Another ECG for you this week, thanks for all the cases you have sent me (firstname.lastname@example.org), excited to use them in the coming weeks
Just like before, lowest training level with correct answer wins some excellent chocolate!
Answer: left atrial enlargement
Sorry for the small EKG (will work on making it expandable in the future)
The most important finding on this EKG is left atrial enlargement (LAE). This is characterized as a wide, bifid p wave in lead 2 (classically an M shape and >120ms), and/or a negative terminal deflection in V1 p wave that is >40ms in length AND >1mm in negative amplitude.
A classic boards question would be younger female immigrant presenting with SOB found to have LAE on EKG with a diastolic murmur…all caused by mitral stenosis.
Check back on thursday/friday for a great CXR/case from the VA
email@example.com with interesting images