Endocardial Cushion Defect
Report:
Sinus rhythm
Borderline left atrial abnormality
First degree AV block
PR 0.26â
Left axis deviation â 90o
Right ventricular hypertrophy
Possible left ventricular (â´biventricular) hypertrophy
Comment:
This is another RVH, but with an LAD of â 90o. The patient had a large cleft in the mitral valve and a large defect at both ventricular and atrial level, with pulmonary hypertension and secondary polycythæmia (Eisenmenger syndrome). She still worked as a nurse at the Canberra Hospital.
The diagnosis of RVH would have been more difficult had the 0.11â QRS prolonged itself into the RBBB range. The LVH diagnosis rests on >13 mm R wave in aVL.
The P waves are just short of the P congenitale RAA amplitude, but the LAA can be diagnosed through P duration of 0.10â.
97. 18 year old boy in Casualty with pharyngitis and vague chest pains
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