What can PJT look like on an EKG?

What can PJT look like on an EKG?

• A. Uniform P waves before each QRS complex
• B. An inverted P wave immediately before each upright QRS
• C. A mixture of irregular beats
• D. Flat T waves throughout

Answer: (B)

The presence of an inverted P wave immediately before each upright QRS complex is characteristic of P-junctional tachycardia (PJT). In this arrhythmia, the ectopic foci located near the atrioventricular (AV) node can cause the atria to depolarize in a retrograde manner, leading to the inverted P waves. This indicates that the electrical impulse originating from the junctional area is traveling backward into the atria rather than forward from the sinoatrial (SA) node to the ventricles.

In PJT, the relationship between the P waves and QRS complexes is crucial. The inverted P waves are typically seen in conjunction with narrow QRS complexes, indicating that the ventricular depolarization is occurring normally despite the irregular atrial conduction. This distinguishes PJT from other forms of tachycardia that may not show this specific pattern of P wave morphology.

Understanding this specific EKG hallmark that correlates with PJT is essential for accurate diagnosis and treatment. Each of the other options presented would produce different EKG features that do not align with the expected presentation of PJT.