Prominent A-Wave: Causes & Reasons

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Possible Causes for Prominent A-Wave

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]

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

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]

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]

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]

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]

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]

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]

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]

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]

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]

Patent Foramen Ovale

Int J Stroke. 2017 Dec;12(9):998-1004. doi: 10.1177/1747493017701152. Epub 2017 Mar 24. Author information 1 1 Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA. 2 2 Department of Neurology, Haukeland University Hospital, Bergen, Norway. 3 3 Department of Cardiology, Rigshospitalet, Copenhagen,[…] [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]

Ventricular Septal Defect

Ventricular septal defect (VSD) is an anatomical anomaly consisting in the presence of one or more openings on the ventricular septum, the wall dividing the two ventricles, which allows arterial blood to flow from the left side to the right side of the heart. The symptoms and physical findings of VSD strongly[…] [symptoma.com]

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]

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]

[…] 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]

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

Congenital Heart Disease

BACKGROUND: Congenital heart disease is a significant problem world over especially in neonates. Early diagnosis and prompt interventions in neonatal period precludes the mortality associated with this disorder. The objective of this study was to highlight the diversity of congenital cardiac defects in our region so[…] [ncbi.nlm.nih.gov]

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]

Scimitar Syndrome

Scimitar syndrome, or congenital pulmonary venolobar syndrome, is a rare congenital heart defect characterized by anomalous venous return from the right lung (to the systemic venous drainage, rather than directly to the left atrium). [1] This anomalous pulmonary venous return can be either partial (PAPVR) or[…] [en.wikipedia.org]

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]

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]

Andersen-Tawil Syndrome

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]

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]

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. [litfl.com]

prominent U waves require hospital admission. [physio-pedia.com]

Prolongation of the PR interval T wave flattening and inversion ST depression Prominent U waves (best seen in the precordial leads) Apparent long QT interval due to fusion [litfl.com]