in mitral regurgitation
