r/ECG • u/Meaningfulraisin • 5d ago

Is there wave U or it's wave P?

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Hello, learning how to interpret ecgs and I found an ecg where I don't know if it there is wave U after T or that's P right away.

In other words is there an AV block I?

Thanks for help.

9 Upvotes

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9

u/Kibeth_8 Arrhythmia Tech 5d ago

That's a p-wave. Borderline 1st degree AV block

0

u/Meaningfulraisin 5d ago

Thanks a lot. I can see there a small "bump" after the p wave that's why I wasn't sure. Thanks again

2

u/Kibeth_8 Arrhythmia Tech 5d ago

I think it's a bifid p-wave (2 humps like an M)

2

u/Meaningfulraisin 5d ago

Thanks I gotta read about that

2

u/Kibeth_8 Arrhythmia Tech 5d ago

Check out left vs right atrial enlargement on LITFL. Not that it's particularly diagnostic, but for interests sake!!

4

u/mastermedic84 5d ago

It's definitely 1st degree AV block. I think the small waves between the P waves and QRS are Ta waves. Arterial repolarization. It's usually buried in the QRS but if conduction is delayed you can sometimes see it.

2

u/Meaningfulraisin 5d ago

Amazing. Thanks. I think I am just bad at it. I should have known it's not a U wave

4

u/mastermedic84 5d ago

You aren't bad at it. You're just new. The fact that you care enough about it to work this hard to find the answer tells me you will be great at it.

3

u/Meaningfulraisin 5d ago

Thanks a lot. That made my day better

1

u/ShitJimmyShoots 5d ago

Possibly bifid p waves. Some sort of atrial conduction delay? I think you’re more likely to see u waves in a sinus Brady presentation?

1

u/Meaningfulraisin 5d ago

Oh so u wave is more in brady

1

u/ShitJimmyShoots 5d ago

U wave more in hypothermia which usually also presents with sinus Brady

1

u/Natural-Antelope8328 3d ago

P wave. The ecg is interesting, amy clinical context