ECG Quest > Shapes > P wave > Inverted P waves

Inverted P waves

Inverted P waves are upside down. This can be normal (i.e. lead aVR) or abnormal (i.e. leads II, III, aVF).

If they are abnormal, the rhythm may be not originating from the SA node (e.g. atrial or junctional rhythms). Atrial rhythms will have a normal PR interval (i.e. 3-5 small squares) while junctional rhythms will have a short PR interval (less than 3 small squares at standard settings).

See also: P wave

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References

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In the ECGquest archives, this ECG has been tagged with: - Inverted P waves Atrial tachycardia 12-Lead Dr Smith's ECG Blog CC BY-NC
Regular, steady, and fast at 170 (wide or narrow?), hypoxic, crackles in lungs, B-lines, unconscious. Repeat ECG after fluids.

This ECG is from a man in his 60s who was found unconscious and hypoxic.

This ECG shows atrial tachycardia with negative P waves in V1-V2.

In the ECGquest archives, this ECG has been tagged with: - Incorrect Machine Interpretation Inverted P waves Narrow QRS Retrograde P waves Short PR Accelerated junctional rhythm 12-Lead Dr Smith's ECG Blog CC BY-NC
What is going on here?? (The computer called it “STEMI” and “Intraventricular Conduction Delay”!!)
In the ECGquest archives, this ECG has been tagged with: - Electrode misplacement Extreme Axis Normal rate Regular Inverted P waves Inverted T waves 12-Lead ECG of the Week CC-BY-NC-SA
ECG of the Week – 24th September 2018 – Interpretation

This ECG is from a male in his teens who presented with episodes of his hands turning cold and blue for several hours at a time.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Incorrect Machine Interpretation Inverted P waves Lead misplacement 12-Lead Dr Smith's ECG Blog CC BY-NC
Chest pain and T-wave inversion in lead V2

This ECG is from a healthy young man who presented with chest pain. This was the initial ECG.

In the ECGquest archives, this ECG has been tagged with: - Palpitations Normal Axis Normal rate Inverted P waves Narrow QRS Short PR Accelerated junctional rhythm 12-Lead ECG of the Week Dr John Larkin CC-BY-NC-SA
ECG of the Week – 30th April 2018 – Interpretation

This ECG is from a man in his 70s who presented after an episode of palpitations at home. He had a past history of paroxysmal atrial fibrillation, CABG, diabetes and had undergone a MAZE procedure in the last 12 months.