What condition is associated with peaked P-waves due to high right atrial pressure?

The presence of peaked P-waves on an electrocardiogram is often indicative of right atrial enlargement, which can occur due to increased pressure in the right atrium. This condition is most commonly associated with pulmonary hypertension. When pulmonary hypertension develops, it leads to increased resistance in the pulmonary arteries, which creates pressure overload on the right side of the heart. As a result, the right atrium enlarges to accommodate the increased volume and pressure, leading to the characteristic morphology of peaked P-waves, also referred to as P pulmonale.

Pulmonary hypertension can result from various underlying causes, including lung diseases, congenital heart defects, or primary pulmonary vascular disease, and the resulting elevation in right atrial pressure is a direct consequence of the increased workload placed on the right atrium. This understanding of the electrical changes in the heart in response to structural and pressure adaptations is fundamental in recognizing the implications of heart disease and related conditions.