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105 Possible Causes for Inverted P Wave

  • Paroxysmal Supraventricular Tachycardia

    Most patients present with palpitations and dizziness, and their electrocardiogram demonstrates a narrow QRS complex and regular tachycardia with hidden or inverted P waves[ncbi.nlm.nih.gov] P waves in leads II, III, aVF, V 3 -V 6 Rare: References: [1] [3] [4] Pathophysiology AVNRT The AV node contains two electrical pathways: one fast and one slow the electrical[amboss.com] Upright retrograde P waves in aVR Inverted retrograde P waves lead II Example 5b The same patient following resolution of the AVNRT: Sinus rhythm.[lifeinthefastlane.com]

  • Supraventricular Tachycardia

    Inverted P waves are sometimes seen after the QRS complex. These are called retrograde p waves.[acls-algorithms.com] Retrograde (inverted) P waves may also be seen. 5.[clinicaladvisor.com] Upright retrograde P waves in aVR Inverted retrograde P waves lead II Example 5b The same patient following resolution of the AVNRT: Sinus rhythm.[lifeinthefastlane.com]

  • Atrial Bigeminy

    P wave with a PRI 120ms.[app.figure1.com] This is visible on the ECG as an inverted P wave (“retrograde P wave”), usually occurring after the QRS complex.[lifeinthefastlane.com] PACS arising close to the AV node (“low atrial” ectopics) activate the atria retrogradely, producing an inverted P wave with a relatively short PR interval 120 ms (PR interval[lifeinthefastlane.com]

  • Premature Atrial Contractions

    wave is abnormal Premature (earlier than expected) Morphology different than normal P wave Inverted P wave suggests atrial source near AV junction Nearly normal P waves suggest[fprmed.com] PACS arising close to the AV node (“low atrial” ectopics) activate the atria retrogradely, producing an inverted P wave with a relatively short PR interval 120 ms (PR interval[lifeinthefastlane.com] However, the P wave is different from the sinus P waves.[aibolita.com]

  • Cardiomyopathy

    There are some signs of left atrial enlargement — leftward deviation of the P wave axis (positive P waves in I and aVL, inverted in III and aVF) and prolongation of the terminal[lifeinthefastlane.com] […] portion of the P wave in V1.[lifeinthefastlane.com] […] an interventricular conduction delay mimicking LBBB — however, this is not LBBB as the morphology is not typical and there are small Q waves in V5-6 ( the presence of Q waves[lifeinthefastlane.com]

  • Situs Inversus

    Though the P waves were inverted in leads I and aVL of the right sided ECG, R wave progression in the precordial leads was normal (Figure 2).[article.sapub.org] Electrocardiogram of our patient with dextrocardia showing sinus rhythm with right axis deviation, inverted P waves in leads I, aVL and aVR as well as predominantly downward[article.sapub.org] Electrocardiogram of the same patient with the chest leads reversed still showing inverted P-waves in leads I, aVL and aVR but a normal R wave progression on the chest leads[article.sapub.org]

  • Situs Inversus Abdominalis

    Electrocardiography (ECG) showed inverted p wave in lead I and positive QRS complex (Figure 2 ), positive p wave in lead avR, inverted p wave in avL and reverse progression[jmedicalcasereports.biomedcentral.com] Figure 2 Electrocardiography showing inverted p wave in lead I. Figure 3 Electrocardiography showing reverse progression of R wave in leads V1 to V6.[jmedicalcasereports.biomedcentral.com]

  • Sinus Arrhythmia

    You might be tempted to call this sinus rhythm with premature atrial beats but the inverted P wave (P6) before R4 is not premature. So, this is not a PAC.[learningecg.blogspot.com]

  • Ostium Primum Atrial Septal Defect

    Mild right ventricular hypertrophy Inverted P waves in Sinous Venosus type Right Bundle Branch Block is seen which is partial or complete 17.[slideshare.net]

  • Torsades De Pointes

    Example 4 Torsades de Pointes: Sinus rhythm, or possibly ectopic atrial rhythm (biphasic / inverted P waves in lead II).[lifeinthefastlane.com]

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