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ECG in Congenital Heart Disease: Difference between revisions
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Congenital Heart Disease can result in ECG changes, often related to atrial or ventricular overload and enlargement. Below a list of relatively common forms of congenital heart disease and their potential ECG changes. Adapted from Khairy et al.<cite>khairy</cite> | Congenital Heart Disease can result in ECG changes, often related to atrial or ventricular overload and enlargement. Below a list of relatively common forms of congenital heart disease and their potential ECG changes. Adapted from Khairy et al.<cite>khairy</cite> | ||
==Secundum atrial septal defect== | ==Secundum atrial septal defect== | ||
Information about [[w:Atrial_septal_defect|Secundum atrial septal defec on Wikipedia (external link)]] | |||
*[[Rhythm]]: normal sinus rhythm, increased risk of AF with age | *[[Rhythm]]: normal sinus rhythm, increased risk of AF with age | ||
*[[Conduction|PR interval]]: first degree AV block in 6-19% | *[[Conduction|PR interval]]: first degree AV block in 6-19% | ||
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==Ventricular Septal Defect== | ==Ventricular Septal Defect== | ||
Information about [[w:Ventricular_septal_defect|Ventricular Septal Defect on Wikipedia (external link)]] | |||
*[[Rhythm]]: normal sinus rhythm, PVCs | *[[Rhythm]]: normal sinus rhythm, PVCs | ||
*[[Conduction|PR interval]]: Normal or mild ↑; 1° AVB 10% | *[[Conduction|PR interval]]: Normal or mild ↑; 1° AVB 10% | ||
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==AV canal defect== | ==AV canal defect== | ||
Information about [[w:Atrioventricular_septal_defect|AV canal defect on Wikipedia (external link)]] | |||
*[[Rhythm]]: normal sinus rhythm, PVCs 30% | *[[Rhythm]]: normal sinus rhythm, PVCs 30% | ||
*[[Conduction|PR interval]]: 1° AVB >50% | *[[Conduction|PR interval]]: 1° AVB >50% | ||
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==Patent ductus arteriosus== | ==Patent ductus arteriosus== | ||
Information about [[w:Patent_ductus_arteriosus|Patent ductus arteriosus on Wikipedia (external link)]] | |||
*[[Rhythm]]: normal sinus rhythm, ↑ IART/AF with age | *[[Rhythm]]: normal sinus rhythm, ↑ IART/AF with age | ||
*[[Conduction|PR interval]]: ↑ PR 10% to 20% | *[[Conduction|PR interval]]: ↑ PR 10% to 20% | ||
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==Pulmonary stenosis== | ==Pulmonary stenosis== | ||
Information about [[w:Pulmonary_valve_stenosis|Pulmonary stenosis on Wikipedia (external link)]] | |||
*[[Rhythm]]: normal sinus rhythm | *[[Rhythm]]: normal sinus rhythm | ||
*[[Conduction|PR interval]]: Normal | *[[Conduction|PR interval]]: Normal | ||
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==Aortic coarctation== | ==Aortic coarctation== | ||
Information about [[w:Coarctation_of_the_aorta|Aortic coarctation on Wikipedia (external link)]] | |||
*[[Rhythm]]: normal sinus rhythm | *[[Rhythm]]: normal sinus rhythm | ||
*[[Conduction|PR interval]]: Normal | *[[Conduction|PR interval]]: Normal | ||
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[[File:E000403.jpg|thumb|300px|ECG from a patient with Ebstein's anomaly showing huge P waves and low amplitude QRS waves. RBBB and T wave inversion are not present on this ECG.]] | [[File:E000403.jpg|thumb|300px|ECG from a patient with Ebstein's anomaly showing huge P waves and low amplitude QRS waves. RBBB and T wave inversion are not present on this ECG.]] | ||
[[File:DVA0559.jpg|thumb|300px|ECG from a patient with Ebstein's anomaly]] | [[File:DVA0559.jpg|thumb|300px|ECG from a patient with Ebstein's anomaly]] | ||
Information about | Information about [[w:Ebstein's_anomaly|Ebstein's anomaly on Wikipedia (external link)]] | ||
*[[Rhythm]]: normal sinus rhythm, possible EAR, SVT; AF/IART 40% | *[[Rhythm]]: normal sinus rhythm, possible EAR, SVT; AF/IART 40% | ||
*[[Conduction|PR interval]]: 1° AVB common; short if WPW | *[[Conduction|PR interval]]: 1° AVB common; short if WPW | ||
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*[[Chamber_Hypertrophy_and_Enlargment|Ventricular hypertrophy]]: Diminutive RV | *[[Chamber_Hypertrophy_and_Enlargment|Ventricular hypertrophy]]: Diminutive RV | ||
*Particularities: Accessory pathway common; Q II, III, aVF, and V<sub>1</sub>–V<sub>4</sub> | *Particularities: Accessory pathway common; Q II, III, aVF, and V<sub>1</sub>–V<sub>4</sub> | ||
{{clr}} | |||
==Surgically repaired TOF== | ==Surgically repaired TOF== | ||
Information about [[w:Tetralogy_of_Fallot|Surgically repaired TOF on Wikipedia (external link)]] | |||
*[[Rhythm]]: normal sinus rhythm, PVCs; IART 10%; VT 12% | *[[Rhythm]]: normal sinus rhythm, PVCs; IART 10%; VT 12% | ||
*[[Conduction|PR interval]]: Normal or mild ↑ | *[[Conduction|PR interval]]: Normal or mild ↑ | ||
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==Congenitally corrected TGA== | ==Congenitally corrected TGA== | ||
Information about [[w:Levo-Transposition_of_the_great_arteries|Congenitally corrected TGA on Wikipedia (external link)]] | |||
*[[Rhythm]]: normal sinus rhythm | *[[Rhythm]]: normal sinus rhythm | ||
*[[Conduction|PR interval]]: 1° AVB >50%; AVB 2%/year | *[[Conduction|PR interval]]: 1° AVB >50%; AVB 2%/year | ||
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*Particularities: Absent sinus node in LAI; AV block with L-loop or AVCD | *Particularities: Absent sinus node in LAI; AV block with L-loop or AVCD | ||
==Dextrocardia== | ==Dextrocardia / Situs inversus== | ||
Information about [[w:Dextrocardia|Dextrocardia on Wikipedia (external link)]] | |||
[[File:Puzzle_2007_12_426_fig1.jpg|thumb|300px|An example of dextrocardia]] | |||
[[File:Situs_inversus.jpg|thumb|300px|Situs inversus]] | |||
[[File:Situs_inversus_mirrored_lead_positioning.jpg|thumb|300px|Dextrocardia with mirrored lead positioning]] | |||
*[[Rhythm]]: normal sinus rhythm, P-wave axis 105° to 165° with situs inversus | *[[Rhythm]]: normal sinus rhythm, P-wave axis 105° to 165° with situs inversus | ||
*[[Conduction|PR interval]]: Normal | *[[Conduction|PR interval]]: Normal | ||
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*[[Chamber_Hypertrophy_and_Enlargment|Ventricular hypertrophy]]: LVH: tall R V<sub>1</sub>–V<sub>2</sub>; RVH: deep Q, small R V<sub>1</sub> and tall R right lateral | *[[Chamber_Hypertrophy_and_Enlargment|Ventricular hypertrophy]]: LVH: tall R V<sub>1</sub>–V<sub>2</sub>; RVH: deep Q, small R V<sub>1</sub> and tall R right lateral | ||
*Particularities: Situs solitus: normal P-wave axis and severe CHD | *Particularities: Situs solitus: normal P-wave axis and severe CHD | ||
{{clr}} | |||
==ALCAPA== | ==ALCAPA== | ||
Information about [[w:Anomalous_Left_Coronary_Artery_From_the_Pulmonary_Artery|ALCAPA on Wikipedia (external link)]] | |||
*[[Rhythm]]: normal sinus rhythm | *[[Rhythm]]: normal sinus rhythm | ||
*[[Conduction|PR interval]]: Normal | *[[Conduction|PR interval]]: Normal | ||