Electrocardiographic characteristics of P pulmonale waves of coronary origin

Abstract Thirty patients with angina pectoris presented P pulmonale waves of coronary origin. The linear and angular structure of these waves was minutely studied and compared with the structure of true P pulmonale waves. Disturbances in the coronary circulation cause changes not only in the ventricular complex of the electrocardiogram but also in the atrial wave. Tall, peaked P waves are the morphologic responses of the atrial musculature to the alterations of hypoxemia. Rightward shift of the electrical axis of the atria is caused by lesion of the left atrial musculature which by passive electrical preponderance expresses the prevalence of the unaltered vectorial forces of the right atrial cavity.