Ebsteins anomaly of the tricuspid valve electrocardiogram: Difference between revisions

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==Overview==
==Overview==
The EKG is abnormal in 50 to 60% of patients,  and will often show signs of [[right atrial enlargement]], including [["Himalayan" P waves]] which are [[P waves greater than 2.5 mm in height in leads 2, 3, and aVF]].
The EKG is abnormal in 50 to 60% of patients,  and will often show signs of [[right atrial enlargement]], including [["Himalayan" P waves]] which are [[P waves greater than 2.5 mm in height in leads 2, 3, and aVF]].  [[First-degree AV block]], [[low QRS voltage]], an atypical [[right bundle branch block]], [[T wave inversions]], and [[Wolff-Parkinson-White syndrome]] may also be present.


==EKG Abnormalities==
==EKG Abnormalities==

Revision as of 17:40, 20 October 2012

Ebsteins anomaly of the tricuspid valve Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]}; Claudia P. Hochberg, M.D.; Priyamvada Singh, MBBS [3] Assistant Editor-In-Chief: Kristin Feeney, B.S. [4]

Overview

The EKG is abnormal in 50 to 60% of patients, and will often show signs of right atrial enlargement, including "Himalayan" P waves which are P waves greater than 2.5 mm in height in leads 2, 3, and aVF. First-degree AV block, low QRS voltage, an atypical right bundle branch block, T wave inversions, and Wolff-Parkinson-White syndrome may also be present.

EKG Abnormalities

Electrocardiographic Example

Shown below is the EKG of a woman with Ebstein's anomaly. The ECG shows signs of right atrial enlargement. The P waves in leads 2,3, and aVF are tall and greater than 2.5 mm in height. These large P waves are termed "Himalayan" P waves. There is also a right bundle branch block pattern and a first degree atrioventricular block (prolonged PR-interval) due to intra-atrial conduction delay. There is no evidence of a Kent-bundle in this patient. There is T wave inversion in V1-4 and a marked Q wave in III; these two changes are characteristic for Ebstein's anomaly and do not reflect ischemic ECG changes in this patient.


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