 [ Symptoms ] been getting chest pains for years ekg shows problem p wave did i have heart attack [ Disease ] most probably not a heart attach p wave is indicator of right atrial enlargement usually due to pulmonary hypertension e g cor pulmonale from chronic respiratory disease borderline ecg can be due to many reasons structural cardiac problems or sometimes due to stress or fear if the test itself you may redo the ecg and echo findings should be correlated with symptoms