creators_name: Kumar SS, S creators_name: Babu, SNM creators_name: Mahajan, SK creators_name: Kaushik, M creators_name: Verma, BS creators_name: Kaushal, SS creators_id: nmsbabu18@yahoo.com editors_name: Kakkilaya, Srinivas editors_id: Kakkilaya BS type: journale datestamp: 2015-02-21 14:36:20 lastmod: 2015-04-20 11:43:10 metadata_visibility: show title: Himalayan P waves in COPD - A Rare Feature ispublished: pub subjects: OJHAS full_text_status: public keywords: Himalayan P waves; Giant; Chronic obstructive pulmonary disease abstract: Himalayan or giant P-waves (amplitude =5 mm) are often known to be classically associated with congenital heart diseases with right to left shunt like tricuspid atresia, Ebstein anomaly, combined tricuspid and pulmonic stenosis, etc, where they indicate a dilated right atrium and tend to be persistent. These type P waves are rarely seen in chronic obstructive pulmonary disease (COPD) and in this condition it may be due to structural right atrial changes or hypoxemia or combination of both. Here we report a case of COPD with Himalayan P waves which is a rare entity. date: 2014-02-20 date_type: published publication: Online Journal of Health and Allied Sciences volume: 12 number: 4(13) publisher: Kakkilaya BS refereed: TRUE referencetext: 1. Reddy SC, Zuberbuhler JR. Himalayan P-waves in a patient with tricuspid atresia.Circulation.2003;107:498. 2. Hernandez FA, Rochkind R, Cooper HR. The intracavitary electrocardiogram in the diagnosis of Ebstein’s anomaly. Am J Cardiol. 1958;1:181–190. 3. Davutoglu V, Kilinc M, Dinckal MH. Himalayan P waves in a patient with combined tricuspid and pulmonic stenosis. Heart 2003;89:1216. 4. Lovely Chhabra, David H. Spodick. Transient Super-Himalayan P-waves in severe pulmonary emphysema. Journal of Electrocardiology. 2012;45:26–27. 5. Vijayakrishnan R, Spodick DH. Himalayan P waves in the setting of severe hypoxemia and emphysema. Can J Cardiol. 2010;26:136. 6. Spodick DH. Electrocardiographic studies in pulmonary disease: establishment of criteria for the electrocardiographic inference of diffuse lung disease. Circulation. 1959;20:1073. 7. Surawicz B, Knilans T, Chou T. Atrial abnormalities. Chou's electrocardiography in clinical practice: adult and pediatric. 6th ed. Philadelphia: Elsevier/Saunders; 2008. p. 33. 8. Zimmerman HA, Bersano E, Dicosky C. The auricular electrocardiogram. Springfield (Ill): Charles C Thomas; 1968. citation: Kumar SS, S and Babu, SNM and Mahajan, SK and Kaushik, M and Verma, BS and Kaushal, SS (2014) Himalayan P waves in COPD - A Rare Feature. [Journal (On-line/Unpaginated)] document_url: http://cogprints.org/9720/1/2013-4-13.pdf