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

The presence of wide, notched P waves in lead II is a characteristic manifestation of left atrial enlargement on an electrocardiogram (EKG). As the left atrium enlarges, the electrical conduction through the atria is affected, leading to a prolonged depolarization phase. This results in the appearance of bifid (notched) P waves when viewed in lead II, where a typical P wave may become wider than normal and demonstrate a distinct notch due to the delayed activation of the enlarged left atrium.

This change can also be linked to increased left atrial pressure and volume, often associated with conditions such as mitral stenosis, mitral regurgitation, or chronic hypertension. Recognizing these EKG changes is crucial for diagnosing underlying heart conditions and managing patient care effectively in critical settings.