RVH in Single Ventricle Transposition with Pulmonary Stenosis

Report:

Sinus rhythm approx 125/min (less than 132/min normal for 3 years)

Third degree AV block

Junctional rhythm 66/min

Right atrial abnormality (P congenitale pattern)

Right ventricular hypertrophy

Comment:

The congenital defects in the title above are only one of the causes of the report that follows it. Also, single ventricle in particular has a range of ECG appearances. Yet it’s a fairly typical tracing. The AV block can be ascribed to the transposition, the RAA to PS, the inferior T inversion to RVH.

In V1, large voltage and qR morphology are specific for RVH. The RAD +125o of course supports it, but it is not too far from upper range of normal for age.

This child was not “bad enough for surgery”, with saturations on room air consistently above 90%.

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