Katz-Wachtel Phenomenon

Report:

Sinus rhythm 71/min

Axis +100o (normal for 9 years)

Katz-Wachtel phenomenon – biventricular hypertrophy

Comment:

QR in V1 strongly suggests RVH, but the frontal axis, although rightward, remains within normal limits for age. This may be due to the associated LVH. The proof of both RVH and LVH are the huge equiphasic mid-precodial complexes – the Katz-Wachtel phenomenon16. The commonest defect responsible for biventricular hypertrophy, in children as well as adults17, is a VSD.

Below (Fig 11a) is another example, also with a VSD, from a 6 week old infant.

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