Step 3 P wave Morphology (Shape) ECG Interpretation


Description

  • The lead most commonly referenced in cardiac monitoring is lead II.
  • For the purposes of this training module, lead two will specifically be referenced unless otherwise specified.
  • The P wave in lead II in a normal heart is typically rounded and upright in appearance.
  • Changes in shape must be reported. This can be an indicator that the locus of stimulation is changing or the pathway taken is changing.
  • P waves may come in a variety of morphologies i.e. rounded and upright, peaked, flattened, notched, biphasic (second complex, pictured), inverted and even buried or absent!
  • Remember to describe the shape. This can be very important to the physician when diagnosing the patient.
analysis ecg image 110


P Wave Practice 1

analysis ecg image 111

Analyze this tracing. Describe the P waves.

Reveal Answer Upright and uniform


P Wave Practice 2

analysis ecg image 111

Analyze this tracing. Describe the P waves.

Reveal Answer Variable, upright, inverted and absent





Authors and Sources

Authors and Reviewers


Sources

  • Electrocardiography for Healthcare Professionals, 6th Edition Kathryn Booth and Thomas O'Brien
    ISBN10: 1265013470, ISBN13: 9781265013479
    McGraw Hill, 2023
  • Rapid Interpretation of EKG's, Sixth Edition
    Dale Dublin
    Cover Publishing Company
  • EKG Reference Guide
    EKG.Academy
  • 12 Lead EKG for Nurses: Simple Steps to Interpret Rhythms, Arrhythmias, Blocks, Hypertrophy, Infarcts, & Cardiac Drugs
    Aaron Reed
    Create Space Independent Publishing
  • Heart Sounds and Murmurs: A Practical Guide with Audio CD-ROM 3rd Edition
    Elsevier-Health Sciences Division
    Barbara A. Erickson, PhD, RN, CCRN
  • The Virtual Cardiac Patient: A Multimedia Guide to Heart Sounds, Murmurs, EKG Jonathan Keroes, David Lieberman
    Publisher: Lippincott Williams & Wilkin)
    ISBN-10: 0781784425; ISBN-13: 978-0781784429
  • Project Semilla, UCLA Emergency Medicine, EKG Training Breena R. Taira, MD, MPH
  • ECG Reference Guide
    PracticalClinicalSkills.com






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