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Dr. Andrew Rynne

Family Physician

Exp 50 years

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ECG showed biphasic P waves in V1. Family history of heart failure. Any complication?

Answered by
Dr. Aslam Lalani


Practicing since :2000

Answered : 356 Questions

Posted on Tue, 8 Jan 2013 in Hypertension and Heart Disease
Question: i am suspecting i have the early stages of an Intraatrial conduction delay as that i have biphasic P waves in V1; and when viewing them, you notice that the first part is much wider than the second. I also have syncopes from time to time, tired when i walk up a decent flight of stairs, and i am beginning to retain much more fluid in my legs than i did when i was younger. The rest of my ECG looks quite normal. what do you think?
Answered by Dr. Aslam Lalani 1 hour later
Welcome to health care magic,
it is my pleasure to answer you ,
from your history and ECG finding it is more look like you have problem related to your right side of heart , and you also have family history of heart failure in that case it is more look like genetic problem runs in your family causing problem involving right side of heart and over a period of time weakening its pumping function ,
Due to advancement in medical science now a days good medicine are available to control progress of heart failure and improve pumping function of heart ,
At present i would like to advice you to consult cardiologist who has more expertise in managing patient with heart failure ,
many base line investigation like 2D Echo , kidney function test , liver function test , thyroid function test , serum electrolyte ,
and Hb and many other test also and many test required to be done regularly ,

be regular in your follow up with cardiologist ,
take your medicine regularly ,
adopt healthy diet habit ,
avoid physical strain ,
take care of your self ,
if you have any further queries , feel free to ask me ,
regards ,

Above answer was peer-reviewed by : Dr. Aparna Kohli
Follow up: Dr. Aslam Lalani 24 hours later
The last GFR reading for my kidneys read 60. As for my electrolytes, they all came in the middle range. Thyroid test and liver tests, are normal, as was Hb. I have a sinus arrythmia and I have had bouts of AFib. Any further infor would be great, thanks for your time.
Answered by Dr. Aslam Lalani 8 hours later
Hello and thanks again,

Based on your ECG finding and further information given in form of other lab report which are almost normal (except GFR), you probably seem to have right sided heart failure with enlargement of right atrium - this cause biphasic P wave with first part much wider.

Besides that, right side heart failure cause weak right ventricular pumping function which can cause water retention and swelling in legs. Weak pumping function of right side of heart also reduces cardiac output leading to tiredness and episodes of syncope.

My prediction is based on this history given and the ECF finding reported. We will need the help of echocardiogram to confirm this prediction. Therefore I request you to consult a cardiologist at the earliest and get your heart function evaluation. We will require 2D Echo report in detail to guide you further. Please consult a cardiologist nearby and take treatment as per his advice.

Hope this answers your query. If you have further queries feel free to ask me. I will be available for further discussion if you can send the detailed echo report.

Take care

Above answer was peer-reviewed by : Dr. Prasad

The User accepted the expert's answer

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