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==Clinical presentation==
The presentation and symptoms a patient can present with are varied and often dependent on the underlying cause of the junctional rhythm. Patient's can be [[asymptomatic]] for example, or experience difficulty breathing and chest pain if they have underlying [[congestive heart failure]]. Other nonspecific findings include dizziness, fatigue, [[palpitations]], and passing out. This diagnosis is made via ECG. <ref name="StatPearls" /><ref name="eMedicine" />
==ECG findings==
The first finding is that junctional rhythms are regular rhythms. This means that the time interval between beats stays constant. The next normal finding is a normal QRS. Since the impulse still travels down the bundle of His, the QRS will not be wide. The most obvious abnormal finding will be abnormal P waves. One of three options can occur: <ref>{{Cite web |title=ECG Study Guide |url=https://www.bannerhealth.com/-/media/files/project/bh/careers/reviewforekgs2016aclsv51.ashx}}</ref>
1. There are no P waves. This is because of either failure of retrograde flow to the atria or the P wave is hidden in the QRS. If the P wave is hidden that implies the atria depolarize at the same time as the ventricles.
2. There are inverted P waves prior to the QRS complex. This is because of retrograde flow to the atria causing depolarization prior to the ventricular contraction. Since the depolarization is occurring in the opposite direction, the P wave deflection is inverted.
3. There are inverted P waves after the QRS complex. This is because of retrograde flow to the atria after ventricular contraction.
==Classes of junctional rhythms==
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