P wave variety 1
There are wide range in variation of sinus P wave since several factors may effect the P wave. These include: Anatomic cardiac position to the anterior chest wall; state of autonomic influence; intra and/or interatrial conduction abnormality; pressure and/or volume load; atrial/atria diseases; electrode positioning (precordial lead).
I	II	III	V1	V2	V6
RA abnormality pattern in both lead II and lead V1.
Patient. 9/23/02. 69 year old male admitted with history of progressive dyspnea. He carries a diagnosis of advanced metastatic non-small cell lung cancer. Other diagnosis include hypertension, DVT, diabetes and hyperlipidemia. Suboptimal echocardiogram revealed normal left atrial size, normal left ventricular size and systolic function. Right heart size is grossly normal. No pulmonary artery pressure calculated.
Possible Biatrial abnormality with RA abnormality pattern in lead II and possible LA abnormality in lead V1.
Patient. 8/15/02. 65 year old female was admitted with COPD exacerbation and hypercarbia. troponin were elevated, She recently had ventriculostomy and shunting procedure following an intracerebral hemorrhage. Technical difficulty echocardiogram suggested normal left atrial size, probably normal left ventricular size and systolic function. Right heart study was inadequate for interpretation.
Possible Biatrial abnormality with LA abnormality pattern in V1 and possible RA abnormality pattern in lead II.
Patient. 8/29/02. 47 year old female. Echocardiogram showed moderate left atrial enlaregement or 51 mm. There are moderate pulmonary hypertension, moderate concentric LVH,
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