Pædiatric RVH: Upright TV1
Report:
Sinus rhythm 160/min [rate 110-178 3-11 months]
Left atrial abnormality
Right axis deviation +120o [normal for age]
Right ventricular hypertrophy
Left ventricular hypertrophy voltage RV6 = 30 mm
Possible biventricular hypertrophy
Comment:
The diagnosis of RVH is based on the R wave height in V1 > 17 mm (1.7 mV) and upright T wave in the same lead. There exists, also, a voltage criterion for LVH in lead V6: R wave > 30 mm.
The boy had a large proximal VSD with evidence of pulmonary hypertension; the left ventricle was relatively hypokinetic. The left ventricular function improved following patching of the VSD. Clinically, therefore, there was a biventricular hypertrophy but the ECG, ominously, showed more RVH than LVH. The classic Katz-Wachtel appearance of biventricular hypertrophy may have been present earlier.
206. 56 year old man with severe chest pain. Where in the chest was it?
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