ECG changes in VSD

Ventricular septal defects can present with a myriad of ECG changes.What matters is the size of vsd and associated anomalies

  1. Normal ecg -In a small defect,its not uncommon to find a normal ekg.
  2. LVH with left atrial abnormality-common pattern in a left to right shunt especially moderate to large
  3. RVH-Suspect raised RV pressures in large or moderate vsd or an associated double chambered RV(means obstruction between RV inflow and outflow)
  4. Katz wachtel sign-Large equiphasic qrs in midprecordial leads due to biventricular hypertrophy
  5. AV blocks -uncommon but also can be a life threatening complication of device closures.There lies the importance of rhythm monitoring post device closures (for interventionists).

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