Cytochrome Oxidase Deficiency (Mitochondrial Myopathy)
Report:
Sinus rhythm 118/min
Left anterior hemiblock
Axis -40o
Comment:
Rates up to 163/min are below the ‘tachycardia’ range for infants up to 2 years.
RSR’ pattern as seen here in V1-2 is also normal, at any age.
Left axis deviation, however, is abnormal even in the range considered normal for adults, viz. 0o - 30o. There is no certainty that it equates with LAHB in this infant, who had no clinical heart disease, but the hemiblock is the most likely explanation. It is almost certainly an expression of his myopathy.
He had terminal myopathy and was extubated and allowed to die in the ICU.
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