COAD: P Pulmonale Causing ST Segment Depression
Report:
Sinus tachycardia 117/min
Right atrial abnormality
Small voltage (absolute)
Late transition
Borderline ST segment changes
Comment:
The P wave axis is 86o, with 0.4 mV amplitude in lead 2 and the characteristic peaked shape. As often happens in COAD, the V1 P wave has increased PTF, more commonly seen in left atrial enlargement.
Some of the ST segment depression in the inferior leads may be due to atrial repolarisation (TA wave). Some may also be due to baseline (TP segment) not being reached by the end of T wave in tachycardia, before the next P wave.
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