P Pulmonale: Causes & Reasons

Possible Causes for P Pulmonale

“P pulmonale” was found in one third of the emphysema group but was inconstant. [ajconline.org]

Peaked P waves in the inferior leads > 2.5 mm (P pulmonale) with a rightward P-wave axis (inverted in aVL) Clockwise rotation of the heart with a delayed R/S transition point [lifeinthefastlane.com]

The pseudo P-pulmonale. Circulation. 1965; 32: 96 Scopus (26) PubMed Crossref Google Scholar Simonson E. [ajconline.org]

Acute Cor Pulmonale

Tall tented p-pulmonale may also be seen. 3) Echocardiography may show dilatation and also allows indirect measurement of pulmonary artery pressures. [myvmc.com]

ECG changes in Cor Pulmonale include right axis deviation, R/S amplitude ratio in V1 greater than 1, R/S amplitude ratio in V6 less than 1 and P-Pulmonale pattern (Klinger [asrn.org]

Right Atrial Hypertrophy

The P-wave amplitude is >2.5 mm in P pulmonale. [ecgwaves.com]

In general, left atrial enlargement is used as a synonym for p mitrale, right atrial enlargement for p pulmonale, and biatrial enlargement for p biatriale. [link.springer.com]

[…] by, last update January 29, 2019 ECG Criteria of Right Atrial Enlargement Right atrial enlargement produces a peaked P wave ( P pulmonale ) with amplitude: > 2.5 mm in the [lifeinthefastlane.com]

Biventricular Hypertrophy

Deep S-wave in V5 or V6 (>6 mm) Large RS complexes in multiple leads P pulmonale Figure 1. [ecgwaves.com]

P pulmonale: It is reflected by the presence of tall- and peaked P waves in leads II, III and aVF. The amplitude is more than 2.5 mm. [yourarticlelibrary.com]

(pseudo-P pulmonale). [ahajournals.org]

Pulmonary Emphysema

With development of cor pulmonale, the following additional changes are seen: Right atrial enlargement (P pulmonale) Right ventricular hypertrophy 3. [lifeinthefastlane.com]

Related Topics Right axis deviation Low voltage QRS complexes Right atrial enlargement (P pulmonale) Right ventricular hypertrophy Right bundle branch block References Harrigan [lifeinthefastlane.com]

Acute Massive Pulmonary Embolism

SI, QIII, TIII -> non specific ST changes or TWI in anterior leads (right heart strain), -> right axis deviation -> s wave (I and aVL) > 1.5mm -> Q wave in III and aVF -> p [lifeinthefastlane.com]

Sinus tachycardia, supraventricular tachyar-rhythmias, the S1Q3T3 pattern, new complete or incomplete right bundle branch block, and p pulmonale are some of the ECG patterns [ncbi.nlm.nih.gov]

"Acute cor pulmonale resulting from pulmonary embolism". [en.wikipedia.org]

Recurrent Pulmonary Embolism

SI, QIII, TIII -> non specific ST changes or TWI in anterior leads (right heart strain), -> right axis deviation -> s wave (I and aVL) > 1.5mm -> Q wave in III and aVF -> p [lifeinthefastlane.com]

Right axis deviation (R > S in V1) and P-pulmonale may be present. T-wave inversion in leads V1 to V4 also occurs. [merckmanuals.com]

pulmonale -> RBBB CXR: rules out other pathology, focal oligaemia, wedge density (pulmonary infarction) ABG: reduced PaO2 in keeping with size of PE, metabolic acidosis with [lifeinthefastlane.com]

Chronic Right-Sided Congestive Heart Failure

pulmonale. [escardio.org]

They are usually recommended where P a O 2 is a O 2 is [ 5 ]. [patient.info]

Electrocardiography in patients with pulmonary hypertension shows signs of RV hypertrophy in the form of right axis deviation, dominant R in V1 and dominant S in V5 or 6 + P [escardio.org]

Eisenmenger Syndrome

ECG: almost always abnormal; shows features suggestive of right heart hypertrophy (with tall R wave in V1, deep S wave in V6, ST and T wave abnormalities, P pulmonale) as [patient.info]

Chronic Obstructive Pulmonary Disease

pulmonale" (right atrial enlargement) multifocal atrial tachycardia In contrast to asthma, the histologic changes of COPD are irreversible and gradually progress over time [radiopaedia.org]

Edema in cor pulmonale. Lancet 1975 ; ii: 1289 – 1290. Google Scholar 27 Richens JM Howard P. Oedema in cor pulmonale. Clin Sci 1982 ; 62: 255 – 259. [oadoi.org]

[…] the limb leads or <10 mm in the precordial leads right ventricular hypertrophy right axis deviation dominant R wave in V1 with an amplitude >7 mm often associated with "P [radiopaedia.org]

Pulmonary Embolism

Electrocardiographic findings ACS ( n =198) APE ( n =81) TC ( n =21) p value P pulmonale (%) 8 (4) 10 (12) 0 0.014 Right axis deviation (%) 0 6 (7) 0 Left axis deviation [ncbi.nlm.nih.gov]

Right axis deviation (R > S in V1) and P-pulmonale may be present. T-wave inversion in leads V1 to V4 also occurs. [merckmanuals.com]

P pulmonale, right and left axis deviation, S 1 S 2 S 3 and S 1 Q 3 T 3 patterns, low voltage and clockwise rotation were specific, but not sensitive for APE. [ncbi.nlm.nih.gov]

Tetralogy of Fallot

Supporting criteria Right atrial enlargement (P pulmonale). [litfl.com]

Example 2 Right axis deviation (+150 degrees) P pulmonale (P wave in lead II > 2.5 mm) Incomplete RBBB Right ventricular strain pattern with T-wave inversion and ST depression [litfl.com]

pulmonale) would be considered suggestive of RVH. [litfl.com]

Pulmonary Hypertension

[…] failure – increased JVP, (large V waves), parasternal heave, TR murmur, hepatomegaly, peripherial oedema other signs of CHF hypoxaemia INVESTIGATIONS Bedside ECG – RVH, RAD, p-pulmonale [lifeinthefastlane.com]

Pulmonary Bullous Emphysema

P., S. E. Ford, and R. G. Price. Subacute cor pulmonale due to tumor embolization. Arch Pathol Lab Med. 1992. 116:131–134. [Google Scholar] Soares, F. A., A. E. [archivesofpathology.org]

Pulmonary Arteritis

Banode P, Kothari N. [lungindia.com]

Rheumatoid interstitial lung disease presenting as cor pulmonale. [lungindia.com]

Lung India 2010;27:256-9 How to cite this URL: Acharya S, Mahajan S N, Shukla S, Diwan S K, Banode P, Kothari N. [lungindia.com]

Cystic Fibrosis

Probably as a result of more successful treatment of classic bacterial infections in CF, there are now increasing problems with multi-resistant isolates of P. aeruginosa and [patient.info]

[…] morbidity and mortality associated with CF is caused by respiratory disease where chronic infection and inflammation lead to bronchiectasis, progressive airflow obstruction, cor pulmonale [patient.info]

Tricuspid Valve Insufficiency

Google Scholar 69 Burgess MI, Mogulkoc N, Bright-Thomas RJ, Bishop P, Egan JJ, Ray SG. [doi.org]

Right-heat failure and cor pulmonale. In: Crawford MH, DiMarco JP, Paulus WJ, eds. Cardiology. 2nd ed. St Louis, Mo: Mosby; 2004 : 1017. [doi.org]

Pulmonary Histiocytosis X

New York: Thieme; 2005. p. 601-673. Popper HH. Die pulmonale Langerhans-zell-histiozytose. Der Pathologe 2015;36:451-457. https://doi.org/10.1007/s00292-015-0052-9. [medicinaylaboratorio.com]

Pulmonary Vascular Disorders

Polycythemia secondary to chronic hypoxemia - SaO2 less than 85% (give O2 and % should increase) - EKG: may show RAD, peaked P waves, deep S waves in V6, may see Q waves [brainscape.com]

[…] distended neck veins - RV heave or gallop - prominent lower sternal or epigastric pulsations - hepatomegaly - dependent edema - ascites - severe lung disease Dx studies for Cor Pulmonale [brainscape.com]

Sleep Apnea

Practice Essentials Obstructive sleep apnea (OSA)—also referred to as obstructive sleep apnea-hypopnea—is a sleep disorder that involves cessation or significant decrease in airflow in the presence of breathing effort. It is the most common type of sleep-disordered breathing and is characterized by recurrent[…] [emedicine.medscape.com]

Obstructive Sleep Apnea

Atrial Septal Defect

Development of a new defect following transcatheter closure of an atrial septal defect has yet to be reported. In this study, we present an acutely successful atrial septal defect closure with a STARFlex device, resulting in surgical explantation after discovery of device fracture, thrombus formation, and a second[…] [ncbi.nlm.nih.gov]

Pneumothorax

The underlying pathophysiology of pneumothorax is reviewed in this section. Spontaneous pneumothorax Spontaneous pneumothorax in most patients occurs from the rupture of blebs and bullae. Although PSP is defined as occurring in patients without underlying pulmonary disease, these patients have asymptomatic blebs[…] [emedicine.medscape.com]

Pulmonary Fibrosis

PFA Joins Over 200 Groups in Applauding Congressional Leaders for Increased NIH Funding In a letter to the four leading appropriators in Congress -- Sen. Roy Blunt, Sen. Patty Murray, Rep. Tom Cole, and Rep. Rosa DeLauro -- PFA joined over 200 leading patient, provider, and industry groups to champion their[…] [pfadvocates.org]

Central Sleep Apnea

Sleep Med Clin. 2017 Dec;12(4):565-572. doi: 10.1016/j.jsmc.2017.07.006. Epub 2017 Sep 6. Author information 1 Sleep Laboratory, Bethesda North Hospital, 10535 Montgomery Road, Suite 200, Cincinnati, OH 45242, USA; The University of Cincinnati, Cincinnati, OH, USA; The Ohio University Medical School, Columbus, OH, USA.[…] [ncbi.nlm.nih.gov]

Pulmonary Sarcoidosis

We present the case of a 71-year-old woman with a long-standing history of refractory pulmonary sarcoidosis, who, upon commencement of treatment with lenalidomide for her newly diagnosed 5q-myelodysplastic syndrome, showed a remarkable, immediate, unexpected response and recovery of her sarcoidosis-related[…] [ncbi.nlm.nih.gov]

Granulomatous Lung Disease

BACKGROUND: Angiogenesis-angiostasis balance and leukocyte recruitment are influenced by different concentrations of distinct chemokines. OBJECTIVE: To investigate the relative contribution of angiogenic and angiostatic CXC chemokines to the pathogenesis of idiopathic pulmonary fibrosis (IPF) and granulomatous lung[…] [ncbi.nlm.nih.gov]

Ayerza Syndrome

Ayerza syndrome is named after Abel Ayerza and encompasses the clinical features of pulmonary hypertension. It is a progressive disease with mixed etiology, characterized by increased resistance in the pulmonary blood vessels. Ayerza syndrome (AS) describes the signs of pulmonary (arterial) hypertension. It is[…] [symptoma.com]

Pulmonary Alveolar Proteinosis

Sivaresmi Unnithan 1 * and Ranjan K Das 2 Attending Consultant in Respiratory Medicine, Calcutta Medical Research Institute Consultant Pulmonologist, Calcutta Medical Research Institute Corresponding Author: Dr. Sivaresmi Unnithan,Attending Consultant in Respiratory Medicine, Calcutta Medical Research Institute, Kolkata[…] [medical-case-reports.imedpub.com]

Tricuspid Stenosis

A 47-year-old man with history of familial cardiomyopathy and orthotopic heart transplant at the age of 34 years presented severe tricuspid stenosis (TS) with a mean transvalvular gradient of 10 mm Hg. The patient opted against tricuspid valve replacement and was offered percutaneous transcatheter tricuspid[…] [ncbi.nlm.nih.gov]