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Patient
62-year-old woman, smoker, followed for chronic bronchitis, centrilobular emphysema and chronic respiratory failure;
Trace
Sinus rhythm with biatrial enlargement: P-wave amplitude increased in lead II (3 mm), with widened (> 40 ms) and deep (> 1.5 mm) negative component in V1, bifid pattern in lead I, P-wave duration of 115 ms in V4-V5; right ventricular hypertrophy (right axis, incomplete right bundle branch block, R/S ratio > 1 in V1); ultrasound revealed a significant dilatation of both atria;
Patient
Young girl 13 years of age, with extremely severe dilated cardiomyopathy and major dilatation of both atria with predominance in the right atrium;
Trace
Marked contrast between a major increase in atrial voltage and a decrease in ventricular voltage (low voltage); biatrial dilatation predominant in the right atrium with increased voltage in lead II, tall and wide positive atrial component (right atrial enlargement) and an increase in P-wave duration (left atrial enlargement);
Exergue
The respective enlargement of each of the two atria predominantly affects a different component of the wave P. Biatrial enlargement is diagnosed when the criteria of right atrial enlargement and left atrial enlargement are fulfilled.
Biatrial hypertrophy is reflected by combined signs of right and left atrial enlargement. The diagnosis is made on the basis of P-waves which have both a high amplitude and a duration greater than 110 ms.