Professional and Linguistic Assessments Board (PLAB) Practice Exam

Which of the following conditions can lead to a 'P-mitrale' pattern on an ECG?

1. Atrial Fibrillation

2. Mitral Stenosis

3. Ventricular Hypertrophy

4. Bradycardia

The correct answer is: Mitral Stenosis

A 'P-mitrale' pattern on an electrocardiogram (ECG) is characterized by broad, notched P waves, typically found in leads II, III, and aVF. This pattern is most commonly associated with left atrial enlargement, which occurs in certain conditions. Mitral stenosis is a primary cause of left atrial enlargement, resulting in the characteristic 'P-mitrale' changes on the ECG. In this condition, the mitral valve becomes narrowed, impeding blood flow from the left atrium to the left ventricle during diastole. As the left atrium works harder to push blood through the stenotic valve, it dilates and enlarges over time, leading to changes in the electrical activity of the heart that manifest as the 'P-mitrale' pattern. Conditions like atrial fibrillation, while they can impact the appearance of the P wave on an ECG, do not typically produce the notched P wave indicative of left atrial enlargement. Ventricular hypertrophy may affect the overall morphology of the ECG but is not responsible for the 'P-mitrale' pattern. Bradycardia may influence heart rate and rhythm but does not directly cause the specific changes seen in 'P