ECG changes in mitral stenosis
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
- a dominant R wave in V1 and V2 indicates pulmonary hypertension
- right axis deviation
- there may be digitalis effects
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