Left Atrial Enlargement
Let’s talk about left atrial enlargement (LAE).
LAE is characterized electrocardiographically by the presence of notched P wave and/or biphasic P wave.
Criteria
Notched P wave
- Morphology: "M" shape.
- Duration: ≥0.12 sec.
- Usually seen in II, III and aVF.
Note the notched P waves with M shape.
Biphasic P wave
- Biphasic P wave in V1 with terminal negative deflection >1 mm and >0.04 sec.
Note the terminal negative deflection of the P wave >1 mm and >0.04 sec. in V1.
Possible causes:
- Valve disease
- Hypertensive heart disease
- LVH
- MI
- others
NOTE: EKG has poor diagnostic sensitivity for chamber enlargement, therefore an echocardiogram is necessary.
Do you want to practice with complex EKGs?
If you are a cardiology fellow who needs to practice for the ABIM cardiology board or you are someone who wants to practice with complex 12-lead EKGs, our Volume II is what you need.
Do you want to improve your EKG skills?
With our unique, revolutionary and innovative educational platform, you will learn EKG easier than ever. Download the App here and get started. I hope you enjoy our interactive way of learning EKG.
Related articles
It may interest you
Read more
Thanks for joining us.