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Editorials |

Watch the P Wave : It Can Change!

Patrick Yue; J. Edwin Atwood; Vic Froelicher
Author and Funding Information

Affiliations: Stanford, CA
 ,  Washington, DC
 ,  Palo Alto, CA
 ,  Dr. Yue is a Cardiology Fellow, and Dr. Froelicher is Professor of Medicine, Stanford University. Dr. Atwood is affiliated with Walter Reed Army Medical Center.

Correspondence to: Vic F. Froelicher, MD, Palo Alto Veterans Affairs Medical Center, 3801 Miranda Ave, Bldg 100, Room E2-441, Palo Alto, CA 94304-1207; e-mail: vicmd@aol.com



Chest. 2003;124(2):424-426. doi:10.1378/chest.124.2.424
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COPD is the fourth leading cause of mortality in the United States, accounting for 119,000 deaths in the year 2000 alone.1 Acute exacerbations of COPD are a common complication, resulting in significant morbidity2 and mortality.3

The ECG finding of P pulmonale refers to a pattern in which the P-wave amplitude in leads II, III, and/or aVF is augmented to > 2.5 mm.4 It is thought to reflect the overload of the right atrium (so-called right heart strain) and is accordingly a marker for disease processes that involve stress to the right heart circulation.

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