P Mitrale: Causes & Reasons

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Possible Causes for P Mitrale

Mitral Valve Disease

Mitral reintervention did not differ between mitral repair and replacement (cumulative risk of reoperation, 27% vs 15%; P = .64). [ncbi.nlm.nih.gov]

[…] results of preoperative and postoperative echocardiographic data showed significant decrease in pulmonary arterial systolic pressure (101.2 ± 20.3 versus 48.1 ± 14.3 mmHg, P [ncbi.nlm.nih.gov]

CONCLUSIONS: Mitral valve disease in children leads to abnormal airway and respiratory tissue mechanics. [ncbi.nlm.nih.gov]

Mitral Valve Insufficiency

 Electrocardiography: P mitrale is broad, notched P waves in several or many leads with a prominent late negative component to the P wave in lead V1, and may be seen in [slideshare.net]

Electrocardiography[edit] P mitrale is broad, notched P waves in several or many leads with a prominent late negative comp[[mb b [[]]]]onent to the P wave in lead V1, and [en.wikipedia.org]

RESULTS: Cardiopulmonary bypass time and ischemia time were shorter in the MVP-group, p CONCLUSION: Mitral valve plasty for MR is efficient and associated with shorter CPB [ncbi.nlm.nih.gov]

Mitral Valve Stenosis

Mild mitral regurgitation was also more frequent in patients with AF (71%vs 51%, p < 0.03). [ncbi.nlm.nih.gov]

[…] see X-ray findings in pulmonary congestion) Lateral image Dorsal displacement of the esophagus (visible in barium swallow test) Signs of right ventricular hypertrophy ECG P [amboss.com]

0.33) and mitral valve volume (P = 0.08). [ncbi.nlm.nih.gov]

Left Atrial Ball Valve Thrombus

Left atrial Abnormality of P wave with a divot(double bump mitral). [brainscape.com]

ECG Right ventricular hypertrophy: tall R waves in V1–V3 P mitrale or atrial fibrillation Chest X-ray Enlarged LA and appendage Signs of pulmonary venous congestion Echocardiogram [med.rimikri.com]

Conradie C, Schall R, Marx JD (1993) Echocardiographic study of left atrial thrombi in mitral stenosis. Clin Cardiol 16(10):729–731. Google Scholar 9. [link.springer.com]

Giant Left Atrium

After mitral valve replacement, left atrium mean diameter was significantly decreased in Group A from 8.1 +/- 1.3 mm to 6.2 +/- 1.6 mm ( p < 0.01). [ncbi.nlm.nih.gov]

The cardiothoracic ratio decreased from 74.8 +/- 8.3% to 62.8 +/- 9.0% (P < 0.01) and the vital capacity of the lungs increased from 71.1 +/- 18.0% to 82.9 +/- 22.2% (P < [ncbi.nlm.nih.gov]

[…] with a giant left atrium than in those without (n = 14, 69.9 +/- 15.3 cm/sec and 30.5 +/- 9.6 mm, respectively); in the latter, the IVC orifice dimension was significantly (p [ncbi.nlm.nih.gov]

Papillary Muscle Dysfunction

Rossi A, Dini FL, Faggiano P, et al. Independent prognostic value of functional mitral regurgitation in patients with heart failure. [emedicine.medscape.com]

[…] without mitral regurgitation (1129 ± 38 msec vs 1134 ± 58 msec, p = 0.93). [jcmr-online.biomedcentral.com]

Chronic ischemic mitral regurgitation: repair, replace or rethink? Ann Thorac Surg. 2006;81:1153-1161. Rossi A, Dini FL, Faggiano P, et al. [read.nxtbook.com]

Left Atrial Hypertrophy

This is called P mitrale, because mitral valve disease is a common cause (Figure 1). The duration of the P-wave will exceed 120 milliseconds in lead II. [ecgwaves.com]

Systemic hypertension Aortic stenosis Mitral incompetence Hypertrophic cardiomyopathy ECG Examples Example 1 Broad (>110ms), bifid P wave in lead II (P mitrale) with > 40ms [litfl.com]

Schirmer H, Lunde P, Rasmussen K. Mitral flow derived Doppler indices of left ventricular diastolic function in a general population; the Tromso study. [ekjm.org]

Left Ventricular Hypertrophy

P mitrale – Left atrial enlargement ( P mitrale ) may develop because LVH affects the hemodynamics of the left atrium. Left axis deviation – is common in LVH. [ecgwaves.com]

In addition to the dramatic T waves, he also has P waves suggestive of “P mitrale”, or left atrial enlargement. [ecgguru.com]

[…] wave in lead II prominent terminal negative component to P wave in lead V1 (shown here) See also - mitral stenosis. [ecglibrary.com]

Aortic Valve Insufficiency

[…] significant linear relationship between mitral tenting area and severity of mitral regurgitation (P=0.001). [oadoi.org]

Pinero A, Marcos-Alberca P, Fortes J. Cabergoline-related severe restrictive mitral regurgitation. N Engl J Med 2005 ;353: 1976 - 1977 7. [oadoi.org]

The relative risk for moderate or severe valve regurgitation in the pergolide group was 6.3 for mitral regurgitation (P=0.008), 4.2 for aortic regurgitation (P=0.01), and [oadoi.org]

Endocardial Fibroelastosis

He had P mitrale and ST changes on ECG (Fig. 4A), septal thickness of 22 mm (4B), LVEF 65%, biatrial enlargement (4C) and a grade III diastolic dysfunction (4D). [escardio.org]

Endocardial Fibroelastosis Monica P. Revelo, MD, PhD Gross specimen shows left ventricle with white opaque thickened endocardium and flat trabeculae. [basicmedicalkey.com]

[…] to thick echogenic endocardium Moller JH, Lucas RV Jr, Adams P Jr et.al. [fetalultrasound.com]

Left Ventricular Dilatation

- signs of pulmonary congestion. 2.ECG: - P mitral. - LV dilatation. 3.Echocardiography: - determine degree of regurge. - LV dimensions. - EF 25 Complications: LV failure [slideplayer.com]

(end-diastolic volume >or=110 ml/m(2)) (p CONCLUSION: Symptoms and signs predict LV dilatation and/or dysfunction with fair sensitivity and excellent specificity. [ncbi.nlm.nih.gov]

Hecker SL, Zabalgoitia M, Ashline P, Oneschuk L, O'Rourke RA, Herrera CJ. Comparison of exercise and dobutamine stress echocardiography in assessing mitral stenosis. [revespcardiol.org]

Left Ventricular Outflow Obstruction

The AML and PML heights and the mitral annulus diameter were measured by TEE using mid-esophageal four-chamber and long-axis planes. [ncbi.nlm.nih.gov]

± 7° [ P = 0.0002] and 89 ± 2° [ P 0.0001]). [em-consulte.com]

LV outflow tract was significantly narrower and the angle between the ejection flow and the mitral valve was larger in provocable patients. [ncbi.nlm.nih.gov]

Aortic Valve Disorder

Current prognosis of ischemic mitral regurgitation. Implications for future management. Circulation 1988,78(suppl I): I51-9. Kay GL, Kay JH, Zubiate P, et al. [heart.bmj.com]

Nephrol Dial Transplant 8:335 -340, 1993 ↵ Fernandez-Reyes MJ, Auxiliadora Bajo M, Robles P, Selgas R, Oliver J, Del Peso G, Garcia G, Jimenez C, Garcia-Gallego F: Mitral [jasn.asnjournals.org]

Schon HR, Schroter G, Barthel P, et al. Quinapril therapy in patients with chronic mitral regurgitation. J Heart Valve Disease 1994;3:197–204. [ncbi.nlm.nih.gov]

Rheumatic Heart Disease

(30.4% vs. 19%, p = 0.001). [ncbi.nlm.nih.gov]

S., Rajagopal P., Somaraju B. Surgical pathology of mitral valves--the Indian scene. [ncbi.nlm.nih.gov]

Subgroup analysis by ethnicity showed no positive relationship in Asians as well (P > 0.05). [ncbi.nlm.nih.gov]

Congestive Heart Failure

1 Structure of human G protein-coupled receptor kinase 2 in complex with the kinase inhibitor balanol. 54 61 20128603 2010 2 Effects of eythropoietin administration on mitral [malacards.org]

Lancellotti P, Gerard PL, Pierard LA. Long-term outcome of patients with heart failure and dynamic functional mitral regurgitation. [emedicine.medscape.com]

[…] regurgitation and left ventricular remodeling in heart failure patients. 61 54 Cosyns B...Lancellotti P 18760492 2010 3 Provider adherence to clinical guidelines related [malacards.org]

Cardiomyopathy

각 군의 최고 심실조기수축의 평균수는 1군에서 시간당 23.3±12.7회, 2군에서 589.78±609.4회로 유의한 차이를 보였다(p value<0.05). 4. [ir.ymlib.yonsei.ac.kr]

Four DCM patients with moderate-severe MR had unbalanced remodeling, such as excessive LV dilatation, short anterior mitral leaflets, and short chordae tendineae.The development [ncbi.nlm.nih.gov]

심초음파 검사상 systolic anterior motion of anterior mitral leaflet(SAM)은 1군에서는 4명(44%), 2군에서는 5명(42%)으로 통계학적인 차이가 없었다. [ir.ymlib.yonsei.ac.kr]

Coarctation of the Aorta

Mean mitral valve diameter z score was lower ( P z score was higher in fetuses with CoA than in those without CoA ( P =0.01). [ncbi.nlm.nih.gov]

Fetuses with CoA presented with a narrower, but not shorter, left ventricle when compared with controls (mitral valve diastolic diameter, 5.90 vs 8.50 mm; P = 0.002; left [ncbi.nlm.nih.gov]

MV, mitral valve; AOV, aortic valve; AAO, ascending aorta. [nature.com]

Rheumatic Valvulitis

No patient developed mitral or aortic stenosis: this suggests that regular prophylaxis may prevent the development of stenosis. [circ.ahajournals.org]

P 1 (anterior), P 2 (middle), P 3 (posterior)―are the scallops (clefts or indendations) of PML (posterior mitral leaflet), A 1, A 2, A 3 ―are the corresponding segments of [scirp.org]

Allen P. [educalingo.com]

Left Cardiac Ventricle Disorder

Aortic Regurgitation. 6. 9 m/s or mean P 20– 39 mm Hg The murmur of mitral regurgitation is a mid-frequency, rectangular murmur taking up all of systole. [v-secure.in]

Analysis of the relationships between clinical and biochemical parameters and left ventricular diastolic dysfunction Odds ratio 95.0% CI p value Age 1.120 1.027-1.221 0.010 [ekjm.org]

A pansystolic murmur of mitral regurgitation at the apex may occur in either HFrEF or HFpEF. [merckmanuals.com]

Hypertensive Heart Disease

Significance was defined as p RESULTS: HHD and HCM cohorts were age-/gender-matched. [ncbi.nlm.nih.gov]

Kruger R, Schutte R, Huisman HW, Hindersson P, Olsen MH, Eugen-Olsen J, Schutte AE. [portal.findresearcher.sdu.dk]

Magnitude and location of maximal EDWT, presence of late gadolinium enhancement (LGE), LV asymmetry (>1.5-fold opposing segment) and systolic anterior motion of the mitral [ncbi.nlm.nih.gov]

Atrial Myxoma

C.: Mitral valve. In, "Cardiac Ultrasound" (EditorsGramiak and Waay). The C. V. Mosby and Company, Saint Louis 1975, p. 47. 7. Goldberg, H. P., Glenn, F., Dotter, C. [jpgmonline.com]

AU - Rama Rao, Anil P AU - Morales, Monty C. AU - Copeland, Jack G. [arizona.pure.elsevier.com]

In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. [mountsinai.org]

Dilated Cardiomyopathy

Four DCM patients with moderate-severe MR had unbalanced remodeling, such as excessive LV dilatation, short anterior mitral leaflets, and short chordae tendineae.The development [ncbi.nlm.nih.gov]

Major cardiac findings include cardiomegaly, quiet precordium, tachycardia, gallop rhythm (S 3 and/or S 4 ), accentuated P-2, and murmurs of mitral and tricuspid regurgitation [transplantbuddies.org]

[…] markedly longer chordae tendineae (DCM-lowMR: 24 [20-26] mm; controls: 14 [13-16] mm; P < 0.01) and larger anterior leaflets (DCM-lowMR: 30 [27-31] mm; controls: 22 [20-24] mm; P [ncbi.nlm.nih.gov]

Aortic Valve Stenosis

Flachskampf FA, Chandra S, Gaddipatti A, Levine RA, Weyman AE, Ameling W, Hanrath P, Thomas JD. [ahajournals.org]

Analysis of shape and motion of the mitral annulus in subjects with and without cardiomyopathy by echocardiographic 3-dimensional reconstruction.J Am Soc Echocardiogr. 2000 [ahajournals.org]

Corrected Transposition of the Great Vessels

[…] plasty in one) vs. 94.1% in group II (P < 0.05 vs. group I; aortic valve replacement in one). [ncbi.nlm.nih.gov]

The freedom from reoperation was 77.6% in group I (redo-Rastelli in five patients, subaortic stenosis resection in three, tricuspid valve replacement in one and mitral valve [ncbi.nlm.nih.gov]

Patent Ductus Arteriosus

History As discussed in Pathophysiology, the ductus arteriosus is always patent in the fetus if the cardiovascular system is otherwise normal. Normally, the ductus arteriosus closes functionally in the first 10-18 hours of life. Prematurity, perinatal distress, and hypoxia delay closure of the ductus arteriosus;[…] [emedicine.medscape.com]

Right Atrial Hypertrophy

This is called P mitrale, because mitral valve disease is a common cause (Figure 1). The duration of the P-wave will exceed 120 milliseconds in lead II. [ecgwaves.com]

In general, left atrial enlargement is used as a synonym for p mitrale, right atrial enlargement for p pulmonale, and biatrial enlargement for p biatriale. [link.springer.com]

Mitrale ECG Hocm EKG Atrial Hypertrophy EKG Right Atrial Enlargement Heart Murmur Possible Right Atrial Enlargement Atrial Enlargement EKG Finding Loading... [thepinsta.com]

Aortopulmonary Septal Defect

Abstract The Richardson classification system for aortopulmonary septal defect (APSD) includes simple defects between the ascending aorta and pulmonary trunk (type I), defects extending distally to include the origin of the right main pulmonary artery (type II), and anomalous origin of the right main pulmonary[…] [ncbi.nlm.nih.gov]

Coronary Arteriovenous Fistula

Abstract We experienced a rare case in which a guidewire was advanced into a coronary vein through an arteriovenous fistula caused by wire perforation. The patient, who had chronic total occlusion (CTO) of the left circumflex coronary artery, was treated successfully with a procedure guided by intravascular[…] [ncbi.nlm.nih.gov]

Persistent Truncus Arteriosus

OBJECTIVE: The aim of our study was to analyse experience with repair of truncus arteriosus with interrupted aortic arch. METHODS: Between 1993 and 2004, eight consecutive patients underwent repair of truncus arteriosus with interrupted aortic arch. The median age was 6.5 days (range 1-85 days) and median[…] [ncbi.nlm.nih.gov]

Trilogy of Fallot

The trilogy of Fallot is a congenital heart disease consisting of the following defects: pulmonary valve stenosis, right ventricular hypertrophy and atrial septal defect. This disease is 1.6-1.8% of all congenital heart defects. It consists of the following: pulmonary valve stenosis right ventricular hypertrophy atrial[…] [en.wikipedia.org]