Document Detail

Significance of electrocardiographic isolated abnormal terminal P-wave force (left atrial abnormality). An echocardiographic and clinical correlation.
MedLine Citation:
PMID:  2968074     Owner:  NLM     Status:  MEDLINE    
An abnormal terminal negative deflection in precordial lead V1 (PTFV1) is occasionally present as an isolated electrocardiographic finding. To determine the significance of this, 41 patients with PTFV1 greater than or equal to 0.04 mms were recalled for a repeated electrocardiogram as well as an echocardiographic examination. Patients were classified as cardiovascular normal (n = 15) or abnormal (n = 26). Left atrial enlargement was the most common echocardiographic abnormality found, but represented less than a third of the total. P-wave prolongation (greater than 110 ms) was present in 30 of the 41 patients and 21 of the 26 abnormal patients. This persisted into the second study, while the PTFV1 fell significantly in both the normal and abnormal groups. Among the P-wave abnormalities found, combinations were used to identify patients most likely to have cardiovascular disease. The most discriminating was an initial abnormal PTFV1 in combination with P-wave prolongation (sensitivity, 82%; specificity, 40%; positive predictive value, 70%; and negative predictive value, 55%). Maximal specificity (93%) and positive predictive value (88%) were achieved when P-wave prolongation and PTFV1 greater than or equal to 0.06 mms were present in both studies, although the sensitivity for this criterion was only 27%. The isolated P-wave abnormality described may be helpful in suggesting the presence of underlying cardiovascular disease and indicate the need for further evaluation.
L Jin; A B Weisse; F Hernandez; T Jordan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of internal medicine     Volume:  148     ISSN:  0003-9926     ISO Abbreviation:  Arch. Intern. Med.     Publication Date:  1988 Jul 
Date Detail:
Created Date:  1988-07-26     Completed Date:  1988-07-26     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0372440     Medline TA:  Arch Intern Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1545-9     Citation Subset:  AIM; IM    
Department of Medicine, University of Medicine and Dentistry, New Jersey Medical School, Newark.
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MeSH Terms
Cardiomegaly / diagnosis
Cardiovascular Diseases / diagnosis*
Hypertension / diagnosis
Middle Aged
Pulmonary Wedge Pressure

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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