Collection of a few ECGs in congenital heart diseases

Classical QRS pattern in ASD is the rSR’ in V1 suggestive incomplete RBBB. This pattern in ASD is due to RV volume overload. QRS axis is usually rightward, more so when there is severe PAH. Left axis deviation is feature of ostium primum ASD. First degree AV block may be noted in both primum and secundum ASD. Familial ASD with first degree AV block has been reported in secundum ASD. This type of familial ASD has an autosomal dominant inheritance pattern. There is also a higher incidence of SCD in this group. IRBBB pattern in ASD Crochetage sign in ASD, manifest as notching of R wave near the apex in inferior leads (arrows). Sharp P waves in V1 and 3 mm tall P waves in lead II suggest right atrial overload. rSr’S’ pattern in V1 is suggestive of right ventricular volume overload. Crochetage sign on ECG in ASD ECG in ASD with severe pulmonary hypertension: Tall R’ in V1, ST depression in inferior leads and V2-V5, and T inversion in inferior leads and V1-V6 are seen. ECG in atrial septal defect with severe pulmonary hypertension The Katz-Wachtel phenomenon/sign is tall diphasic RS complexes at least 50 mm in height in lead V2, V3 or V4 – mid precordial leads The original description by Katz and Wachtel was published in 1937. The sign has been described in VSD with biventricular hypertrophy in children. It can be seen with isolated VSD as well as complex ventricular septal defect. In fact the Circulation article cited is on Complete Transposition of the Great Vessels...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: ECG / Electrophysiology ECG Library Source Type: blogs