What is a manifestation of left atrial enlargement seen on an EKG lead II?

A manifestation of left atrial enlargement on an EKG, particularly noted in lead II, is the appearance of wide, notched P waves. This characteristic reflects the prolonged conduction time through the enlarged left atrium, which can result from conditions such as hypertension, mitral valve disease, or heart failure. The notching occurs as the electrical impulse spreads more slowly through the enlarged atrial tissue.

In clinical practice, when evaluating P wave morphology, identifying a notched configuration in lead II suggests left atrial overload and is essential for diagnosing potential underlying cardiac pathologies. Many times, clinicians also consider the height and duration of the P wave to further assess atrial enlargement. However, the prominent feature related to left atrial enlargement is indeed the appearance of these wide, notched P waves in lead II.