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ECG changes in mitral stenosis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

In mitral stenosis the ECG is often normal.

Pathological changes in the ECG include:

  • left atrial hypertrophy:
    • causes P mitrale
    • increased voltage in the later part of the P wave gives it a large, bifid appearance in leads II, III and aVF
    • the second half of the P wave is negative in V1

  • atrial fibrillation is present in 60 to 70%

  • right ventricular hypertrophy:
    • a dominant R wave in V1 and V2 indicates pulmonary hypertension

  • right axis deviation

  • there may be digitalis effects

Click for more detailed information and ECG examples


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