Prominent A-Wave: Causes & Reasons

Possible Causes for Prominent A-Wave

The S waves are prominent in leads V5 and V6. The amplitude of R wave is more than 5 mm in lead VI. [yourarticlelibrary.com]

For example, positioning leads V1 and V2 too high ( by 1 or 2 interspaces ) on the chest — may result in prominent P wave negativity, that in lead V1 might falsely suggest [ecg-interpretation.blogspot.com]

Look for signs of atrial abnormalities in leads in which the P wave is most prominent: usually lead II, but also leads III, aVF, and V1. [medicine-on-line.com]

Cor Pulmonale

 History collection  Physical examination  ECG ( prominent R wave and inverted T wave)  Chest X Ray – enlargement of the main pulmonary artery and the descending right [slideshare.net]

Clinical findings associated with pulmonary heart disease include jugular venous distension, prominent v-wave in the jugular venous pulsation, narrow S-2 split or no split [acphospitalist.org]

Investigations X-Ray Chest (Right Ventricular Enlargement, Right atrial dilatation, prominent pulmonary artery) ECG: RVH, Prominent R wave in lead VI Ech: RV dilatation Treatment [bionity.com]

Tricuspid Valve Insufficiency

Physical Examination Findings on cardiovascular examination in patients with tricuspid regurgitation include the following: S 3 gallop Jugular venous distention with a prominent [emedicine.medscape.com]

Catheterization findings include a prominent right atrial c-v pressure wave during ventricular systole. [msdmanuals.com]

V wave In some patients, a pansystolic murmur Diminished peripheral pulse volume secondary to impaired forward blood flow; patients with this sign may have relative hypotension [emedicine.medscape.com]

Tricuspid Stenosis

Patients often display a prominent A Wave as atrial systole against the stenotic tricuspid valve results in an exaggerated increase in right atrial pressure and thus bulging [pathwaymedicine.org]

[…] atrial hypertrophy, a prominent A wave becomes the dominant feature. [tele.med.ru]

Jugular venous pressure is elevated with a prominent systolic 'v' wave. Right ventricular impulse is hyperdynamic and may be thrusting in quality. [patient.info]

Pulmonary Valve Stenosis

ECG of pulmonary valve stenosis Electrical axis deviation to right or right ventricular hypertrophy, prominent P wave. [remedyland.com]

Visible and palpable signs reflect the effects of right ventricular (RV) hypertrophy and include a prominent jugular venous a wave (due to forceful atrial contraction against [msdmanuals.com]

Ostium Primum Atrial Septal Defect

If MR is present, the findings of ASD may be modified Prominent v wave in JVP LV type apex IE may occur (unlike secundum ASD) ECG Incomplete RBBB pattern in v1 as in secundum [heartpearls.com]

The notched R waves in inferior leads are not so prominent. ECG 11. [metealpaslan.com]

Corrected Transposition of the Great Vessels

ECG absence of Q waves in the lateral precordium (V4-6) physiologic Q waves in these leads often referred to as "septal" Q waves prominent Q waves in right precordium (V1- [radiopaedia.org]

Eisenmenger Syndrome

ECG of Eisenmenger syndrome Usually there is right ventricular hypertrophy with prominent P waves. [remedyland.com]

Elevated jugular venous pressure and prominent "v" wave in right heart failure and severe tricuspid regurgitation. [ncbi.nlm.nih.gov]

Chest X-ray showed cardiomegaly with prominent pulmonary conus and increased pulmonary vascularity (Fig. 2). [bmccardiovascdisord.biomedcentral.com]

Pulmonary Hypertension

[…] for conditions that can produce pulmonary hypertension (murmurs, collagen disease, valve pathology, VTE, OSA, alcohol consumption, chronic respiratory disease) Examination prominent [lifeinthefastlane.com]

A prominent A wave may be observed in the jugular venous pulse. A right-sided fourth heart sound (S 4 ) with a left parasternal heave may be auscultated. [emedicine.medscape.com]

The jugular venous pulse tracing demonstrates a prominent a wave without a c or v wave being observed. [en.wikipedia.org]

Chronic Right-Sided Congestive Heart Failure

Distended neck veins with raised and/or prominent JVP and visible a or v waves. 3rd/4th heart sounds and pansystolic murmur of tricuspid regurgitation over right heart. [patient.info]

In patients with considerable tricuspid regurgitation, a prominent systolic pulsation of the liver, attributable to an enlarged right atrial V wave, is often noted. [emedicine.medscape.com]

Patent Ductus Arteriosus

The R wave exceeds 15 mm in aVL, and the sum of the S wave in V1 and the R wave in V5 exceeds 35 mm. [accessmedicine.mhmedical.com]

The PA, aorta, and LA are prominent because they all are in the shunt pathway. eFigure 10–29. Left ventricular hypertrophy. [accessmedicine.mhmedical.com]

Atrial Septal Defect

In sinus venosus ASD, it shows left axis deviation and a negative P wave in lead III. [symptoma.com]

Imaging The chest X-ray shows a dilated pulmonary artery, prominent pulmonary vascular markings, and enlarged right atrial and ventricular chambers in patients with significant [symptoma.com]

Pulmonary Arterial Hypertension

The jugular venous pulse tracing demonstrates a prominent a wave without a c or v wave being observed. [en.wikipedia.org]

Physical examination findings sometimes observed in PH and right ventricular (RV) dysfunction include: an elevated jugular venous pressure with prominent A waves (due to increased [content.onlinejacc.org]

Scimitar Syndrome

FINDINGS Heart rate: 62 bpm QRS axis: −30° QRS duration: 110 msec Sinus rhythm, normal intervals, and P-wave axis. Prominent anterior forces. Leftward QRS axis. [thoracickey.com]

Comments: The ECG is almost entirely normal except for the high R-wave voltages in the early precordial leads. [thoracickey.com]

Congenital Heart Disease

A and V waves Diffuse, displaced left ventricular impulse; palpable RV impulse Increased first heart sound; persistent splitting of second heart sound Systolic ejection-type [doi.org]

Clinical Signs and Symptoms Observed in Normal Pregnancy Hyperventilation causing shortness of breath and dyspnea Brisk, full carotid upstroke with distended jugular veins with prominent [doi.org]

Holt-Oram Syndrome

Chest x-ray showed plethoric lung fields, cardiomegaly, prominent pulmonary conus and enlarged central pulmonary arteries. [jpma.org.pk]

Electrocardiogram showed sinus rhythm, right axis deviation, tall and peaked P waves in leads II and V2 to V6, and right ventricular hypertrophy. [jpma.org.pk]

Congenital Heart Block

[…] impulse (heave) Investigations Chest radiograph Normal or post-stenotic dilatation of the pulmonary artery ECG Shows evidence of right ventricular hypertrophy (upright T wave [rcemlearning.co.uk]

[…] ejection systolic murmur best heard at the upper left sternal edge; thrill may be present An ejection click best heard at the upper left sternal edge When severe there is a prominent [rcemlearning.co.uk]

Posterior Myocardial Infarction

The additional findings of upright T waves and prominent R waves in the same leads suggested posterior wall ST segment elevation AMI. [journals.lww.com]

A common theory is that prominent R-waves may actually represent inverted Q-waves.1,8 Interestingly, over a third of patients had prominent R-waves in either V1 or V2. [bjcardio.co.uk]

Prominent R wave Prominent, upright T wave Combination of horizontal ST-segment depression with upright T wave What is the correct placement of leads V7 – V9? [aliem.com]

Third Degree Atrioventricular Block

Introduction Swallow syncope is a neurally mediated syncope. Multiple causes have been described in literature. A rare cause is arrhythmias. Only a limited amount of cases present the association of swallow syncope and third degree AV-block. Case presentation A 39-year-old man presented with episodes of presyncope[…] [ncbi.nlm.nih.gov]

Right Ventricular Disorder

The R wave will be prominent in V 1 with deep S waves in the lateral precordial leads indicating right ventricular hypertrophy. [phaonlineuniv.org]

The electrocardiogram in advanced stages of pulmonary hypertension and right ventricular failure may reveal right axis deviation, RBBB, p wave amplitude of more than 2.5 mm [phaonlineuniv.org]

Patent Foramen Ovale

Interventional Cardiology Clinics Transcatheter Closure of Patent Foramen Ovale Preface: Transcatheter Closure of Patent Foramen Ovale Cryptogenic Stroke and Patent Foramen Ovale Risk Assessment Identification and Quantification of Patent Foramen Ovale–Mediated Shunts: Echocardiography and Transcranial Doppler[…] [elsevier.com]

Andersen-Tawil Syndrome

In ATS1, the QT interval can appeared prolonged and difficult to quantify because of a prominent U-wave. [wikidoc.org]

Figure 1: Baseline electrocardiogram of patient 1 with the presence of prominent U waves in V1-V4 at rest. [innovationsincrm.com]

Zhang et al. 18 described prominent U-waves and prolonged QT-U interval compared with healthy individuals (650 ms versus 600 ms). [innovationsincrm.com]

Ventricular Septal Defect

(rollover to compare with normal) What Is It? A Ventricular Septal Defect (VSD) is a hole in the ventricular septum - the muscular wall that separates the right and left ventricles, or main pumping chambers, of the heart. This opening allows the movement, or "shunting," of blood between the ventricles. Most[…] [pted.org]

Lateral Myocardial Infarction

Prominent R wave Prominent, upright T wave Combination of horizontal ST-segment depression with upright T wave What is the correct placement of leads V7 – V9? [aliem.com]

Q-T Interval, Prominent U Waves, Digitalis Effect, Hyperkalemia, Hypokalemia, Hypercalcemia, Hypocalcemia, Secundum Atrial Septal Defect, Primum Atrial Septal Defect, Dextrocardia [play.google.com]

R waves are observed in the right precordial leads. [ahcmedia.com]

Double Outlet Right Ventricle

Abstract Patients with double outlet right ventricle can be separated into four distinct groups. In the largest (Group III), patients have a subaortic ventricular septal defect and pulmonary stenosis and clinically resemble patients with tetralogy of Fallot. In the next largest group (Group I), patients have a[…] [ncbi.nlm.nih.gov]

Aortopulmonary Septal Defect

Surgical repair of an aortopulmonary septal defect, interrupted aortic arch and the duct that coexists in this setting usually includes closure of the aortopulmonary septal defect, reconstruction of the arch, and interruption of the duct. A 20-month-old girl underwent a successful one-stage repair of such[…] [ncbi.nlm.nih.gov]

Persistent Truncus Arteriosus

OBJECTIVE: Establishing a new continuity between the right ventricle and the pulmonary artery is the mainstay of repair for persistent truncus arteriosus. We used the Tran Viet-Neveux technique without a Lecomte maneuver to construct the connection without a conduit. Here, we retrospectively review the mid-term[…] [ncbi.nlm.nih.gov]

Diffuse Intraventricular Block

Prominent R-wave in lead V1 (R/S ratio >1) WPW Posterior MI RBBB (or incomplete RBBB) Ventricular ectopy RVH Acute right ventricular dilatation (right ventricular “strain, [lifeinthefastlane.com]

Large negative T waves over the precordial leads are observed frequently. Prolonged QT-interval. Prominent u-waves. [en.ecgpedia.org]

[…] changes; prominent U wave; ST elevation; prolonged QTc interval; low voltage; and signs indicating previous myocardial infarction. [journals.plos.org]

Left-to-Right Cardiac Shunt

Abstract Congenital heart disease (CHD) affects roughly 8/1000 live births. Improvements in medical and surgical management in recent decades have resulted in significantly more children with left-to-right cardiac shunts surviving into adulthood. Surgical care of these patients for their original cardiac defect(s) or[…] [ncbi.nlm.nih.gov]

Hypokalemia

T wave inversion. Prominent U waves. Long QU interval. This patient had a serum K+ of 1.7 Example 2 Hypokalaemia ST depression. T wave inversion. Prominent U waves. [lifeinthefastlane.com]

[…] inversion Prominent U waves Long QU interval This patient had a serum K+ of 1.7 Example 2 Hypokalaemia ST depression and T wave inversion best noted in inferior leads Prominent [litfl.com]

Early EKG changes may include increased amplitude and width of P-waves, PR segment prolongation, T-wave flattening and inversion, ST-segment depression, prominent U waves [emra.org]