Normal P waves

A normal P wave is positive (upright) in leads I and II, but negative (inverted) in aVR. It should be less than 3 small squares wide (120 ms), and less than 2.5 mm tall (or <1.5 mm in the chest leads V1-V6) 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: - Chest pain Dyspnoea Normal Axis Regular Tachycardia Anterior ST depression Inferior ST elevation Narrow QRS Normal P waves Reciprocal ST depression Sinus tachycardia Multi-vessel disease 12-Lead Dr Pendell Meyers Dr Smith's ECG Blog Dr Ken Grauer CC BY-NC
Arrhythmia? Ischemia? Both? Electricity, drugs, lytics, cath lab? You decide. Repeat 1 min later.

This ECG is from a man in his 60s who presented with intermittent shortness of breath and chest pressure over the past few days. This was his repeat ECG after the rhythm changed.

This ECG shows a sinus tachycardia with ST elevation in inferior leads and ST depression in anterior leads and aVL. He underwent angiography and had stents inserted to the left circumflex and right coronary arteries.

In the ECGquest archives, this ECG has been tagged with: - Normal Axis Regular Narrow QRS Normal P waves Normal 12-Lead Dr Pendell Meyers Dr Smith's ECG Blog Dr Ken Grauer CC BY-NC
Arrhythmia? Ischemia? Both? Electricity, drugs, lytics, cath lab? You decide. Baseline ECG.

This ECG is from a man in his 60s who presented with intermittent shortness of breath and chest pressure over the past few days. This was his baseline ECG for comparison.

This ECG shows a normal ECG.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Dyspnoea Normal P waves Takotsubo cardiomyopathy 12-Lead Dr Smith's ECG Blog Dr Ken Grauer CC BY-NC
A 60 year old patient with large T-wave inversions

This ECG is from a woman in her 60s who presented with intermittent chest pain and dyspnoea for the past day, on a background of stage IV lung cancer. This was her baseline ECG.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Dyspnoea Deeply inverted T waves Normal P waves Takotsubo cardiomyopathy 12-Lead Dr Smith's ECG Blog Dr Ken Grauer CC BY-NC
A 60 year old patient with large T-wave inversions

This ECG is from a woman in her 60s who presented with intermittent chest pain and dyspnoea for the past day, on a background of stage IV lung cancer. This was her repeat ECG the next day.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Chronic kidney disease Normal Axis Normal P waves 12-Lead Serial 12-lead Dr Pendell Meyers Dr Smith's ECG Blog CC BY-NC
“Are these hyperacute T-waves?” – what is your recommendation for the team in these two cases? Case 2

This ECG is from a man in his 40s who presented with crushing chest pain described as 'like my other heart attacks'. He had also missed dialysis.

In the ECGquest archives, this ECG has been tagged with: - Chronic kidney disease Normal Axis Normal P waves 12-Lead Serial 12-lead Dr Pendell Meyers Dr Smith's ECG Blog CC BY-NC
“Are these hyperacute T-waves?” – what is your recommendation for the team in these two cases? Case 2 Baseline

This ECG is from a man in his 40s who presented with crushing chest pain described as 'like my other heart attacks'. He had also missed dialysis. This was his baseline ECG.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Dyspnoea Tachycardia Fragmented QRS Normal P waves Wide QRS Sinus tachycardia Wide complex tachycardia LBBB 12-Lead Serial 12-lead Dr Smith's ECG Blog Dr Ken Grauer CC BY-NC
Sudden Chest pain and SOB with a Wide Complex Tachycardia: Repeat after unsynchronised cardioversion

This ECG is from a man in his 60s who presented with sudden onset severe chest pain and dyspnoea. He had no medical history or medications. On arrival he was in extremis with altered mentation, cyanosis and diaphoresis . There was no palpable radial pulse. Pulse oximetry read HR 170 and saturation 53%. This was the repeat ECG after unsynchronised cardioversion.

In the ECGquest archives, this ECG has been tagged with: - High V1/V2 misplacement Normal Axis Normal P waves Normal T waves Normal Sinus Rhythm Normal 12-Lead Serial 12-lead Dr Pendell Meyers Dr Smith's ECG Blog Dr Ken Grauer CC BY-NC
A pathognomonic ECG you should recognize instantly. Baseline ECG

This ECG is from a patient of unknown age who presented with generalised weakness and malaise. This was the baseline ECG from a previous presentation.

In the ECGquest archives, this ECG has been tagged with: - Bradycardia Normal Axis Early R wave transition Narrow QRS Normal P waves Normal PR Tall QRS Sinus arrhythmia Sinus bradycardia 12-Lead ECG of the Week Dr John Larkin CC-BY-NC-SA
ECG of the Week – 23rd April 2018 – Interpretation
In the ECGquest archives, this ECG has been tagged with: - Dizziness Palpitations Normal Axis Standard Calibration Delta wave Normal P waves Short PR Wide QRS Wolff Parkinson White syndrome 12-Lead ECG of the Week Dr John Larkin CC-BY-NC-SA
ECG of the Week – 12th February 2018 – Interpretation

This ECG is from a 12 yr old male who presented to the Emergency Department following an episode of palpitations and near-syncope. He had no known past medical history.

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