LVH with Psedo P Pulmonale

Report:

Sinus rhythm

Left atrial abnormality

Borderline RAA

Left ventricular hypertrophy with ST/T changes

Comment:

The atrial abnormality is probably all left atrial in this setting. LVH is, at times, associated with apparent RAA, called pseudo P pulmonale100.

This is a typical LVH morphology, with tendency to upward convexity in depressed ST segments merging into inverted T waves. The voltage criteria are present in both the precordial and the limb leads, down to the little used 15 mm R wave in Lead 2.

Septal q wave is absent from V6, but the QRS is too narrow to contemplate incomplete LBBB; it will come later if the patient lives long enough.

138. Clubbed and cyanosed 41 year old survivor of congenital disease described as ‘a variant of single ventricle’

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