Definition: Tall, narrow, peaked P waves in electrocardiographic leads II, III, and aVF, and often a prominent initial positive P wave component in V1, presumed to be characteristic of cor pulmonale. (Although this term is extensively used in the electrocardiographic literature, it is actually a misnomer and should be more appropriately called P-dextrocardiale, because it results from overload of the right atrium regardless of the cause, as in tricuspid stenosis, and may occur independently of cor pulmonale.) In lung disease, P pulmonale is usually transient, occurring during exacerbations, usually asthmatic.
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