Back to basics: ECG criteria of atrial enlargement

Righ Atrial Enlargement (RAE):

• In lead II: Peaked P wave (A-like appearance)
• Normal P-wave duration
• Increase in the maximal amplitude of the P wave to >0.20 mV in leads II and aVF, and to >0.10 mV in leads V1 and V2

Left Atrial Enlargement (LAE):

• In lead II: gives a notch in the P-wave followed by a second hump (M-like appearance)
• Prolonged P-wave duration(>0.12s) and prollongation of the negative terminal portion of P-wave in lead V1
• Increase only in the amplitude of the terminal negatively directed portion of the P-wave in lead V1 to >0.10 mV

ECGs of patients with atrial enlargement. Arrows, P-wave changes in atrial enlargement; asterisks, left-atrial enlargement.(click image to enlarge)

Good book: ACLS Review: Pearls of Wisdom

ACLS Review: Pearls of Wisdom



A very nice book that will help you to master all knowledge needed for ACLS in almost every possible situation. It is in the form of Q&A which makes it more interesting. You can download the 6mb pdf document from either links below.



link 1



link2

New guidelines for appropriateness for coronary revascularization

These are the recently released guidelines to help in decision making regarding coronary revascularization. They ilustrate 180 possible scenarios and help with appropriate decision in each. you can download the pdf file from here:

http://content.onlinejacc.org/cgi/reprint/j.jacc.2008.10.005v1.pdf.

And do not forget to get your CME credit from medscape here:

http://www.medscape.com/viewarticle/586383