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ECG changes in mitral stenosis

Authoring team

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

  • right axis deviation

  • there may be digitalis effects

Click for more detailed information and ECG examples

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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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