Monday, April 8, 2013


Challenge: This EKG is taken in a pediatric patient who is not cyanotic; in fact, the patient has no signs or symptoms, but has a future risk of arrhythmia and heart failure. What's the diagnosis?

Image shown under Fair Use.


Reflex Hammer said...

Right axis deviation suggests RVH, so VSD with possibility of future Eisenmenger syndrome?

sibogox said...

What is it i wonder.. Dextrocardia? but what is with the pulsus alternans on V1 lead?

Craig Chen said...

this one's very tricky

This is isolated L-transposition of the great arteries. Note the absence of initial Q’s typically seen in V5 and V6 as well as abnormal initial Q’s seen in V3R and V1. These findings represent abnormal depolarization of the interventricular septum seen in ventricular inversion.

Source: UpToDate.