Pædiatric LAD & LVH: Tricuspid Atresia

Report:

Sinus rhythm 160/min

Right atrial abnormality, P congenitale type

Left axis deviation –30o (for age: 0o - -90o)

Left ventricular hypertrophy

Comment:

The infant had a systemic-pulmonary artery shunt and was doing well clinically.

The striking feature is the LVH, ascertainable on multiple criteria. With ST/T changes? Well, T waves could be larger in several LV leads, but it is best to under-report tracings like this: LVH is enough. The P congenitale RAA is also evident in the right precordial leads, with P > 2 mm in height.

Two months earlier, the computer suggested tricuspid atresia, which impressed everybody (Fig 81a). It performed less well on several other occasions, including Fig 81.

81a. 82. Cyanosed 11 year old boy with history of Blalock and Glenn shunts for TGA.

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