I put together these medical challenges. The cases are hypothetical and do not necessarily represent actual or typical presentations of medical diseases. Disclaimer is at the bottom of this page.
Monday, April 8, 2013
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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?
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.
Right axis deviation suggests RVH, so VSD with possibility of future Eisenmenger syndrome?
ReplyDeleteWhat is it i wonder.. Dextrocardia? but what is with the pulsus alternans on V1 lead?
ReplyDeletethis one's very tricky
ReplyDelete-
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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.