title: Transient Super-Himalayan P-waves in severe pulmonary emphysema.
abstract: Himalayan P-waves are classically associated with congenital heart diseases with right to left shunt where they indicate a dilated right atrium and tend to be persistent. We report a case of transient Himalayan P-waves of 9-mm amplitude associated with a severe emphysema exacerbation. Patient had a normal right atrial size. The giant P-waves were likely the result of severe pulmonary hyperinflation, right atrial hypoxia, and transient mechanical load on the right atrium directly resulting from the bronchospasm. Transient Himalayan P-waves of quite such amplitude have not been reported previously, which makes our case the first such report in literature.
authors: Department of Internal Medicine, Saint Vincent Hospital, University of Massachusetts Medical School, Worcester, MA, USA.
authors: Lovely
authors: L
authors: Chhabra
authors: David H
authors: DH
authors: Spodick
mesh_terms: D001784:Blood Gas Analysis; D004562:Electrocardiography; D005260:Female; D006325:Heart Atria / Q000503:physiopathology*; D006801:Humans; D008875:Middle Aged; D010092:Oximetry; D011656:Pulmonary Emphysema / Q000503:physiopathology*