Ventricular septal defects can present with a myriad of ECG changes.What matters is the size of vsd and associated anomalies
- Normal ecg -In a small defect,its not uncommon to find a normal ekg.
- LVH with left atrial abnormality-common pattern in a left to right shunt especially moderate to large
- RVH-Suspect raised RV pressures in large or moderate vsd or an associated double chambered RV(means obstruction between RV inflow and outflow)
- Katz wachtel sign-Large equiphasic qrs in midprecordial leads due to biventricular hypertrophy
- 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).