Right atrial enlargement

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Right atrial enlargement
RAE.png
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [3]

Synonyms and Keywords: Himalayan P waves, Himalayan P-wave, giant P waves, P pulmonale, right atrial abnormality, RAE

Overview

Right atrial enlargement can result from increased pressure in the pulmonary artery. A P wave >2.5 mm in leads II, III and aVF or a P wave >1.5 mm in lead V1 indicates right atrial enlargement. Despite the increase in the height of the P wave, the width of the P wave does not change. Sometimes these large P waves can be referred to as Himalayan P waves.

Causes of Right Atrial Enlargement

In alphabetical order:

The EKG in Right Atrial Enlargement

Right atrial enlargement is defined as either:

  • A P wave >2.5 mm in leads II, III and aVF
  • A P wave >1.5 mm in lead V1

Shown below is an illustration of right atrial enlargement:

Right atrial enlargement.jpg


Shown below is an EKG demonstrating large P waves in leads to 2,3, and aVF which have a P-wave height greater than 2.5 mm consistent with right each one enlargement:

Right atrial enlargement

Chest X-Ray

Shown below is the chest x-ray of a patient with Ebstein's anomaly in whom the right atrium is markedly enlarged as demonstrated by the convex curvature to the right border the heart.

Ebstein's anomaly 2.JPG

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