Endocardial Cushion Defect

Report:

Sinus rhythm

Borderline left atrial abnormality

First degree AV block

PR 0.26”

Left axis deviation – 90o

Right ventricular hypertrophy

Possible left ventricular (∴biventricular) hypertrophy

Comment:

This is another RVH, but with an LAD of – 90o. The patient had a large cleft in the mitral valve and a large defect at both ventricular and atrial level, with pulmonary hypertension and secondary polycythæmia (Eisenmenger syndrome). She still worked as a nurse at the Canberra Hospital.

The diagnosis of RVH would have been more difficult had the 0.11” QRS prolonged itself into the RBBB range. The LVH diagnosis rests on >13 mm R wave in aVL.

The P waves are just short of the P congenitale RAA amplitude, but the LAA can be diagnosed through P duration of 0.10”.

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