Prominent-a-wave: Causes & Reasons

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Possible Causes for prominent a wave

Cor Pulmonale

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]

On electrocardiogram, there was right axis deviation, p-pulmonale, features of right ventricular hypertrophy along with presence of prominent Q waves in leads II, III and [ijem.in]

The most typical ECG findings in emphysema are: Rightward shift of the P wave axis with prominent P waves in the inferior leads and flattened or inverted P waves in leads [lifeinthefastlane.com]

Posterior Myocardial Infarction

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]

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]

R waves in V1-V3, R/S wave ratio 1.0 in lead V2, upright T-waves in V1-V3, often coexisting inferior or lateral MI. [errolozdalga.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]

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]

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]

In tricuspid regurgitation, the jugular venous pressure may be elevated and shows a prominent "v" wave, Fig. ( 2 ). [ncbi.nlm.nih.gov]

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]

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]

‘a’ wave palpable P2 right heart failure – increased JVP, (large V waves), parasternal heave, TR murmur, hepatomegaly, peripherial oedema other signs of CHF hypoxaemia INVESTIGATIONS [lifeinthefastlane.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 Atrial Hypertrophy

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]

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]

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

Physical examination findings include jugular venous distension with a prominent v-wave, hepatomegaly and, rarely, a soft systolic regurgitant murmur can be heard that increases [heart.bmj.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]

Patent Foramen Ovale

Entrapped thrombus in a patent foramen ovale is a rare form of right heart thromboembolism. Various treatments have been used, such as anti-coagulation and thrombolytic therapy, vena cava filter, percutaneous thrombectomy and surgical embolectomy. A 60-year-old Kosovan woman was admitted to our hospital with a[…] [ncbi.nlm.nih.gov]

Pulmonary Valve Stenosis

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

With increasing right ventricular hypertrophy, right ventricular compliance decreases with a resultant increase in end-diastolic pressure and with prominent a waves in the [emedicine.medscape.com]

Large Ventricular Septal Defect

Abstract The use of Doppler color flow imaging and axial contrast angiography in the preoperative detection of additional ventricular septal defects (in the setting of a known large defect) were compared in a prospective fashion. One hundred seventy-nine infants with two ventricles (each of at least normal size)[…] [ncbi.nlm.nih.gov]

Ventricular Septal Defect

The medical and surgical management of patients with multiple muscular ventricular septal defects (VSDs) is associated with morbidity and mortality. Three children with Swiss cheese VSDs were treated with transcatheter occlusion of their multiple defects using the Amplatzer muscular VSD occluder. Seventeen defects[…] [ncbi.nlm.nih.gov]

Pulmonary Arterial Hypertension

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]

Early Repolarization Syndrome

Early repolarization syndrome is a well-recognized idiopathic electrocardiographic phenomenon characterized by prominent J wave and ST-segment elevation predominantly in left [ncbi.nlm.nih.gov]

Terminal QRS slurring or notching (J Waves). Concave upward ST-segment elevation. Prominent T waves 4 5. [en.my-ekg.com]

ST-segment elevation with upper concavity, and prominent T waves in at least 2 contiguous leads. [e-arrhythmia.org]

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]

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]

Double Outlet Right Ventricle

Visceroatrial situs, ventricular morphology, and atrioventricular and ventriculoarterial alignments can reliably be assessed with fetal echocardiography. We herein describe, to our knowledge, the first reported fetal echocardiographic diagnosis of a fetus with visceroatrial situs solitus, atrioventricular alignment[…] [ncbi.nlm.nih.gov]

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]

Aortopulmonary Septal Defect

Aortopulmonary septal defect Specialty Cardiology Aortopulmonary septal defect is a rare congenital heart disorder accounting for only 0.1-0.3% of congenital heart defects worldwide. [1] It is characterized by a communication between the aortic and pulmonary arteries, with preservation of two normal semilunar[…] [en.wikipedia.org]

Scimitar Syndrome

Scimitar syndrome has a variable presentation depending on the age at which the diagnosis is made. We report a case of a young woman (age 18 years) with suspected right pulmonary hypoplasia in whom a scimitar syndrome was diagnosed. Using MRI morphological findings and hemodynamic significance of the syndrome[…] [ncbi.nlm.nih.gov]

Persistent Truncus Arteriosus

OBJECTIVE: This study aimed to report our experiences with surgical repair in patients of all ages with persistent truncus arteriosus. METHODS: From July 2004 to July 2014, 50 consecutive patients with persistent truncus arteriosus who underwent anatomical repair were included in the retrospective review. Median[…] [ncbi.nlm.nih.gov]

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]

Left to Right Cardiac Shunt

Abstract A 55-year-old man, with a history of nephrectomy for renal cell carcinoma, was evaluated using radionuclide angiocardiography to exclude cardiac shunts as the cause of vascular bruits heard at auscultation. A pulmonary time-activity curve derived from the right lung showed a pattern typical of a large[…] [ncbi.nlm.nih.gov]

Cardiodysrhythmic Potassium-Sensitive Periodic Paralysis

Accounting for the small sample size, prominent U-waves and the “U on P sign” seem to be the most consistent across studies. [innovationsincrm.com]

ECG was notable for prominent U waves, with sinus rhythm and a normal QT interval. Genetic screening identified a heterozygous mutation in the KCNJ2 gene. [neurologytimes.com]

U wave; (3) at least two of the following dysmorphic features: low-set ears, wide-set eyes, a small mandible, fifth-digit clinodactyly, and syndactyly; and (4) a family member [en.wikipedia.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]

[…] upright T-waves in leads V1-V3 Combination of horizontal ST-segment depression with Prominent R-waves in leads V1-V3 R/S ratio 1 in lead V2 Co-existing acute inferior and [emdocs.net]

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]

[…] ventricular tachycardia) Prominent U-wave In case of intoxication, the above mentioned characteristics are more prominent Additionally, several arrhthytmias can be seen. [en.ecgpedia.org]

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