Introduction
According to echocardiography mean RA area is approx. 14 cm2, considered enlarged when >18 cm2.
Causes
- raised right ventricular pressures
- pulmonary arterial hypertension
- cor pulmonale
- valvular disease
- tricuspid regurgitation
- Ebstein anomaly
- atrial septal defect (ASD)
- atrial fibrillation (AF)
- dilated cardiomyopathy
ECG findings suggestive of right atrial enlargement:
- P pulmonale: P wave amplitude >2.5mm in inferior leads (II, III, AVF) or >1.5mm in V1/V2
- P wave axis shifted rightward >70°
P pulmonale
ECG 1 Patient with pulmonary artery hypertension - RBBB, right axis deviation (dominant negative deflection in leads I and aVL), R wave > 7mm in V1, ST depressions in V1-V3, P pulmonale
ECG 2 P pulmonale in a patient with right atrial enlargement
References
- Ryan JJ, Thenappan T, Luo N, et al. The WHO classification of pulmonary hypertension: A case-based imaging compendium. Pulm Circ. 2012;2(1):107-121. doi:10.4103/2045-8932.94843
- Lan NSH, Massam BD, Kulkarni SS, Lang CC. Pulmonary Arterial Hypertension: Pathophysiology and Treatment. Diseases. 2018;6(2):38. Published 2018 May 16. doi:10.3390/diseases6020038
- Henkens IR, Scherptong RW, van Kralingen KW, Said SA, Vliegen HW. Pulmonary hypertension: the role of the electrocardiogram. Neth Heart J. 2008;16(7-8):250-254. doi:10.1007/BF03086156
- Barto, Donna MA, RN, CCRN Recognizing pulmonary hypertension on the ECG, Nursing Critical Care: March 2011 - Volume 6 - Issue 2 - p 11-13 doi: 10.1097/01.CCN.0000394497.97148.d7
Introduction
According to echocardiography mean RA area is approx. 14 cm2, considered enlarged when >18 cm2.
Causes
- raised right ventricular pressures
- pulmonary arterial hypertension
- cor pulmonale
- valvular disease
- tricuspid regurgitation
- Ebstein anomaly
- atrial septal defect (ASD)
- atrial fibrillation (AF)
- dilated cardiomyopathy
ECG findings suggestive of right atrial enlargement:
- P pulmonale: P wave amplitude >2.5mm in inferior leads (II, III, AVF) or >1.5mm in V1/V2
- P wave axis shifted rightward >70°
P pulmonale
ECG 1 Patient with pulmonary artery hypertension - RBBB, right axis deviation (dominant negative deflection in leads I and aVL), R wave > 7mm in V1, ST depressions in V1-V3, P pulmonale
ECG 2 P pulmonale in a patient with right atrial enlargement
References
- Ryan JJ, Thenappan T, Luo N, et al. The WHO classification of pulmonary hypertension: A case-based imaging compendium. Pulm Circ. 2012;2(1):107-121. doi:10.4103/2045-8932.94843
- Lan NSH, Massam BD, Kulkarni SS, Lang CC. Pulmonary Arterial Hypertension: Pathophysiology and Treatment. Diseases. 2018;6(2):38. Published 2018 May 16. doi:10.3390/diseases6020038
- Henkens IR, Scherptong RW, van Kralingen KW, Said SA, Vliegen HW. Pulmonary hypertension: the role of the electrocardiogram. Neth Heart J. 2008;16(7-8):250-254. doi:10.1007/BF03086156
- Barto, Donna MA, RN, CCRN Recognizing pulmonary hypertension on the ECG, Nursing Critical Care: March 2011 - Volume 6 - Issue 2 - p 11-13 doi: 10.1097/01.CCN.0000394497.97148.d7
