â€˜Pâ€™ MITRALE AND LEFT ATRIAL ENLARGEMENT: COMPARISON WITH ECHOCARDIOGRAPHY
Keywords:Left atrial enlargement, ECG, â€˜Pâ€™ Mitrale, echocardiography
Background: This study was carried out to determine the sensitivity and specificity of â€˜Pâ€™ Mitrale in diagnosing left atrial enlargement by comparing it with the Gold Standard of echocardiography. Methods: The study was carried out at the department of Physiology, Army Medical College, Rawalpindi and department of Cardiology at Armed Forces Institute of Cardiology / National Institute of Heart Diseases. 50 clinically diagnosed cases of left atrial enlargement were included in the study. ECG of the patients was recorded and â€˜Pâ€™ Mitrale observed. This was followed by echocardiography and using 2-D echocardiogram as a guideline M-mode recording was obtained and left atrial size was calculated. Results: â€˜Pâ€™ Mitrale has a sensitivity of 22.5% and specificity of 100%. The positive and negative predictive value and diagnostic efficacy of the test were also calculated. Conclusion: Sensitivity of ECG is low in detecting left atrial enlargement. However its sensitivity can be increased by combining â€˜Pâ€™ Terminal Force in lead V1 and P/P-R ratio to â€˜Pâ€™ Mitrale. ECG is however still recommended as a routine investigation because of its cost effectiveness and easy availability.
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