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Right atrial enlargement is a form of cardiomegaly, or heart enlargement. It can broadly be classified as either right atrial hypertrophy , overgrowth, or dilation, like an expanding balloon. Common causes include pulmonary hypertension, which can be the primary defect leading to RAE, or pulmonary hypertension secondary to tricuspid stenosis; pulmonary stenosis or Tetralogy of Fallot i.e. congenital diseases; chronic lung disease, such as cor pulmonale. Other recognised causes are: right ventricular failure, tricuspid regurgitation, and atrial septal defect.
It is characterized by a high P wave amplitude , i.e. a height greater than 2.5 mm in inferior ECG leads ; and greater than 1.5 mm in right sided precordial leads.
Large "a" waves on the JVP waveform can also aid in diagnosis.